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ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Anxiety and Stress Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1567448
The Comorbidity of Anxiety and Depression Symptoms in Obsessive-Compulsive Disorder (OCD): A Network Analysis
Provisionally accepted
Sizhe Cheng 1*
Zhiguo Chen 2
Wu Chao 1
Xinhong Li 1,3 Xin Shen 2
Rui Qiu 1
Tang Nailong 1,2 Chong Feng 2
Wang Wenwen 1* Jing Lv 4* Shuiping Yuan 2
Xufeng Liu 1*- 1 Air Force Medical University, Xi'an, China
- 2 No.907 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army (PLA), Nanping, China
- 3 Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
- 4 People's Liberation Army General Hospital, Beijing, Beijing Municipality, China
Objective: People with obsessive-compulsive disorder (OCD) frequently suffer from comorbid anxiety and depression. From the perspective of the network model, this comorbidity is thought to be an interacting system of 3 symptoms. In the study, we conducted a network analysis of anxiety and depression comorbidity in OCD, aiming to identify the central and bridge symptoms and make informed suggestions for clinical interventions and psychotherapy.Methods: A total of 356 individuals with OCD were enrolled in the study. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were selected to evaluate anxiety, depression, and obsessive-compulsive symptoms, respectively, followed by network analysis to construct the interacting networks.Results: "Panic" and "Distress caused by obsessive-compulsive behavior" had the highest expected influence, indicating that the two variables were the most associated nodes in the network. "Tachycardia", "Constipation", "Fatigue", "Panic", "Easy fatiguability, weakness", "Palpitation", "Crying spells", "Psychomotor agitation", "Mental disintegration" and "Nightmares" were the bridge nodes that had the strongest connection with OCD.Conclusions: Panic and distress caused by obsessive-compulsive, the central and bridge symptoms of the interacting network of anxiety and depression symptoms in OCD might be a significant transdiagnostic intervention target for the management of the comorbidity. Additionally, it might be beneficial to consider implementing clinical prevention and psychotherapy, focusing on somatic symptoms, psychological symptoms and sleep that have the strongest associations with OCD.
Keywords: Obsessive-Compulsive Disorder, Anxiety, Depression, Network analysis, Comorbidity
Received: 27 Jan 2025; Accepted: 11 Mar 2025.
Copyright: © 2025 Cheng, Chen, Chao, Li, Shen, Qiu, Nailong, Feng, Wenwen, Lv, Yuan and Liu. 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:
Sizhe Cheng, Air Force Medical University, Xi'an, China
Wang Wenwen, Air Force Medical University, Xi'an, China
Jing Lv, People's Liberation Army General Hospital, Beijing, 100853, Beijing Municipality, China
Xufeng Liu, Air Force Medical University, Xi'an, China
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