The Network Structure of Sleep Disorders, Depression, and Anxiety Among Healthcare Workers in High-Population Density City of China

Objective To identify the network structure of depressive symptom and anxiety symptoms among healthcare workers with and without sleep disorders in a high population density city of China. Methods A cross-sectional study was conducted from March to December 2023, the psychological distress were assessed using the Symptom Checklist-90 (SCL-90) and the Pittsburgh Sleep Quality Index (PSQI) among 1,373 healthcare workers. Network analysis was employed to identify the network structure of depressive symptoms and anxiety among individuals with and without sleep disorders separately. Results A stronger correlation between anxiety and depression symptoms, a higher number of edges, more integration and overlap, and a tighter network structure was found among individuals with sleep disorders. Notably, the key bridging symptoms was "sudden, unexplained fear" (A3) and "fear" (A4). Conclusion The sudden, unexplained fear and fear are the core symptoms of comorbid depression and anxiety among hospital medical staff. Focusing on the two symptoms as the main intervention targets may be helpful to prevent and treat comorbidities of depression and anxiety among healthcare workers.