Network analysis of depressive and anxiety symptoms in adolescents during the COVID-19 pandemic

Adolescence represents a critical period of vulnerability for the development of mental health disorders. The COVID-19 pandemic has exerted psychological impacts not only on adults but also on adolescents, largely due to various containment and transmission control measures. Identifying these psychological effects and exploring their interrelationships is essential for informing mental health services. The present study aimed to use network analysis to cross-sectionally identify the most central symptoms within the depressive-anxiety symptom network in a sample of adolescents during the pandemic. Depressive symptoms were assessed using The Patient Health Questionnaire-9 (PHQ-9), while anxiety symptoms were measured with The Generalized Anxiety Disorder-7 (GAD-7) scale. The network analysis revealed that PHQ-2 (sad mood), GAD-1 (nervousness), PHQ-4 (fatigue), and GAD-2 (uncontrollable worry) emerged as the most central symptoms in the network model. Additionally, the key bridge symptoms linking depressive and anxiety symptom clusters were PHQ-6 (feelings of guilt), PHQ-2 (depressed mood), and GAD-5 (restlessness). Identifying these central and bridge symptoms through network analysis may offer valuable insights for designing targeted interventions for adolescents. Furthermore, this study provides an important foundation for future research, representing the first investigation conducted within a Turkish adolescent sample.