Depression, anxiety and suicidality among Chinese mental health professionals immediately after China's dynamic zero-COVID policy: A network perspective

Feb 5, 2024Journal of affective disorders

Depression, anxiety, and suicide risk among Chinese mental health workers right after China's zero-COVID policy change, viewed as connected symptoms

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Abstract

The prevalence of depression, anxiety, and suicidality among mental health professionals was 45.99%, 28.40%, and 7.71%, respectively.

GAD5 ('Restlessness') emerged as the most central symptom in the network analysis of mental health issues.
PHQ4 ('Fatigue') and GAD7 ('Feeling afraid') followed as significant symptoms linked to the overall structure.
Bridge symptoms, including PHQ6 ('Guilt'), GAD5 ('Restlessness'), and PHQ8 ('Motor disturbance'), connected depressive and anxiety symptoms with suicidality.
The strongest associations identified were between suicidality and the symptoms PHQ6 ('Guilt'), GAD7 ('Feeling afraid'), and PHQ2 ('Sad mood').
Findings indicate a need for mental health interventions focusing on these central and bridge symptoms.

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BACKGROUND: Using network analysis, the interactions between mental health problems at the symptom level can be explored in depth. This study examined the network structure of depressive and anxiety symptoms and suicidality among mental health professionals after the end of China's Dynamic Zero-COVID Policy.

METHODS: A total of 10,647 mental health professionals were recruited nationwide from January to February 2023. Depression and anxiety were assessed using the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively, while suicidality was defined by a 'yes' response to any of the standard questions regarding suicidal ideation (SI), suicide plan (SP) and suicide attempt (SA). Expected Influence (EI) and Bridge Expected Influence (bEI) were used as centrality indices in the symptom network to characterize the structure of the symptoms.

RESULTS: The prevalence of depression, anxiety, and suicidality were 45.99 %, 28.40 %, and 7.71 %, respectively. The network analysis identified GAD5 ("Restlessness") as the most central symptom, followed by PHQ4 ("Fatigue") and GAD7 ("Feeling afraid"). Additionally, PHQ6 ("Guilt"), GAD5 ("Restlessness"), and PHQ8 ("Motor disturbance") were bridge nodes linking depressive and anxiety symptoms with suicidality. The flow network indicated that the strongest connections of S ("Suicidality") was with PHQ6 ("Guilt"), GAD7 ("Feeling afraid"), and PHQ2 ("Sad mood").

CONCLUSIONS: Depression, anxiety, and suicidality among mental health professionals were highly prevalent after China's Dynamic Zero-COVID Policy ended. Effective measures should target central and bridge symptoms identified in this network model to address the mental health problems in those at-risk.

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Depression, anxiety and suicidality among Chinese mental health professionals immediately after China's dynamic zero-COVID policy: A network perspective

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