KSE
Search
- Page Path
- HOME > Search
COVID-19: Original Article
- Comorbidity network of post-traumatic stress and depressive symptoms during the COVID-19 pandemic in Korea
- Yujin Lee, Ji Su Yang, Alexander C. Tsai, Jee In Kang, Hearan Koo, Hyeon Woo Yim, Hyeon Chang Kim, Sun Jae Jung
- Epidemiol Health. 2026;48:e2026006. Published online January 23, 2026
- DOI: https://doi.org/10.4178/epih.e2026006
- 2,118 View
- 85 Download
-
Abstract
Summary
PDF
Supplementary Material -
AbstractOBJECTIVES
The coronavirus disease 2019 (COVID-19) pandemic had direct effects on population health through infection and morbidity, as well as indirect effects on population mental health. We estimated the network structure of post-traumatic stress symptoms (PTSS) and depressive symptoms throughout the pandemic in Korea and aimed to identify the most central and bridging symptoms.METHODSParticipants aged 30–64 years completed mental health surveys across 3 phases of the COVID-19 pandemic: March 2020 (n=1,925), February–March 2021 (n=1,754), and December 2021–January 2022 (n=1,595). Using PTSS and depressive symptom data, we conducted network analyses, and the primary measures of symptom importance (centrality) were expected influence and bridge expected influence.RESULTSIn the comorbidity network, although the most central symptoms fluctuated over the course of the pandemic, sleep problems were consistently identified as the most influential bridge symptoms throughout. The symptom network structure differed between the subacute and chronic phases of the pandemic.CONCLUSIONSWe found evidence of changes in the network structure of PTSS and depressive symptoms, even as sleep problems retained a consistent role as a bridging symptom. Although overall network structures varied across phases of the pandemic, the bridging role of sleep-related symptoms remained consistently strong, suggesting that sleep problems may represent a general and enduring mechanism underlying PTSS–depression comorbidity. During future pandemics, prompt screening for sleep problems may help prevent the development of comorbidity between PTSS and depressive symptoms. -
SummaryKorean summary
- 팬데믹 아급성기에서 만성기로 진행되며 외상후 스트레스 증상 및 우울증상의 네트워크 구조에서 중심증상 변화가 관측되었다. - 아급성기에는 ‘침습적 재경험(flashbacks)’과 ‘우울한 기분(depressed mood)’, 만성기에는 ‘우울한기분(depressed mood)’과 ‘무모하거나 자기파괴적인 행동(reckless behavior)’이 중심증상이었다. - ‘수면 문제(sleeping problems)’는 전 기간 동안 핵심 브리지증상으로 나타났다.Key Message
- The comorbidity network between PTSS and depressive symptoms shifted from the subacute to the chronic phase of the COVID-19 pandemic, with changes in central symptoms. - “Flashbacks” and “depressed mood” were central in the subacute phase, whereas “depressed mood” and “reckless behavior” were central in the chronic phase. - “Sleep problems” consistently acted as a key bridge symptom, suggesting its potential as an intervention target.
First
Prev
