ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Psychological Therapy and Psychosomatics
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1617999
Network analysis of depressive symptoms in Chinese outpatients with somatic symptom disorder
Provisionally accepted
- 1Gannan Medical University, Ganzhou, China
- 2The Third People's Hospital of Ganzhou, Ganzhou, China
- 3Tianjin Medical University, Tianjin, China
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Abstract Background Somatic symptom disorder and depression in clinical practice are strongly correlated. In this study, network analysis was used to assess the depressive symptoms of patients with somatic symptom disorder to identify the most core and influential symptoms. The aim of this study was to provide new perspectives for the treatment and rehabilitation of patients with somatic symptom disorder. Methods A total of 899 individuals were enrolled from Gannan Medical University’s First Affiliated Hospital, Ganzhou People’s Hospital, and Third People’s Hospital of Ganzhou. A version of the Patient Health Questionnaire-9 was administered to assess symptoms of depression. We described the network structure of depressive symptoms, utilizing indicators of “strength,” “betweenness,” and “closeness” to identify the key symptoms within the network. A bootstrap approach with case-dropping was used to test the network’s stability. Results Concentration (PHQ7), Motor (PHQ8), and Anhedonia (PHQ1) symptoms had the highest centrality values, the strength values are 1.67, 1.62, and 1.58 respectively. The edge connecting sad mood (PHQ2) and energy (PHQ4) were the most influential in the model, with an edge weight of 0.69, the highest among all edges. Conclusions This network analysis study identifies distinct depressive symptomatology within the Chinese SSD patient population. Core symptoms anhedonia, cognition, and motivation primarily drive depressive symptoms, underscoring the need for clinical focus on these manifestations to prevent exacerbation. Tailored interventions targeting these core symptoms, including the integration of pleasant experiences, dopamine-based medications, attention bias modification training, and behavioral activation therapy, should be considered in treatment strategies.
Keywords: Network analysis, depressive symptoms, Chinese outpatients, Somatic symptom disorder, network accuracy and stability
Received: 25 Apr 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Li, Fang, Zhong, Li, Liao and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hong Tang, Gannan Medical University, Ganzhou, China
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