Journal of International Psychiatry

Objective: Depression is often associated with anxiety disorders. Network models suggest that mental disorders arise from a direct interaction between symptoms. In this case, Comorbidity may occur when certain symptoms of a mental disorder activate the symptoms of other mental disorders. These specific symptoms are called bridge symptoms. Bridge symptom may be an effective target to prevent and treat Comorbidity of depression and anxiety. The study was designed to explore the depression and anxiety network in psychiatric outpatients. Methods: A network analysis was performed on the data of depression and anxiety symptoms of 23735 patients in a general hospital outpatient department of mental and physical department (total score of depression subscale ≥26 and total score of anxiety subscale ≥20). Results: The network shows that there is a clear regularization between the symptoms of "excessive worry" and "trembling", "fear for no reason" and "easy to cry", and "feeling lonely" and "beating heartbeat". "Feeling cheated, trapped or wanted" , "feeling depressed" , "feeling lonely" had the highest expected impact; "trembling" , "waves of fear or panic" , "excessive worry" had the highest expected impact. Conclusion: Depressive symptom of "feeling duped, trapped or wanted" is the most important symptom in the network; anxiety symptoms of "shaking" and "waves of fear or panic" are the most critical bridging symptoms. "Trembling" and "waves of fear or panic" as the main intervention targets may help to prevent and treat psychiatric outpatient with depression and anxiety comorbidity.

Network analysis, psychopathology, bridge nodes, Comorbidity of depression and anxiety