Network analysis of anxiety and depressive symptoms among patients with heart failure

Abstract 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 o...

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Main Authors: Qiuge Zhao, Xiaofei Sun, Yanting Zhang, Yuzhen Zhang, Cancan Chen
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-024-06259-0
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author Qiuge Zhao
Xiaofei Sun
Yanting Zhang
Yuzhen Zhang
Cancan Chen
author_facet Qiuge Zhao
Xiaofei Sun
Yanting Zhang
Yuzhen Zhang
Cancan Chen
author_sort Qiuge Zhao
collection DOAJ
description Abstract 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.
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spelling doaj-art-819f5ecb5c814a309e8367ad2af2dada2025-01-12T12:34:33ZengBMCBMC Psychiatry1471-244X2024-11-0124111110.1186/s12888-024-06259-0Network analysis of anxiety and depressive symptoms among patients with heart failureQiuge Zhao0Xiaofei Sun1Yanting Zhang2Yuzhen Zhang3Cancan Chen4School of Nursing, Shandong Second Medical UniversitySchool of Humanities and Design, Zhengzhou Vocational University of Information and TechnologySchool of Nursing, Zhengzhou Railway Vocational and Technical CollegeSchool of Nursing, Shandong Second Medical UniversityDepartment of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s HospitalAbstract 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.https://doi.org/10.1186/s12888-024-06259-0Heart failureAnxiety symptomsDepressive symptomsNetwork analysis
spellingShingle Qiuge Zhao
Xiaofei Sun
Yanting Zhang
Yuzhen Zhang
Cancan Chen
Network analysis of anxiety and depressive symptoms among patients with heart failure
BMC Psychiatry
Heart failure
Anxiety symptoms
Depressive symptoms
Network analysis
title Network analysis of anxiety and depressive symptoms among patients with heart failure
title_full Network analysis of anxiety and depressive symptoms among patients with heart failure
title_fullStr Network analysis of anxiety and depressive symptoms among patients with heart failure
title_full_unstemmed Network analysis of anxiety and depressive symptoms among patients with heart failure
title_short Network analysis of anxiety and depressive symptoms among patients with heart failure
title_sort network analysis of anxiety and depressive symptoms among patients with heart failure
topic Heart failure
Anxiety symptoms
Depressive symptoms
Network analysis
url https://doi.org/10.1186/s12888-024-06259-0
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AT yuzhenzhang networkanalysisofanxietyanddepressivesymptomsamongpatientswithheartfailure
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