Network analysis in depressed adolescents with suicidal ideation: the role of depression, anxiety, and childhood abuse

IntroductionAdolescent depression is a global public health issue strongly associated with suicidal ideation and childhood abuse. Although family systems and ecological theories highlight the multilevel influences of family environment on mental health, most studies focus on overall symptom scores r...

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Main Authors: Ziyang Huang, Liya A, Kewen Yan, Hailiang Ran, Yusan Che, Runxu Yang, Linling Jiang, Rui Xiao, Rushuang Zeng, Tong Li, Yiling Xie, Yuanyuan Xiao, Jin Lu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1645303/full
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author Ziyang Huang
Ziyang Huang
Ziyang Huang
Liya A
Liya A
Liya A
Liya A
Kewen Yan
Kewen Yan
Kewen Yan
Hailiang Ran
Yusan Che
Runxu Yang
Runxu Yang
Runxu Yang
Linling Jiang
Linling Jiang
Linling Jiang
Rui Xiao
Rui Xiao
Rushuang Zeng
Rushuang Zeng
Rushuang Zeng
Tong Li
Tong Li
Tong Li
Yiling Xie
Yiling Xie
Yiling Xie
Yuanyuan Xiao
Jin Lu
Jin Lu
Jin Lu
author_facet Ziyang Huang
Ziyang Huang
Ziyang Huang
Liya A
Liya A
Liya A
Liya A
Kewen Yan
Kewen Yan
Kewen Yan
Hailiang Ran
Yusan Che
Runxu Yang
Runxu Yang
Runxu Yang
Linling Jiang
Linling Jiang
Linling Jiang
Rui Xiao
Rui Xiao
Rushuang Zeng
Rushuang Zeng
Rushuang Zeng
Tong Li
Tong Li
Tong Li
Yiling Xie
Yiling Xie
Yiling Xie
Yuanyuan Xiao
Jin Lu
Jin Lu
Jin Lu
author_sort Ziyang Huang
collection DOAJ
description IntroductionAdolescent depression is a global public health issue strongly associated with suicidal ideation and childhood abuse. Although family systems and ecological theories highlight the multilevel influences of family environment on mental health, most studies focus on overall symptom scores rather than examining how specific forms of abuse relate to distinct symptoms. Employing symptom network analysis, this study investigates the interactions among depressive symptoms, anxiety, and childhood abuse in adolescents diagnosed with major depressive disorder (MDD) and suicidal ideation.MethodsWe analyzed data from 733 Chinese adolescents diagnosed with MDD (mean age = 14.81 years). Symptom networks were constructed via LASSO-regularized models using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Centrality (strength and bridge strength) and stability analysis identified core symptoms and bridging pathways.ResultsDepressive and anxiety symptoms showed strong comorbidity, with “Uncontrollable worry” (GAD2) and “Fatigue” (PHQ4) as central nodes. Key bridge symptoms included “Motor” (PHQ8), “Death” (PHQ9), “Restless” (GAD5), and “Emotional abuse” (EA). Childhood abuse exhibited intra-group correlations (emotional-physical abuse), and emotional abuse was directly linked to death-related thoughts. The network demonstrated strong stability.ConclusionsEmotional abuse and bridge symptoms (e.g., fatigue and uncontrolled worry) are critical intervention targets for suicide−prevention interventions. A multimodal approach integrating cognitive-behavioral therapy for core symptom management, family-based interventions to address attachment disruptions, and policy initiatives to reduce childhood abuse is recommended.
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spelling doaj-art-ab085cfccf2d4f5494797dc93863410d2025-08-20T02:55:06ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-08-011610.3389/fpsyt.2025.16453031645303Network analysis in depressed adolescents with suicidal ideation: the role of depression, anxiety, and childhood abuseZiyang Huang0Ziyang Huang1Ziyang Huang2Liya A3Liya A4Liya A5Liya A6Kewen Yan7Kewen Yan8Kewen Yan9Hailiang Ran10Yusan Che11Runxu Yang12Runxu Yang13Runxu Yang14Linling Jiang15Linling Jiang16Linling Jiang17Rui Xiao18Rui Xiao19Rushuang Zeng20Rushuang Zeng21Rushuang Zeng22Tong Li23Tong Li24Tong Li25Yiling Xie26Yiling Xie27Yiling Xie28Yuanyuan Xiao29Jin Lu30Jin Lu31Jin Lu32Psychiatric Department, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaMental Health Institute of Yunnan, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaYunnan Clinical Research Center for Mental Health, Kunming, ChinaPsychiatric Department, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaMental Health Institute of Yunnan, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaYunnan Clinical Research Center for Mental Health, Kunming, ChinaTaylor’s University, Subang Jaya, Selangor, MalaysiaPsychiatric Department, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaMental Health Institute of Yunnan, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaYunnan Clinical Research Center for Mental Health, Kunming, ChinaSchool of Public Health, Kunming Medical University, Kunming, ChinaSchool of Public Health, Kunming Medical University, Kunming, ChinaPsychiatric Department, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaMental Health Institute of Yunnan, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaYunnan Clinical Research Center for Mental Health, Kunming, ChinaPsychiatric Department, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaMental Health Institute of Yunnan, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaYunnan Clinical Research Center for Mental Health, Kunming, ChinaDepartment of Pediatrics, The First People’s Hospital of Yunnan Province, Kunming, ChinaDepartment of Pediatrics, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, ChinaPsychiatric Department, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaMental Health Institute of Yunnan, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaYunnan Clinical Research Center for Mental Health, Kunming, ChinaPsychiatric Department, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaMental Health Institute of Yunnan, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaYunnan Clinical Research Center for Mental Health, Kunming, ChinaPsychiatric Department, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaMental Health Institute of Yunnan, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaYunnan Clinical Research Center for Mental Health, Kunming, ChinaSchool of Public Health, Kunming Medical University, Kunming, ChinaPsychiatric Department, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaMental Health Institute of Yunnan, First Affiliated Hospital of Kunming Medical University, Kunming, ChinaYunnan Clinical Research Center for Mental Health, Kunming, ChinaIntroductionAdolescent depression is a global public health issue strongly associated with suicidal ideation and childhood abuse. Although family systems and ecological theories highlight the multilevel influences of family environment on mental health, most studies focus on overall symptom scores rather than examining how specific forms of abuse relate to distinct symptoms. Employing symptom network analysis, this study investigates the interactions among depressive symptoms, anxiety, and childhood abuse in adolescents diagnosed with major depressive disorder (MDD) and suicidal ideation.MethodsWe analyzed data from 733 Chinese adolescents diagnosed with MDD (mean age = 14.81 years). Symptom networks were constructed via LASSO-regularized models using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Centrality (strength and bridge strength) and stability analysis identified core symptoms and bridging pathways.ResultsDepressive and anxiety symptoms showed strong comorbidity, with “Uncontrollable worry” (GAD2) and “Fatigue” (PHQ4) as central nodes. Key bridge symptoms included “Motor” (PHQ8), “Death” (PHQ9), “Restless” (GAD5), and “Emotional abuse” (EA). Childhood abuse exhibited intra-group correlations (emotional-physical abuse), and emotional abuse was directly linked to death-related thoughts. The network demonstrated strong stability.ConclusionsEmotional abuse and bridge symptoms (e.g., fatigue and uncontrolled worry) are critical intervention targets for suicide−prevention interventions. A multimodal approach integrating cognitive-behavioral therapy for core symptom management, family-based interventions to address attachment disruptions, and policy initiatives to reduce childhood abuse is recommended.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1645303/fulldepressed adolescentsnetwork analysissuicidal ideationchildhood abusedepression and anxiety symptoms
spellingShingle Ziyang Huang
Ziyang Huang
Ziyang Huang
Liya A
Liya A
Liya A
Liya A
Kewen Yan
Kewen Yan
Kewen Yan
Hailiang Ran
Yusan Che
Runxu Yang
Runxu Yang
Runxu Yang
Linling Jiang
Linling Jiang
Linling Jiang
Rui Xiao
Rui Xiao
Rushuang Zeng
Rushuang Zeng
Rushuang Zeng
Tong Li
Tong Li
Tong Li
Yiling Xie
Yiling Xie
Yiling Xie
Yuanyuan Xiao
Jin Lu
Jin Lu
Jin Lu
Network analysis in depressed adolescents with suicidal ideation: the role of depression, anxiety, and childhood abuse
Frontiers in Psychiatry
depressed adolescents
network analysis
suicidal ideation
childhood abuse
depression and anxiety symptoms
title Network analysis in depressed adolescents with suicidal ideation: the role of depression, anxiety, and childhood abuse
title_full Network analysis in depressed adolescents with suicidal ideation: the role of depression, anxiety, and childhood abuse
title_fullStr Network analysis in depressed adolescents with suicidal ideation: the role of depression, anxiety, and childhood abuse
title_full_unstemmed Network analysis in depressed adolescents with suicidal ideation: the role of depression, anxiety, and childhood abuse
title_short Network analysis in depressed adolescents with suicidal ideation: the role of depression, anxiety, and childhood abuse
title_sort network analysis in depressed adolescents with suicidal ideation the role of depression anxiety and childhood abuse
topic depressed adolescents
network analysis
suicidal ideation
childhood abuse
depression and anxiety symptoms
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1645303/full
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