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Status | 已發表Published |
Inter-relationships of depressive and anxiety symptoms with suicidality among adolescents: A network perspective | |
Hong Cai1,2; Ines H.I. Chow1,2; Si-Man Lei3; Grace K.I. Lok4; Zhaohui Su5; Teris Cheung6; Anastasia Peshkovskaya7,8; Yi-Lang Tang9,10; Todd Jackson11; Gabor S. Ungvari12,13; Ling Zhang14; Yu-Tao Xiang1,2 | |
2023-03-01 | |
Source Publication | JOURNAL OF AFFECTIVE DISORDERS |
ISSN | 0165-0327 |
Volume | 324Pages:480-488 |
Abstract | Background: Persons with suicidality including suicidal ideation (SI), suicide plans (SP) and/or suicide attempts (SA) are at higher risk for future suicide than those without suicidality. To reduce the risk of future suicide, it is important to understand symptoms of emotional distress that have the strongest links with SI, SP and SA. This network analysis examined item-level relations of depressive and anxiety symptoms with suicidality among adolescents during the COVID-19 pandemic. Methods: Adolescents between 12 and 20 years of age were assessed with the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and individual binary reponse (no/yes) items assessing SI, SP, and SA during the pandemic. The structure of depressive symptoms, anxiety symptoms and suicidality was characterized using “Expected Influence” and “Bridge Expected Influence” as centrality indices in the symptom network. Network stability was tested using a case-dropping bootstrap procedure. Node-specific predictive betweenness was computed to examine short paths of anhedonia, other depressive symptoms and anxiety symptoms with suicidality. A Network Comparison Test (NCT) was conducted to examine whether network characteristics differed based on gender. Results: Prevalence rates of depressive symptoms, anxiety symptoms, and suicidality were 44.60 % (95% confidence interval (CI) = 41.53–47.67 %), 31.12 % (95%CI = 28.26–33.98 %), and 16.95 % (95%CI = 14.63–19.26 %), respectively, in the study sample. The network analysis identified GAD3 (“Worry too much”) as the most central symptom, followed by GAD6 (“Irritability”) and PHQ6 (“Guilt”) in the sample. Additionally, PHQ6 (“Guilt”), GAD6 (“Irritability”), and PHQ2 (“Sad mood”) were bridge nodes linking depressive and anxiety symptoms with suicidality. A flow network indicated that the connection between S (“Suicidality”) and PHQ6 (“Guilt”) reflected the strongest connection, followed by connections of S (“Suicidality”) with GAD2 (“Uncontrollable worrying”), and S (“Suicidality”) with PHQ2 (“Sad mood”). Finally, PHQ2 (“Sad mood”) was the main bridge node linking anhedonia with other depressive and anxiety symptoms and suicidality in the sample. Conclusions: Findings highlight the potential importance of reducing specific depressive and anxiety symptoms as possible means of reducing suicidality among adolescents during the pandemic. Central symptoms and key bridge symptoms identified in this study should be targeted in suicide prevention for at-risk adolescents. |
Keyword | Adolescents Anxiety Depression Network Analysis Suicidality |
MOST Discipline Catalogue | 10.1016/j.jad.2022.12.093 |
DOI | 10.1016/j.jad.2022.12.093 |
URL | View the original |
Indexed By | SCIE ; SSCI |
Language | 英語English |
WOS Research Area | Neurosciences & Neurology ; Psychiatry |
WOS Subject | Clinical Neurology ; Psychiatry |
WOS ID | WOS:000923444500001 |
Publisher | ELSEVIER, RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS |
Scopus ID | 2-s2.0-85145830905 |
Fulltext Access | |
Citation statistics | |
Document Type | Journal article |
Collection | DEPARTMENT OF PUBLIC HEALTH AND MEDICINAL ADMINISTRATION Faculty of Education Faculty of Health Sciences Faculty of Social Sciences DEPARTMENT OF PSYCHOLOGY INSTITUTE OF COLLABORATIVE INNOVATION Institute of Translational Medicine |
Corresponding Author | Ling Zhang; Yu-Tao Xiang |
Affiliation | 1.Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China 2.Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China 3.Faculty of Education, University of Macau, Macao SAR, China 4.Kiang Wu Nursing College of Macau, Macao SAR, China 5.School of Public Health, Southeast University, Nanjing, China 6.School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China 7.Neuroscience Center, Tomsk State University, Tomsk, Russia 8.Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia 9.Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA 10.Atlanta Veterans Affairs Medical Center, Decatur, GA, USA 11.Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, SAR, China 12.University of Notre Dame Australia, Fremantle, Australia 13.Division of Psychiatry, School of Medicine, University of Western Australia / Graylands Hospital, Perth, Australia 14.The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China |
First Author Affilication | Faculty of Health Sciences; University of Macau |
Corresponding Author Affilication | Faculty of Health Sciences; University of Macau |
Recommended Citation GB/T 7714 | Hong Cai,Ines H.I. Chow,Si-Man Lei,et al. Inter-relationships of depressive and anxiety symptoms with suicidality among adolescents: A network perspective[J]. JOURNAL OF AFFECTIVE DISORDERS, 2023, 324, 480-488. |
APA | Hong Cai., Ines H.I. Chow., Si-Man Lei., Grace K.I. Lok., Zhaohui Su., Teris Cheung., Anastasia Peshkovskaya., Yi-Lang Tang., Todd Jackson., Gabor S. Ungvari., Ling Zhang., & Yu-Tao Xiang (2023). Inter-relationships of depressive and anxiety symptoms with suicidality among adolescents: A network perspective. JOURNAL OF AFFECTIVE DISORDERS, 324, 480-488. |
MLA | Hong Cai,et al."Inter-relationships of depressive and anxiety symptoms with suicidality among adolescents: A network perspective".JOURNAL OF AFFECTIVE DISORDERS 324(2023):480-488. |
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