Abstract

The current study investigated the mechanism and changes in psychopathology symptoms throughout the COVID-19 outbreak and after peak. Two studies were conducted separately in China during outbreak and the after peak stages, with 2540 participants were recruited from February 6 to 16, 2020, and 2543 participants were recruited from April 25 to May 5, 2020. The network models were created to explore the relationship between psychopathology symptoms both within and across anxiety and depression, with anxiety measured by the Generalized Anxiety Disorder-7 and depression measured by the Patient Health Questionnaire-9. Symptom network analysis was conducted to evaluate network and bridge centrality, and the network properties were compared between the outbreak and after peak. Noticeably, psychomotor symptoms such as impaired motor skills, restlessness, and inability to relax exhibited high centrality during the outbreak, which still relatively high but showed substantial remission during after peak stage (in terms of strength, betweenness, or bridge centrality). Meanwhile, symptoms of irritability (strength, betweenness, or bridge centrality) and loss of energy (bridge centrality) played an important role in the network after the peak of the pandemic. This study provides novel insights into the changes in central features during the different COVID-19 stages and highlights motor-related symptoms as bridge symptoms, which could activate the connection between anxiety and depression. The results revealed that restrictions on movement were associated with worsen in psychomotor symptoms, indicating that future psychological interventions should target motor-related symptoms as priority.

Highlights

  • The COVID-19 pandemic has caused substantial threats to people’s physical health and lives, as well as triggered psychological distresses such as anxiety and depression [1]

  • The current study identified the bridge symptoms and aimed to identify the risks of co-occurrence between anxiety and depressive symptoms during different phrases of COVID-19 to prevent increasing psychological distress

  • The network differences and changes between outbreak and after peak stages showed the impact of the COVID-19 pandemic on psychological interaction patterns

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Summary

Introduction

The COVID-19 pandemic has caused substantial threats to people’s physical health and lives, as well as triggered psychological distresses such as anxiety and depression [1]. A number of recent studies have focused on mental health problems during COVID-19, with the most frequently reported symptoms being depression and anxiety aspects [1, 6, 7]. A meta-analysis on the mental health within the general population during the COVID-19 pandemic reported the prevalence of anxiety to be 31.9% (95% CI: 27.5–36.7) and the prevalence of depression as 33.7% (95% CI: 27.5–40.6) [8]. When understanding mental health problems, co-occurrence becomes a complex and principal issue in regards to treatment adherence and engagement in prevention measures [9]. Considerations to better understand co-occurrence during the pandemic are required

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