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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Mood Disorders
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1513524

Symptom network analysis of insomnia-depression-anxiety-stigma in tuberculosis patients

Provisionally accepted
Xiangmin Liu Xiangmin Liu 1*Xue Qiu Xue Qiu 1Huizhen Lan Huizhen Lan 2Liuyue Diao Liuyue Diao 1Wei Huang Wei Huang 1Yan Wen Yan Wen 1Mei Feng Mei Feng 1,3Xiangdong Tang Xiangdong Tang 4*
  • 1 Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
  • 2 The Fourth People Hospital of Nanning, Nanning, Guangxi Zhuang Region, China
  • 3 Nursing Key Laboratory of Sichuan Province, West China Medical Center, Sichuan Medical University, Chengdu, Sichuan Province, China
  • 4 Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

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

    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.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.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.3Depression (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.

    Keywords: Tuberculosis, insomnia, Depression, Anxiety, stigma, symptom network analysis

    Received: 21 Oct 2024; Accepted: 31 Dec 2024.

    Copyright: © 2024 Liu, Qiu, Lan, Diao, Huang, Wen, Feng 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:
    Xiangmin Liu, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
    Xiangdong Tang, Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

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