Depressive symptoms and gender differences in older adults in Hong Kong during the COVID-19 pandemic: a network analysis approach

Abstract

Background:The 2019 novel coronavirus disease (COVID-19) outbreak had a detrimental impact on the mental health of older adults. This study evaluated the central symptoms and their associations in the network of depressive symptoms and compared the network structure differences between male and female older adults in Hong Kong. Methods: Altogether, 3,946 older adults participated in this study. We evaluated the centrality indicators for network robustness using stability and accuracy tests, and examined the potential differences between the structure and connectivity of depression networks in male and female older adults. Results: The overall prevalence of depressive symptoms was 43.7% (95% CI=40.6-46.7%) in males, and 54.8% (95% CI=53.1-56.5%) in females (P<0.05). Sad Mood, Guilt, Motor problems and Lack of Energy were influential symptoms in the network model. Gender differences were found in the network global strength, especially in the following edges: Sad Mood--Guilt, Concentration--Guilt, Anhedonia--Motor, Lack of Energy--Suicide, Appetite--Suicide and Concentration--Suicide. Conclusions: Central symptoms in the depressive symptom network among male and female older adults may be prioritized in the treatment and prevention of depression during the pandemic.

Depression and quality of life among Macau residents in the 2022 COVID-19 pandemic wave from the perspective of network analysis

“…"Sad mood" (PHQ2) was the most central symptom in the depression network model among Macau residents during the 618 COVID-19 wave, which is consistent with the previous findings in a German general population study (Hartung et al, 2019) and in a study of older adults in Hong Kong (Jin et al, 2022) during the COVID-19 pandemic. According to the Diagnostic and Statistical Manual of Mental Disorder-5 (DSM-5) (APA, 2013), "sad mood" is a core symptom of major depressive disorder (MDD), and persistent sadness is also a risk factor for depression (Wolff, 1999;Davidson and Henriques, 2000).…”

“…Network analysis could help determine nodes that are the most central (influential) in the network model and could be targeted for prevention and intervention ( Borsboom and Cramer, 2013 ; Cramer et al, 2016 ; Marchetti, 2019 ). In the past years network analysis has been widely applied in different populations during the COVID-19 pandemic such as adolescents ( Cai et al, 2022a ), the general population ( Cheung et al, 2021 ; Zavlis et al, 2021 ), older people ( Jin et al, 2022 ), college students ( Bai et al, 2021 ), clinicians ( Cai et al, 2022c ), and psychiatric patients ( Kim et al, 2022 ). Evidence showed that the pattern and clinical features of depression were highly dependent on the socioeconomic context ( Kleinman, 2004 ; Compton et al, 2006 ); therefore, the network structure of the depressive symptoms should be examined separately for the population living in areas with different socioeconomic contexts ( Cheung et al, 2021 ).…”

Prevalence of depression and its association with quality of life in patients after pacemaker implantation during the COVID-19 pandemic: A network analysis

“…The node “Energy” was another significant central symptom in the depression network model, consistent with previous findings reported in community-dwelling older adults ( 66 ), patients with major depressive disorder ( 67 ) and adult Hong Kong residents ( 60 ). Older adults with pacemaker implantation may experience disturbances in sleep and appetite that influence energy levels ( 68 ).…”

Effects of the COVID-19 pandemic on suicide attempts in a rural region in Germany, a 5-year observational study

“…In addition, it was suggested that the fear of contagion and the simultaneous feeling of being a burden to the younger generation because of being severely limited socially had a pessimistic influence on individuals' thoughts about their future and may have reinforced thoughts of death. Some studies found that there is a higher prevalence of anxiety, depression, and loneliness in older adults when compared with prepandemic levels ( Bankole, 2022 ; Jin et al, 2022 ).…”