Exploring bridge symptoms in HIV-positive people with comorbid depressive and anxiety disorders

Background The prevalence of comorbid depressive and anxiety disorders in people living with HIV (PLWH) is high. However, it is unclear which symptom is the bridge symptom between depression and anxiety in PLWH. This study aimed to develop symptom networks for depression and anxiety and explore the bridge symptoms and interconnectedness between these disorders in PLWH with comorbid depressive and anxiety disorders. Methods A multisite, hospital-based cross-sectional study was conducted from March 2020 to November 2021. Depression and anxiety were measured with the Hospital Anxiety and Depression Scale. We visualized the symptom network using the qgraph package and computed the bridge expected influence of each node. The GLASSO layout was used to generate undirected association networks. Results A total of 2016 individuals were included in the analysis. In the anxiety cluster, "not feeling relaxed" had the highest bridge expected influence and strength (r(bridge expected influence) = 0.628, r(strength) = 0.903). In the depression cluster, "not feeling cheerful" was identified as having a high bridge expected influence (r(bridge expected influence) = 0.385). "Not feeling cheerful" and "not feeling relaxed" were the strongest edges across the depression and anxiety clusters (r = 0.30 +/- 0.02). Conclusions Healthcare professionals should take note when PLWH report severe bridge symptoms. To enhance the levels of perceived cheerfulness and relaxation, positive psychology interventions could be implemented.