Central and Bridge Symptoms of Suboptimal Health Status in Chinese Medical Students: a Network Analysis

Background The prevalence of suboptimal health in Chinese medical students is high. However, the bridge symptoms within the three domains of suboptimal health remain ambiguous. The current study investigates the network structure of suboptimal health in Chinese medical students and identifies the central and bridge symptoms, thereby providing potential targets for prevention and intervention. Methods This study used a cross-sectional survey design and stratified random cluster sampling method to recruit participants from November 2022 to March 2023. 2865 medical students were recruited, and 2210 valid questionnaires were to be analyzed. We used R software to visualize the symptom network and identify central symptoms and bridge symptoms. Results The result shows that the B30 “Social relationships” node had the highest strength centrality (strength = 1.113) in the network. The bridge strength analysis identified B29 “Coping ability” (bridge strength = 0.582), B14 “Energy” (bridge strength = 0.399), B27 “Problem-solving ability”(bridge strength = 0.377), and B31 “Performance” (bridge strength = 0.375) as the bridge symptoms. The strongest edge connections across all dimensions included “Share happiness and sadness” with “Close relationships” (B34-B35, edge weight = 0.61) and “Appetite” with “Sleep” (B1-B2, edge weight = 0.51). Conclusions B30 “Social relationships” was the central symptom of the suboptimal health network and could be a target for intervention. Intervening and managing bridge symptoms such as B29 “Coping ability”, B14 “Energy”, B27 “Problem-solving ability”, and B31 “Performance” can effectively impede the spread of symptom activation, thereby decreasing the connections among three domains of suboptimal health in Chinese medical students.