Mapping bridges between anxiety, depression, and somatic symptoms in primary care patients: a network perspective

Abstract

In primary care centers, emotional disorders (EDs; depression, anxiety, and somatoform disorders) frequently appear to be associated. However, there is no previous information on the key (bridge) symptoms that maintain comorbidity. The current study aimed to identify symptoms that may play a linking role in bridging comorbidity among EDs from a network analysis perspective. A sample of adult primary care patients (N = 1704) with symptoms of EDs was assessed using the Patient Health Questionnaire (PHQ). Network analysis was applied to examine the network structure, communities, expected influence, and bridge symptoms between depressive, anxiety, and somatic symptoms. Sad mood and low energy were the most central symptoms. Furthermore, low energy, fainting spells, sad mood, and restlessness were detected as prominent bridge symptoms between anxiety, depression, and somatic symptoms. These bridge symptoms could be therapeutic targets for early intervention and prevent the development of comorbidity among EDs. The results of this research highlight the importance of symptom-specific functional properties for the activation of communities within EDs, providing new insights on a complex phenomenon such as comorbidity.