Charlotte M K Milewczyk, Martin Holtmann, Tanja Legenbauer, Laura M Derks
{"title":"了解COVID-19对青少年精神科住院患者共病抑郁、焦虑和饮食失调的影响：网络分析","authors":"Charlotte M K Milewczyk, Martin Holtmann, Tanja Legenbauer, Laura M Derks","doi":"10.1186/s13034-025-00899-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Many studies have aimed to understand the impact of the COVID-19 pandemic on mental health. However, less research has focused on the changes in symptom clusters of comorbid disorders. To understand the impact of the COVID-19 pandemic it is necessary to evaluate the relationships between symptoms of comorbid disorders. This was the first study to compare comorbidity networks of depression, anxiety and eating disorder (ED) symptoms to investigate the overall connectivity of symptoms before and during the onset of the pandemic.</p><p><strong>Methods: </strong>Self-report questionnaire data from 1361 adolescent psychiatric inpatients (M<sub>age</sub> = 15.32, SD = 1.47) were used for this study. A network analysis was conducted including 52 questionnaire items of depression, anxiety and eating disorder to identify and compare core symptoms and bridge symptoms in a pre and a peri pandemic sample.</p><p><strong>Results: </strong>A significantly higher network density and overall connectivity were found in the peri pandemic sample. Links between feelings of failure in the depression cluster and worry what other people think in the anxiety cluster as well as between difficulties getting rid of bad/ silly thoughts in the anxiety cluster and suicidal thoughts in the depression cluster emerged as the strongest pathways in both networks. Body image disturbance emerged as the strongest bridge symptom for eating disorders in both networks. There were no significant differences in the most prominent core and bridge symptoms between the networks, indicating a high stability of core symptoms and pathways across circumstances.</p><p><strong>Conclusions: </strong>Our findings suggest a multidimensional relationship between symptoms of depression, anxiety, and eating disorders. The persistence of symptom pathways after the onset of the pandemic implies that these pathways may be responsible for the occurrence of comorbidity and should be primary targets of psychotherapy for affected patients. Addressing core and bridge symptoms in the therapy of comorbid disorders should be a priority and may be more effective than conventional treatment strategies.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"19 1","pages":"44"},"PeriodicalIF":3.4000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020227/pdf/","citationCount":"0","resultStr":"{\"title\":\"Understanding the impact of COVID-19 on comorbid depression, anxiety and eating disorders in adolescent psychiatric inpatients: a network analysis.\",\"authors\":\"Charlotte M K Milewczyk, Martin Holtmann, Tanja Legenbauer, Laura M Derks\",\"doi\":\"10.1186/s13034-025-00899-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Many studies have aimed to understand the impact of the COVID-19 pandemic on mental health. However, less research has focused on the changes in symptom clusters of comorbid disorders. To understand the impact of the COVID-19 pandemic it is necessary to evaluate the relationships between symptoms of comorbid disorders. This was the first study to compare comorbidity networks of depression, anxiety and eating disorder (ED) symptoms to investigate the overall connectivity of symptoms before and during the onset of the pandemic.</p><p><strong>Methods: </strong>Self-report questionnaire data from 1361 adolescent psychiatric inpatients (M<sub>age</sub> = 15.32, SD = 1.47) were used for this study. A network analysis was conducted including 52 questionnaire items of depression, anxiety and eating disorder to identify and compare core symptoms and bridge symptoms in a pre and a peri pandemic sample.</p><p><strong>Results: </strong>A significantly higher network density and overall connectivity were found in the peri pandemic sample. Links between feelings of failure in the depression cluster and worry what other people think in the anxiety cluster as well as between difficulties getting rid of bad/ silly thoughts in the anxiety cluster and suicidal thoughts in the depression cluster emerged as the strongest pathways in both networks. Body image disturbance emerged as the strongest bridge symptom for eating disorders in both networks. There were no significant differences in the most prominent core and bridge symptoms between the networks, indicating a high stability of core symptoms and pathways across circumstances.</p><p><strong>Conclusions: </strong>Our findings suggest a multidimensional relationship between symptoms of depression, anxiety, and eating disorders. The persistence of symptom pathways after the onset of the pandemic implies that these pathways may be responsible for the occurrence of comorbidity and should be primary targets of psychotherapy for affected patients. Addressing core and bridge symptoms in the therapy of comorbid disorders should be a priority and may be more effective than conventional treatment strategies.</p>\",\"PeriodicalId\":9934,\"journal\":{\"name\":\"Child and Adolescent Psychiatry and Mental Health\",\"volume\":\"19 1\",\"pages\":\"44\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-04-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020227/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Child and Adolescent Psychiatry and Mental Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13034-025-00899-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Child and Adolescent Psychiatry and Mental Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13034-025-00899-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Understanding the impact of COVID-19 on comorbid depression, anxiety and eating disorders in adolescent psychiatric inpatients: a network analysis.
Background: Many studies have aimed to understand the impact of the COVID-19 pandemic on mental health. However, less research has focused on the changes in symptom clusters of comorbid disorders. To understand the impact of the COVID-19 pandemic it is necessary to evaluate the relationships between symptoms of comorbid disorders. This was the first study to compare comorbidity networks of depression, anxiety and eating disorder (ED) symptoms to investigate the overall connectivity of symptoms before and during the onset of the pandemic.
Methods: Self-report questionnaire data from 1361 adolescent psychiatric inpatients (Mage = 15.32, SD = 1.47) were used for this study. A network analysis was conducted including 52 questionnaire items of depression, anxiety and eating disorder to identify and compare core symptoms and bridge symptoms in a pre and a peri pandemic sample.
Results: A significantly higher network density and overall connectivity were found in the peri pandemic sample. Links between feelings of failure in the depression cluster and worry what other people think in the anxiety cluster as well as between difficulties getting rid of bad/ silly thoughts in the anxiety cluster and suicidal thoughts in the depression cluster emerged as the strongest pathways in both networks. Body image disturbance emerged as the strongest bridge symptom for eating disorders in both networks. There were no significant differences in the most prominent core and bridge symptoms between the networks, indicating a high stability of core symptoms and pathways across circumstances.
Conclusions: Our findings suggest a multidimensional relationship between symptoms of depression, anxiety, and eating disorders. The persistence of symptom pathways after the onset of the pandemic implies that these pathways may be responsible for the occurrence of comorbidity and should be primary targets of psychotherapy for affected patients. Addressing core and bridge symptoms in the therapy of comorbid disorders should be a priority and may be more effective than conventional treatment strategies.
期刊介绍：
Child and Adolescent Psychiatry and Mental Health, the official journal of the International Association for Child and Adolescent Psychiatry and Allied Professions, is an open access, online journal that provides an international platform for rapid and comprehensive scientific communication on child and adolescent mental health across different cultural backgrounds. CAPMH serves as a scientifically rigorous and broadly open forum for both interdisciplinary and cross-cultural exchange of research information, involving psychiatrists, paediatricians, psychologists, neuroscientists, and allied disciplines. The journal focusses on improving the knowledge base for the diagnosis, prognosis and treatment of mental health conditions in children and adolescents, and aims to integrate basic science, clinical research and the practical implementation of research findings. In addition, aspects which are still underrepresented in the traditional journals such as neurobiology and neuropsychology of psychiatric disorders in childhood and adolescence are considered.
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