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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Public Mental Health
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1485726
This article is part of the Research Topic Mental Health of Vulnerable Groups: Predictors, Mechanisms, and Interventions View all 4 articles

Interconnected Mental Health Disorder Symptoms: Network Analysis of Depression, Anxiety, Stress, and Burnout Among Psychiatric Nurses in the Context of the COVID-19 Pandemic

Provisionally accepted
Tao Rui Tao Rui 1Song Wang Song Wang 1Lu Qingfang Lu Qingfang 2Yunxiao Liu Yunxiao Liu 1Lei Xia Lei Xia 1Mo Daming Mo Daming 3Geng Feng Geng Feng 4Liu Tingfang Liu Tingfang 5Yuanli Liu Yuanli Liu 5Feng Jiang Feng Jiang 6Huanzhong Liu Huanzhong Liu 1*Yi-lang Tang Yi-lang Tang 7
  • 1 Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
  • 2 Taihe County Hospital of Traditional Chinese Medicine, Taihe, China
  • 3 Hefei Fourth People's Hospital, Hefei, Anhui Province, China
  • 4 Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
  • 5 Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng, Beijing Municipality, China
  • 6 Shanghai Jiao Tong University, Shanghai, Shanghai Municipality, China
  • 7 Emory University, Atlanta, Georgia, United States

The final, formatted version of the article will be published soon.

    Background: Mental health symptoms such as anxiety, depression, stress, and burnout are common among healthcare workers. However, the interconnections among them remain under-explored. This study aimed to address the interrelationships among these symptoms in psychiatric nurses.We conducted a nationwide survey in the early stage of the COVID-19 pandemic (January to March 2021) to investigate the interconnectedness of depression, anxiety, stress, and burnout among psychiatric nurses. Using network analysis, we identified central symptoms, important bridge symptoms, and the correlations among these central symptoms.Results: Of the 9,224 psychiatric nurses (79.2% female) included in the statistical analyses, 27.6% reported clinically significant depression, 31.2% anxiety, 14.5% stress, and 23.8% burnout. Network analysis revealed that stress had the highest expected influence (EI) value (0.920) and the highest strength among all nodes. The node for depression scored the highest in both closeness and betweenness. Emotional exhaustion (EE) had the highest bridge expected influence (BEI) of 0.340, with the strongest intergroup association between EE and depression. No significant differences were found in gender or frontline work experience (all p > 0.05).Conclusions: Burnout, depression, anxiety, and stress are relatively common among psychiatric nurses in the context of the COVID-19 pandemic. While anxiety was the most prevalent, stress emerged as the core symptom, and depression as an important bridging node. Interventions targeting the core symptoms and bridging nodes may improve the mental health of psychiatric nurses.

    Keywords: Network analysis, burnout, stress, Depression, Anxiety, Psychiatric nurses

    Received: 24 Aug 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Rui, Wang, Qingfang, Liu, Xia, Daming, Feng, Tingfang, Liu, Jiang, Liu and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Huanzhong Liu, Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China

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