BACKGROUND: Mental health issues among patients with physical diseases are increasingly common. This study investigated the prevalence of depression, anxiety, and adverse doctor-patient relationship risks (ADRR) among patients with physical diseases, and the central and bridge symptoms of this network structure.
METHODS: A total of 14,344 patients with physical diseases enrolled in this survey. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Psychological Safety Questionnaire were used to evaluate anxiety, depression, and ADRR. The "qgraph" package in R 4.4.3 was used to construct a network model to identify central and bridge symptoms.
RESULTS: The prevalence rates of depression, anxiety, and ADRR were found to be 9.52 % (95 % confidence interval (CI): 9.04-10.00 %), 19.35 % (95 % CI: 18.71-20.00 %), and 4.29 % (95 % CI: 3.96-4.62 %), respectively. Within the network structure, the central symptoms identified were 'Sad mood,' 'Restlessness,' and 'Excessive worry,' which also served as the bridge symptoms. The flow network analysis revealed that ADRR exhibited the strongest associations with 'Anhedonia', 'Restlessness', and 'Suicidal ideation'. Additionally, 'Suicidal ideation' shows strongest correlations with 'Guilt', 'Concentration', and 'Restlessness'.
LIMITATION: The generalizability of the study's findings is constrained, as the sample consisted exclusively of inpatients, potentially limiting applicability to non-hospitalized individuals with physical illnesses.
CONCLUSION: This study provides novel insights into the comorbidity of depression, anxiety, and ADRR at the symptom level in patients with physical diseases through the application of network analysis. The identification of bridge symptoms highlights potential targets for interventions aimed at addressing the comorbidity among these disorders.
