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This study examined the network structure of depressive and anxiety symptoms and suicidality among psychiatric patients across Asia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data were drawn from the Research on Asian Psychotropic Prescription Patterns for Antidepressants Phase 3 study (REAP-AD3), which included 2,455 psychiatric patients from 11 Asian countries and territories. Depression and anxiety were assessed using the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively, while suicidality (i.e., suicidal thoughts or acts) was assessed by a clinical interview. Expected Influence (EI) and Bridge EI were used as centrality indices in the symptom network to characterize the structure of the symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The point prevalence of suicidality was 30.1% (95% confidence interval [CI]\u2009=\u200928.2, 31.9) among the psychiatric patients. The network analysis identified PHQ2 (\u201cSad mood\u201d) as the most central symptom, followed by GAD2 (\u201cUncontrollable worry\u201d). Additionally, PHQ8 (\u201cMotor disturbances\u201d) and S (\u201cSuicidality\u201d) were identified as bridge nodes linking depression and anxiety with suicidality. The flow network indicated that PHQ6 (\u201cGuilt\u201d) and PHQ2 (\u201cSad mood\u201d) had the strongest positive associations with suicidality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Suicidality was common among psychiatric patients across Asia. The central and bridge symptoms might represent potential clinical markers and generate hypotheses for longitudinal and interventional research on depression, anxiety, and suicidality in the future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00207640261473297","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:23:11Z","timestamp":1785990191000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Inter-Relationships of Depressive and Anxiety Symptoms with Suicidality Among Asian Psychiatric Patients: Findings From the REAP-AD3"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3497-8814","authenticated-orcid":false,"given":"Li-Ya","family":"A","sequence":"first","affiliation":[{"name":"School of Health, Zhuhai College of Science and Technology, Guangdong Province, China"},{"name":"Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China"},{"name":"Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Feng","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders &amp; National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinge","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders &amp; National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian-Mei","family":"Si","sequence":"additional","affiliation":[{"name":"Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy Abraham","family":"Kallivayalil","sequence":"additional","affiliation":[{"name":"Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla and Mar Sleeva Medicity, Palai, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andi J.","family":"Tanra","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Hossein Jalali","family":"Nadoushan","sequence":"additional","affiliation":[{"name":"Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kok Yoon","family":"Chee","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur Hospital, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afzal","family":"Javed","sequence":"additional","affiliation":[{"name":"Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Sim","sequence":"additional","affiliation":[{"name":"Institute of Mental Health, Buangkok Green Medical Park, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0228-3043","authenticated-orcid":false,"given":"Pornjira","family":"Pariwatcharakul","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukako","family":"Nakagami","sequence":"additional","affiliation":[{"name":"Student Support Center, Kyoto University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiya","family":"Inada","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Nagoya University Graduate School of Medicine, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan-Lun","family":"Huang","sequence":"additional","affiliation":[{"name":"Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Ku","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan"},{"name":"Taipei City Hospital and Psychiatric Center, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seon-Cheol","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Hanyang University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Sartorius","sequence":"additional","affiliation":[{"name":"Association for the Improvement of Mental Health Programs, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naotaka","family":"Shinfuku","sequence":"additional","affiliation":[{"name":"School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro A.","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chee H.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The Melbourne Clinic and St Vincent\u2019s Hospital, University of Melbourne, Richmond, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Tao","family":"Xiang","sequence":"additional","affiliation":[{"name":"Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China"},{"name":"Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"A L.-Y. 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