Yuzhen Zhang’s research while affiliated with Covenant Health and other places

Background Patients with cardiovascular disease (CVD) often experience anxiety and depression. However, the central and bridge symptoms of anxiety and depression among patients with CVD remain unclear. Network analysis is a statistical method that can reveal and visualise complex relationships between multiple variables. This study aimed to identify the central and bridge symptoms in the anxiety-depression network, which may provide potential targets for preventing and intervening in anxiety and depression. Methods A total of 1180 patients with CVD were selected from the Psychology and Behavior Investigation of Chinese Residents. The survey was conducted from July 10 to September 15, 2021. Face-to-face electronic questionnaires were distributed to respondents by the investigators. The Generalized Anxiety Disorder 7 (GAD-7) and Patient Health Questionnaire-9 were used to assess anxiety and depressive symptoms among patients with CVD. Network analysis was conducted using R4.02 to identify central and bridge symptoms in the anxiety-depression network. Results Among the 1180 patients with CVD included in this study, 673 (57%) were male and 507 (43%) were female. More than half (53.5%) of patients were under 60 years old. The mean GAD-7 score was 4.66 ± 4.38, and 169 (14.3%) patients had anxiety symptoms. The mean PHQ-9 score was 6.29 ± 5.29, and 235 (19.9%) had depressive symptoms. Furthermore, 144 (12.2%) patients people had both anxiety and depressive symptoms. In the network of anxiety and depressive symptoms, “unable to sit still because of anxiety”, “feeling afraid that something terrible is about to happen”, and “feeling bad or like a failure, or disappointing oneself or family” were the most influential and central symptoms. We also found that “feeling afraid that something terrible is about to happen” and “thoughts of dying or hurting oneself in some way” were pivotal bridge symptoms between anxiety and depression. Conclusions This study provides new insights into the network structure of anxiety and depression in patients with CVD. These identified central and bridge symptoms may be potentially effective targets for preventing anxiety and depression in patients with CVD, and may provide treatment strategies for patients with anxiety and depression.

Background Anxiety and depressive symptoms are common among patients with heart failure (HF). Physical limitations, lifestyle changes, and uncertainties related to HF can result in the development or exacerbating of anxiety and depressive symptoms. However, the central and bridge symptoms of anxiety and depressive symptoms network among patients with HF remain unclear. Network analysis is a statistical method that can discover and visualize complex relationships between multiple variables. This study aimed to establish a network of anxiety and depressive symptoms and identify the central and bridge symptoms in this network among patients with HF. Methods This study employed a cross-sectional study design and convenience sampling to recruit patients with HF. This study followed the Helsinki Declaration and was approved by the Research Ethics Committee of Hospital. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) were administered to evaluate anxiety and depressive symptoms among patients with HF, respectively. Network analysis of anxiety and depressive symptoms was performed using R. Results In the anxiety and depressive symptoms network, PHQ2 (feeling down, depressed, or hopeless), PHQ7 (inability to concentrate), and GAD4 (difficulty relaxing) were the most central symptoms. Anxiety and depressive symptoms were linked by PHQ2 (feeling down, depressed, or hopeless), GAD6 (becoming easily annoyed or impatient), GAD5 (unable to sit still because of anxiety), GAD7 (feeling afraid that something terrible is about to happen), and PHQ6 (feeling bad or like a failure, or disappointing oneself or family). Conclusions This study identified the central and bridge symptoms in a network of anxiety and depressive symptoms. Targeting these symptoms can contribute to interventions for patients with HF at risk of—or suffering from—anxiety and depressive symptoms, which can be effective in reducing the comorbidity of anxiety and depression.