ArticleNature and science of sleep2022
Network Analysis of Comorbid Anxiety and Insomnia Among Clinicians with Depressive Symptoms During the Late Stage of the COVID-19 Pandemic: A Cross-Sectional Study.
Article in Nature and science of sleep, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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27 citing papers in PubMed, 29 citations in OpenAlex.
- Interrelationships of childhood trauma, psychiatric symptoms, neurocognition, and insomnia in chronic schizophrenia: a network perspective.European archives of psychiatry and clinical neuroscience · 2026Article
- Mapping the central symptom structure of the insomnia severity index (ISI-7) and sleep duration: a network analysis.Sleep & breathing = Schlaf & Atmung · 2026Article
- A Network Analysis of the Interrelationships Between Depression, Anxiety, Insomnia and Non-Suicidal Self-Injury in Middle School Students.Psychology research and behavior management · 2026Article
- Mapping the network structure of anxiety, depression, and sleep symptoms in patients with polycystic ovary syndrome.Frontiers in psychiatry · 2026Article
- Network relationships between emotional dysregulation and ADHD symptoms: an investigation of 13,207 clinical children and adolescents.European child & adolescent psychiatry · 2026Article
- Network analysis of burnout, depression, and anxiety with occupational and personal outcomes among clinical nurses in China.Scientific reports · 2025Article
- Comparison of mental health networks across different educational stages.European child & adolescent psychiatry · 2025Article
- Sleep quality and sleep hygiene among medical undergraduates in Himachal Pradesh (North India): A questionnaire-based study.Journal of family medicine and primary care · 2025Article
- Anxiety, depressive and insomnia symptoms among patients with depression: a network perspective.BMC psychology · 2025Article
- Fatigue as a moderator in symptom networks of insomnia, anxiety, and depression: insights from moderated network analysis.Frontiers in psychiatry · 2025Article
- Network of depression and anxiety symptoms in Chinese middle-aged and older people and its relationship with family health.Revista da Escola de Enfermagem da U S P · 2025Article
- Echoes of Strain: A Two-Year Longitudinal Study on the Impact of China's Zero-COVID Policy on College Students' Insomnia and Depressive Symptoms.Nature and science of sleep · 2025Article
- Understanding the complex network of anxiety, depression, sleep problems, and smartphone addiction among college art students using network analysis.Frontiers in psychiatry · 2025Article
- Machine learning and Bayesian network analyses identifies associations with insomnia in a national sample of 31,285 treatment-seeking college students.BMC psychiatry · 2024Article
- Examining Anxiety and Insomnia in Internship Students and Their Association with Internet Gaming Disorder.Journal of clinical medicine · 2024Article
- Network analysis of anxiety and depressive symptoms during the COVID-19 pandemic in older adults in the United Kingdom.Scientific reports · 2024Article
- Relationship between depression and burnout among nurses in Intensive Care units at the late stage of COVID-19: a network analysis.BMC nursing · 2024Article
- Machine Learning and Bayesian Network Analyses Identifies Psychiatric Disorders and Symptom Associations with Insomnia in a national sample of 31,285 Treatment-Seeking College Students.Research square · 2024Article
- Network analysis of mental health problems among adults in Addis Ababa, Ethiopia: a community-based study during the COVID-19 pandemic.BMJ open · 2024Article
- Psychosomatic health status and corresponding comorbid network analysis of college students in traditional Chinese medicine schools.Frontiers in psychiatry · 2024Article
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Authors and funding
13 authors at 6 institutions in 5 countries.
Funding
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Abstract
Background: A high proportion of clinicians experienced common anxiety, insomnia and depression during the COVID-19 pandemic. This study examined the item-level association of comorbid anxiety and insomnia symptoms among clinicians who suffered from depressive symptoms during the late stage of the COVID-19 pandemic using network analysis (NA). Methods: Clinicians with depressive symptoms (with a Patients Health Questionnaire (PHQ-9) total score of 5 and above) were included in this study. Anxiety and insomnia symptoms were measured using the Generalized Anxiety Disorder Scale - 7-item (GAD-7) and Insomnia Severity Index (ISI), respectively. Network analysis was conducted to investigate the network structure, central symptoms, bridge symptoms, and network stability of these disturbances. Expected influence (EI) was used to measure the centrality of index. Results: Altogether, 1729 clinicians were included in this study. The mean age was 37.1 [standard deviation (SD)=8.04 years], while the mean PHQ-9 total score was 8.42 (SD=3.33), mean GAD-7 total score was 6.45 (SD=3.13) and mean ISI total score was 8.23 (SD=5.26). Of these clinicians, the prevalence of comorbid anxiety symptoms (GAD-7≥5) was 76.8% (95% CI 74.82-78.80%), while the prevalence of comorbid insomnia symptoms (ISI≥8) was 43.8% (95% CI: 41.50-46.18%). NA revealed that nodes ISI7 ("Interference with daytime functioning") (EI=1.18), ISI4 ("Sleep dissatisfaction") (EI=1.08) and ISI5 ("Noticeability of sleep problem by others") (EI=1.07) were the most central (influential) symptoms in the network model of comorbid anxiety and insomnia symptoms in clinicians. Bridge symptoms included nodes PHQ3 ("Sleep") (bridge EI=0.55) and PHQ4 ("Fatigue") (bridge EI=0.49). Gender did not significantly influence the network structure, but "having the experience of caring for COVID-19 patients" significantly influenced the network structure. Conclusion: Central symptoms and key bridge symptoms identified in this NA should be targeted in the treatment and preventive measures for clinicians suffering from comorbid anxiety, insomnia and depressive symptoms during the late stage of the COVID-19 pandemic.
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