Network analysis of comorbid depression and anxiety and their associations with academic engagement among medical students in the Post-Peak COVID-19 period in China

Abstract Background Medical students frequently face mental health challenges, underscoring the need for prompt identification and intervention. This research is designed to explore the interconnections between depression, anxiety, and academic engagement among medical students in the Post-Peak COVI...

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Main Authors: Changqing Sun, Jiale Han, Zhengqi Zhu, Qiang Zhang, Panpan Wang, Peijia Zhang, Ying Qin, Yang Li, Wei Xue, Dequan Sun, Zizheng Liu, Lianke Wang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Psychology
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Online Access:https://doi.org/10.1186/s40359-025-03181-2
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author Changqing Sun
Jiale Han
Zhengqi Zhu
Qiang Zhang
Panpan Wang
Peijia Zhang
Ying Qin
Yang Li
Wei Xue
Dequan Sun
Zizheng Liu
Lianke Wang
author_facet Changqing Sun
Jiale Han
Zhengqi Zhu
Qiang Zhang
Panpan Wang
Peijia Zhang
Ying Qin
Yang Li
Wei Xue
Dequan Sun
Zizheng Liu
Lianke Wang
author_sort Changqing Sun
collection DOAJ
description Abstract Background Medical students frequently face mental health challenges, underscoring the need for prompt identification and intervention. This research is designed to explore the interconnections between depression, anxiety, and academic engagement among medical students in the Post-Peak COVID-19 in China, employing a network analysis approach. Method In this research, 928 medical students were enrolled. Depression, anxiety, and academic engagement were measured using the nine-item Patient Health Questionnaire, the seven-item Generalized Anxiety Disorder Scale, and the Utrecht Work Engagement Scale for Students, respectively. Central and bridge symptoms were evaluated by the Expected Influence (EI) and bridge EI. The Network Comparison Test was utilized to assess the variability in depression and anxiety symptom associations across gender and residency. Results In the depression and anxiety network, “Fatigue”, “Guilt”, and “Difficulty relaxing” were the central symptoms. “Sad mood”, “Irritability”, and “Feeling afraid” served as the primary bridge symptoms. “Concentration”, “Anhedonia” and “Motor” exhibited the most robust correlations with academic engagement. Gender and residency did not correlate with global strength and edge weights. Conclusion The findings showed the complex interplay between depression, anxiety, and academic engagement during the Post-Peak COVID-19 period among Chinese medical students. Future interventions should focus on addressing the central and bridge symptoms within medical students, aiming to improve their mental health outcomes.
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spelling doaj-art-2ecee22ac79845529d1c747aa76db2152025-08-20T03:42:04ZengBMCBMC Psychology2050-72832025-07-0113111010.1186/s40359-025-03181-2Network analysis of comorbid depression and anxiety and their associations with academic engagement among medical students in the Post-Peak COVID-19 period in ChinaChangqing Sun0Jiale Han1Zhengqi Zhu2Qiang Zhang3Panpan Wang4Peijia Zhang5Ying Qin6Yang Li7Wei Xue8Dequan Sun9Zizheng Liu10Lianke Wang11School of Nursing and Health, Zhengzhou UniversitySchool of Nursing and Health, Zhengzhou UniversitySchool of Nursing and Health, Zhengzhou UniversitySchool of Nursing and Health, Zhengzhou UniversitySchool of Nursing and Health, Zhengzhou UniversityDepartment of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s HospitalSchool of Nursing and Health, Zhengzhou UniversitySchool of Nursing and Health, Zhengzhou UniversitySchool of Nursing and Health, Zhengzhou UniversitySchool of Nursing and Health, Zhengzhou UniversitySchool of Nursing and Health, Zhengzhou UniversitySchool of Nursing and Health, Zhengzhou UniversityAbstract Background Medical students frequently face mental health challenges, underscoring the need for prompt identification and intervention. This research is designed to explore the interconnections between depression, anxiety, and academic engagement among medical students in the Post-Peak COVID-19 in China, employing a network analysis approach. Method In this research, 928 medical students were enrolled. Depression, anxiety, and academic engagement were measured using the nine-item Patient Health Questionnaire, the seven-item Generalized Anxiety Disorder Scale, and the Utrecht Work Engagement Scale for Students, respectively. Central and bridge symptoms were evaluated by the Expected Influence (EI) and bridge EI. The Network Comparison Test was utilized to assess the variability in depression and anxiety symptom associations across gender and residency. Results In the depression and anxiety network, “Fatigue”, “Guilt”, and “Difficulty relaxing” were the central symptoms. “Sad mood”, “Irritability”, and “Feeling afraid” served as the primary bridge symptoms. “Concentration”, “Anhedonia” and “Motor” exhibited the most robust correlations with academic engagement. Gender and residency did not correlate with global strength and edge weights. Conclusion The findings showed the complex interplay between depression, anxiety, and academic engagement during the Post-Peak COVID-19 period among Chinese medical students. Future interventions should focus on addressing the central and bridge symptoms within medical students, aiming to improve their mental health outcomes.https://doi.org/10.1186/s40359-025-03181-2Academic engagementAnxietyDepressionNetwork analysis
spellingShingle Changqing Sun
Jiale Han
Zhengqi Zhu
Qiang Zhang
Panpan Wang
Peijia Zhang
Ying Qin
Yang Li
Wei Xue
Dequan Sun
Zizheng Liu
Lianke Wang
Network analysis of comorbid depression and anxiety and their associations with academic engagement among medical students in the Post-Peak COVID-19 period in China
BMC Psychology
Academic engagement
Anxiety
Depression
Network analysis
title Network analysis of comorbid depression and anxiety and their associations with academic engagement among medical students in the Post-Peak COVID-19 period in China
title_full Network analysis of comorbid depression and anxiety and their associations with academic engagement among medical students in the Post-Peak COVID-19 period in China
title_fullStr Network analysis of comorbid depression and anxiety and their associations with academic engagement among medical students in the Post-Peak COVID-19 period in China
title_full_unstemmed Network analysis of comorbid depression and anxiety and their associations with academic engagement among medical students in the Post-Peak COVID-19 period in China
title_short Network analysis of comorbid depression and anxiety and their associations with academic engagement among medical students in the Post-Peak COVID-19 period in China
title_sort network analysis of comorbid depression and anxiety and their associations with academic engagement among medical students in the post peak covid 19 period in china
topic Academic engagement
Anxiety
Depression
Network analysis
url https://doi.org/10.1186/s40359-025-03181-2
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