The central symptom of depression among middle-aged and older Chinese adults is identified as 'Felt depressed' in both 2018 and 2020.
No significant differences in the overall structure of depressive symptom networks were found between the two years studied.
Significant differences in global strength and edge strength of depressive symptoms were observed between the two waves.
Internet use is associated with a more complex relationship to depressive symptoms in 2020 compared to 2018.
Targeting central symptoms and strong connections in depressive networks could be beneficial for treatment strategies.
Enhancing guidance on Internet use may positively impact the mental health of older adults.
Simplified
BACKGROUND: The COVID-19 pandemic exacerbates the effects of social isolation on the mental health of middle-aged and older adults. This study aimed to explore the network structures of depressive symptoms among Chinese middle-aged and older adults before and after the COVID-19 outbreak and investigate their associations with Internet use.
METHODS: Two cross-sectional datasets were obtained from the 2018 and 2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms and Internet use were assessed using the Center for Epidemiological Studies-Depression Scale () and self-reported Internet use. was conducted to identify central symptoms and differences between the two networks and their associations with Internet use.
RESULTS: Network analysis revealed that CESD3 "Felt depressed" was the central symptom of the depression network in both waves. No significant differences in network structure were observed, but significant differences in global strength and edge strength were found. Furthermore, Internet use showed a more complex association with depressive symptoms among middle-aged and older adults in wave 2.
CONCLUSION: This study provides novel insights into the central features of depressive symptoms among middle-aged and older adults before and after the COVID-19 outbreak. Targeting interventions to central symptoms and strong edges may have significant implications for depression treatment. In addition, strategies aimed at enhancing Internet use guidance could potentially benefit the mental health of middle-aged and older adults.
Key numbers
45.03%
Increase in Internet Use
Internet use increased from 15.27% in 2018 to 45.03% in 2020.
12,839
Sample Size
Participants who completed the questionnaire in both waves totaled 12,839.
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Declarations. Ethics approval and consent to participate: This study was performed in accordance with the Declaration of Helsinki. Ethics approval was obtained from the Biomedical Ethics Review Committee of Peking University (approval number: IRB00001052-11015). Informed consent was obtained from all participants involved in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
