Network analysis of comorbid posttraumatic stress disorder and depression in adolescents across COVID-19 epidemic and Typhoon Lekima

Abstract

Background: Network analytic studies indicate that posttraumatic stress disorder (PTSD) may be comorbid with depression at the symptom level, but it remains unclear whether these findings are replicable and generalizable across trauma types.

Objective: This study aim was to examine and compare PTSD-depression comorbidity networks of two types of trauma related to Typhoon Lekima and COVID-19 epidemic.

Methods: Participants were 1605 and 601 adolescents recruited following Typhoon Lekima and the COVID-19 outbreak, respectively.

Results: COVID-19 and Lekima PTSD-depression networks had considerable similarities, including adequate stability and accuracy, connected symptoms of PTSD and depression, symptoms with high centralities, and bridge symptoms. PTSD-depression comorbid symptoms were more complicated in the COVID-19 network but may show more persistence in the Lekima network. Distinct bridge symptoms contributed to the heterogeneity of PTSD-depression comorbidity characteristics between the two networks. Specifically, restricted affect and felt down and unhappy were two important bridge symptoms with high centrality unique to the COVID-19 network.

Conclusions: PTSD-depression comorbidity network has considerable replicability across trauma types, but specific symptom-level associations and some bridge symptoms may vary across trauma types. These findings also highlight the importance of negative emotions to comorbid PTSD and depression in adolescents following the COVID-19 outbreak compared with Typhoon Lekima.

Keywords: COVID-19; Depression: Network analysis; PTSD; Typhoon lekima.