Anxiety and depression played a central role in the COVID-19 mental distress: A network analysis

• DOI: 10.1016/j.jad.2023.06.034
• Publication Date: 2023-06-17T23:25:48Z
• Authors: Giovanna Fico; Vincenzo Oliva; Michele De Prisco; Lydia Fortea; Adriana Fortea; Anna Giménez-Palomo; Gerard Anmella; Diego Hidalgo-Mazzei; Mireia Vazquez; Marta Gomez-Ramiro; Bernat Carreras; Andrea Murru; Joaquim Radua; Philippe Mortier; Gemma Vilagut; Franco Amigo; Montse Ferrer; Helena García-Mieres; Eduard Vieta; Jordi Alonso
• Keywords: Depression; Mental distress; 2019-20 coronavirus outbreak

Psychological, socio-demographics, and clinical factors play an important role in patients with COVID-19, but their relationship is complex. The network approach might be used to disentangle complex interactions in different systems. Using data from a multicentre, cross-sectional, survey among patients with COVID-19 in Spain (July-November 2020), we investigated the network structure of mental disorders symptoms, social support, and psychological resilience, and changes in network structures according to the presence of a pre-existing mental disorder or hospitalization for COVID-19.Subjects completed a survey to evaluate sociodemographic characteristics, COVID-19 infection status, resilience, social support, and symptoms of depression, anxiety disorders, post-traumatic stress disorder, panic attacks, and substance use disorder. 2084 patients with COVID-19 were included in the analysis. Network analysis was conducted to evaluate network and bridge centrality, and the network properties were compared between COVID-19 patients with and without a history of lifetime mental disorder, and between hospitalized and non-hospitalized patients.Generalization of our findings may be difficult since differences in network connectivity may exist in different populations or samples.Anxiety and depression showed high centrality in patients with COVID-19 and anxiety showed the highest bridge influence in the network. Resilience and social support showed a low influence on mental disorder symptoms. Global network estimations show no statistically significant changes between patients with and without pre-existing mental disorders or between hospitalized and non-hospitalized patients.Anxiety might be a key treatment target in patients with COVID-19 since its treatment might prevent other mental health adverse outcomes.