A network analysis of depression, anxiety, and their associations with kratom ( <i>Mitragyna speciosa</i> ) use among people who previously used methamphetamine

Kratom has been widely reported to alleviate depression and anxiety; however, its effects on depression and anxiety in people who use methamphetamine (METH) are rarely investigated. This study constructed network structures of kratom use, depressive symptoms, and anxiety symptoms to gain a preliminary understanding of the possible psychopharmacological mechanisms by which kratom affects depression and anxiety. R package (Version 4.4.1) was used to construct network structures, calculate expected influence and bridge expected influence, estimate networks accuracy, and stability. A sample of 403 males who used METH with and without kratom-use history were recruited for this cross-sectional study. Compared with those without kratom-use history, those who co-used METH with kratom had several lower levels of depressive symptoms. The central depressive symptom was "sleep disturbance" (BDI-16) and the central anxiety symptom was "heart pounding or racing" (BAI-7). Kratom dosage per consumption was the most important kratom-use indicator that was associated with depression and anxiety. Our preliminary findings indicate that kratom may affect depression and anxiety in males who used METH in a dose-dependent and frequency-dependent manner. The most correlated symptoms and bridge nodes in this network analysis should be considered as potential targets for intervention.