ArticleFrontiers in psychiatry2024
Symptom network analysis of insomnia-depression-anxiety-stigma in tuberculosis patients.
Article in Frontiers in psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Network analysis of mental health literacy and depressive/anxiety symptoms in patients under maintenance hemodialysis: a cross-sectional study of multicenter data.Scientific reports · 2026Article
- Longitudinal associations among insomnia, stigma, social support, and depressive symptoms in tuberculosis: evidence from RI-CLPM and LGCM.BMC public health · 2026Article
- Comorbidity profiles and their impact on treatment outcomes in elderly patients with pulmonary tuberculosis: a single-center retrospective cohort study.BMC infectious diseases · 2026Article
- Psychosocial factors associated with depression and sleep quality in patients with tuberculosis: a multicenter cross-sectional study.Journal of thoracic disease · 2026Article
- Article
- Network analysis of symptom clusters among patients with pulmonary tuberculosis: a cross-sectional study.BMC infectious diseases · 2026Article
- Network analysis of mental health knowledge and stigma among high school students in Sichuan, China.Frontiers in psychiatry · 2026Article
- The Association Between Tuberculosis-Related Stigma and Sleep Quality Among Hospitalized Tuberculosis Patients: The Indirect Role of Anxiety.Patient preference and adherence · 2026Article
- Occupational and psychosocial correlates of sleep disturbance among Chinese expatriate employees in Iraq's Maysan oilfields: a cross-sectional study using regression and network analysis.Frontiers in psychiatry · 2026Article
- Perioperative symptoms in patients with thyroid cancer: a cross-sectional and longitudinal network analysis.BMC endocrine disorders · 2025Observational
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Abstract
Background: Insomnia, depression, anxiety, and stigma are prevalent and often coexist in patients with Tuberculosis (TB), potentially exacerbating one another. However, the complex intrinsic associations among these four disorders remain unclear, particularly concerning the role of stigma in relation to the other disorders. Methods: A cross-sectional study was conducted at West China Hospital and the Fourth People's Hospital of Guangxi from November 2023 to June 2024. The levels of insomnia, depression, anxiety, and stigma among TB patients were assessed using the Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the TB-Related Stigma Scale (TRSS). Network analysis was used to identify the central and bridge symptoms and explore the role of stigma within the insomnia-depression-anxiety-stigma network. Results: PHQ1 (anhedonia), GAD1 (nervousness), GAD5 (restlessness), and PHQ3 (sleep problems) are central to the network. Bridge symptoms, including PHQ3 (sleep problems), PSQI5 (sleep disturbances), and GAD5 (restlessness) link the depression, insomnia, and anxiety communities. TRSS1 (family's negative perception) of the stigma community exhibited the highest betweenness and second highest bridge betweenness in the network, highlighting the mediating role of family support across insomnia and psychological symptoms. Additionally, the global strength invariance test indicates that gender, age and education level do not significantly impact the network structure. Conclusion: Depression (anhedonia and sleep problems) and anxiety (nervousness and restlessness) are the primary concerns requiring intervention in TB patients. In addition, sleep problems act as a bridge in the overall network. Stigma, particularly negative perceptions from family, may play a crucial mediating role in sustaining the entire symptom network. Consequently, these symptoms could represent potential targets for intervention.
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