Symptom-specific intervention targets for depression and anxiety among older adults by physical multimorbidity patterns: a simulation-based network analysis.
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Abstract
Objectives: This study aimed to investigate the network structure of depressive anxiety symptoms among Chinese community-dwelling older adults with physical multimorbidity and to identify specific symptom targets for preventive and treatment interventions aimed at aggravating and alleviating symptoms by patterns of physical multimorbidity.
Methods: Using data from the 2017/2018 wave of the Chinese Longitudinal Healthy Longevity Survey, latent class analysis (LCA) was conducted to identify physical multimorbidity patterns. Then, the NoeIdentifyR algorithm (NIRA) was employed to assess aggravating and alleviating specific symptoms by physical multimorbidity patterns.
Results: The study encompassed 4859 older adults with physical multimorbidity, and identified 4 patterns of physical multimorbidity (multisystem disease, gastrointestinal-musculoskeletal-urogenital disease, minimal disease, and cardiometabolic disease). GAD4 (trouble relaxing) served as the common aggravating symptom for the multisystem disease, minimal disease, and cardiometabolic disease groups, but GAD2 (uncontrollable worry) for the gastrointestinal-musculoskeletal-urogenital disease group. CESD5 (hopeful about the future) served as the common alleviating symptom for gastrointestinal-musculoskeletal-urogenital disease, minimal disease, and cardiometabolic disease groups, but CESD4 (everything was an effort) as the unique alleviating symptom for the multisystem disease group.
Conclusions: Aggravating and alleviating symptoms within the depressive-anxiety network differ by patterns of physical multimorbidity, which may imply that preventive and treatment targets should be tailored to patterns by physical multimorbidity for enhancing overall mental health among older adults.
期刊介绍：
Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic.
In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation.
Both original work and review articles may be submitted.
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