Longitudinal network analysis of depression, anxiety, and post-traumatic stress disorder comorbidities among adolescents in regional China

Purpose The network theory of mental disorders offers a new perspective for the understanding of comorbidities, but the research on the comorbidities among depression, anxiety, and post-traumatic stress disorder (PTSD) is still insufficient. The aim of this study was to explore the internal relationship by establishing and analyzing the comorbidity networks, and to provide suggestions for the intervention after traumatic events.Methods We utilized data from the second and third wave of the Chengdu Positive Child Development cohort (N = 3,189, 47.79% female), we estimated to network models of depression, anxiety and PTSD. To assess difference in global connectivity between the two networks, we conducted invariance test.Results K27 (Somatic 10), K37 (Generalized Anxiety 9), K15 (Somatic 5), K33 (Generalized Anxiety 7), K24 (Somatic 9) were the most central nodes in both networks, P13 (Sleep problem) had the highest Bridge Expected Influence value. The structural difference between the two networks was statistically significant (M = 0.229, p = 0.010), and the global strength of the network at wave 2 was higher than the network at wave 3 (35.1 vs. 33.9, S = 1.20, p = 0.010).Conclusion The correlation in symptoms of the three disorders underscores the need for more comprehensive treatment options for intervention after traumatic events. Central and bridge nodes could inform targeted interventions or policy decisions. Anxiety disorders, especially Som and Gen dimensions, should be the focus of intervention. The Arousal dimension in PTSD, especially sleep disorders, may contribute to the comorbidities. In addition, this study highlights the importance of staged post-traumatic interventions.