Network analysis of mental health problems among adults in Addis Ababa, Ethiopia: a community-based study during the COVID-19 pandemic

Jan 22, 2024BMJ open

Connections between mental health problems in adults in Addis Ababa during the COVID-19 pandemic

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Abstract

A total of 1127 adults were analyzed for mental health symptoms during the COVID-19 pandemic in Addis Ababa.

Sad mood was identified as the most central and bridge symptom in the network of depression, anxiety, and perceived stress.
Irritability and nervousness were also recognized as significant bridge symptoms within the network.
The strongest connection was found between nervousness and uncontrollable worry in the anxiety community.
The network demonstrated good stability and accuracy across different genders and ages.

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OBJECTIVE: COVID-19 has negatively impacted mental health of adults globally with increased rates of psychiatric comorbidities. However, studies to examine comorbidities and correlations between symptoms of different mental disorders are uncommon in low-income countries. This study aimed to investigate the network structure of depression, anxiety and perceived stress among adults in Addis Ababa and identify the most central and bridge symptoms within the depressive-anxiety-perceived symptoms network model.

DESIGN: Community-based cross-sectional study.

SETTING: This study was carried out on a sample of the general population in Addis Ababa during the first year of the COVID-19 pandemic. A total of 1127 participants were included in this study, of which 747 (66.3%) were females, and the mean age was 36 years.

PRIMARY AND SECONDARY OUTCOME MEASURES: Symptoms of depression, anxiety and stress were measured using the Patient Health Questionnaire, Generalized Anxiety Disorder Scale and the Perceived Stress Scale, respectively.Network analysis was conducted to investigate the network structure. The centrality index expected influence (EI) and bridge EI (1-step) were applied to determine the central and bridge symptoms. Case-dropping procedure was used to examine the network stability.

RESULT: The sad mood (EI=1.52) was the most central and bridge symptom in the depression, anxiety and perceived stress network model. Irritability (bridge EI=1.12) and nervousness and stressed (bridge EI=1.33) also served as bridge symptoms. The strongest edge in the network was between nervousness and uncontrollable worry (weight=0.36) in the anxiety community. The network had good stability and accuracy. The network structure was invariant by gender and age based on the network structure invariance test.

CONCLUSIONS: In this study, the sad mood was the core and bridge symptom. This and the other central and bridge symptoms identified in the study should be targeted to prevent mental health disorders and comorbidities among adults.

Key numbers

10.7%

Prevalence of Mental Health Problems

Percentage of participants with any mental health problems.

1.52

Centrality Index of Sad Mood

Expected influence (EI) score for sad mood.

0.36

Strongest Edge Weight

Weight of the edge in the anxiety community.

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Network analysis of mental health problems among adults in Addis Ababa, Ethiopia: a community-based study during the COVID-19 pandemic

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