{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:37:03Z","timestamp":1792791423228,"version":"4.5.0"},"reference-count":73,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["242102311135"],"award-info":[{"award-number":["242102311135"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["232102311023"],"award-info":[{"award-number":["232102311023"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Central Plains Cultural Leadership Talent Program"},{"DOI":"10.13039\/501100017700","name":"Henan Province Science and Technology Research Project","doi-asserted-by":"crossref","award":["242102310234"],"award-info":[{"award-number":["242102310234"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Psychol"],"DOI":"10.1186\/s40359-025-03181-2","type":"journal-article","created":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T13:26:07Z","timestamp":1753536367000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Network analysis of comorbid depression and anxiety and their associations with academic engagement among medical students in the Post-Peak COVID-19 period in China"],"prefix":"10.1186","volume":"13","author":[{"given":"Changqing","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiale","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengqi","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panpan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peijia","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dequan","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zizheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianke","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,26]]},"reference":[{"issue":"1","key":"3181_CR1","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1186\/s12909-019-1744-2","volume":"19","author":"Y Mao","year":"2019","unstructured":"Mao Y, Zhang N, Liu J, Zhu B, He R, Wang X. A systematic review of depression and anxiety in medical students in China. Bmc Med Educ. 2019;19(1):327.","journal-title":"Bmc Med Educ"},{"issue":"11","key":"3181_CR2","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1111\/jcpp.13606","volume":"63","author":"W Li","year":"2022","unstructured":"Li W, Zhao Z, Chen D, Peng Y, Lu Z. Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta-analysis. J Child Psychol Psychiatry. 2022;63(11):1222\u20131230.","journal-title":"J Child Psychol Psychiatry"},{"key":"3181_CR3","doi-asserted-by":"publisher","first-page":"1257589","DOI":"10.3389\/fmed.2023.1257589","volume":"10","author":"KM Alshamrani","year":"2023","unstructured":"Alshamrani KM, Ghulam EM, Alattas M, Aljaddani H, Alhakami M, Nufaiei ZFA, et al. Transition to remote\/hybrid learning during the covid-19 pandemic among Saudi students of the college of applied medical sciences: a cross-sectional study. Front Med (Lausanne). 2023;10:1257589.","journal-title":"Front Med (Lausanne)"},{"key":"3181_CR4","doi-asserted-by":"publisher","first-page":"1972","DOI":"10.1002\/cpp.2767","volume":"29","author":"G Mansueto","year":"2022","unstructured":"Mansueto G, Palmieri S, Marino C, Caselli G, Sassaroli S, Ruggiero GM, et al. The Italian covid-19 anxiety syndrome scale: investigation of the covid-19 anxiety syndrome and its association with psychological symptoms in an Italian population. Clin Psychol Psychother. 2022;29:1972\u20131990.","journal-title":"Clin Psychol Psychother"},{"key":"3181_CR5","doi-asserted-by":"publisher","first-page":"110371","DOI":"10.1016\/j.paid.2020.110371","volume":"168","author":"ES Grossman","year":"2021","unstructured":"Grossman ES, Hoffman YSG, Palgi Y, Shrira A. Covid-19 related loneliness and sleep problems in older adults: worries and resilience as potential moderators. Pers Individ Dif. 2021;168:110371.","journal-title":"Pers Individ Dif"},{"key":"3181_CR6","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1002\/cpp.2644","volume":"28","author":"G Mansueto","year":"2021","unstructured":"Mansueto G, Lopes FL, Grassi L, Cosci F. Impact of covid-19 outbreak on Italian healthcare workers versus general population: results from an online survey. Clin Psychol Psychother. 2021;28:1334\u20131345.","journal-title":"Clin Psychol Psychother"},{"key":"3181_CR7","doi-asserted-by":"publisher","first-page":"2328","DOI":"10.1007\/s10964-023-01829-z","volume":"52","author":"T Pivec","year":"2023","unstructured":"Pivec T, Kozina A. Anxiety and covid-19 anxiety in positive youth development: a latent profile analysis study. J Youth Adolesc. 2023;52:2328\u20132343.","journal-title":"J Youth Adolesc"},{"key":"3181_CR8","doi-asserted-by":"publisher","first-page":"113596","DOI":"10.1016\/j.psychres.2020.113596","volume":"295","author":"J Brailovskaia","year":"2021","unstructured":"Brailovskaia J, Cosci F, Mansueto G, Miragall M, Herrero R, Banos RM, et al. The association between depression symptoms, psychological burden caused by covid-19 and physical activity: an investigation in germany, italy, russia, and Spain. Psychiatry Res. 2021;295:113596.","journal-title":"Psychiatry Res"},{"key":"3181_CR9","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1007\/s10942-024-00556-z","volume":"42","author":"G Mansueto","year":"2024","unstructured":"Mansueto G, Ruggiero GM, Palmieri S. The relationship between covid-19 fear, affective symptoms and well-being: the mediating role of psychological flexibility. J Ration Emot Cogn Behav Ther. 2024;42:681.","journal-title":"J Ration Emot Cogn Behav Ther"},{"key":"3181_CR10","doi-asserted-by":"publisher","first-page":"e181","DOI":"10.1017\/S2045796020000931","volume":"29","author":"Z Ma","year":"2020","unstructured":"Ma Z, Zhao J, Li Y, Chen D, Wang T, Zhang Z, et al. Mental health problems and correlates among 746 217 college students during the coronavirus disease 2019 outbreak in China. Epidemiol Psychiatr Sci. 2020;29:e181.","journal-title":"Epidemiol Psychiatr Sci"},{"key":"3181_CR11","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1146\/annurev-clinpsy-072220-021440","volume":"18","author":"SM Monroe","year":"2022","unstructured":"Monroe SM, Harkness KL. Major depression and its recurrences: life course matters. Annu Rev Clin Psychol. 2022;18:329\u2013357.","journal-title":"Annu Rev Clin Psychol"},{"issue":"1","key":"3181_CR12","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1186\/s12916-020-01738-z","volume":"18","author":"RN Groen","year":"2020","unstructured":"Groen RN, Ryan O, Wigman JTW, Riese H, Penninx BWJH, Giltay EJ, et al. Comorbidity between depression and anxiety: assessing the role of Bridge mental States in dynamic psychological networks. Bmc Med. 2020;18(1):308.","journal-title":"Bmc Med"},{"key":"3181_CR13","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1037\/a0019682","volume":"102","author":"H Jang","year":"2010","unstructured":"Jang H, Reeve J, Deci EL. Engaging students in learning activities: it is not autonomy support or structure but autonomy support and structure. J Educ Psychol. 2010;102:588\u2013600.","journal-title":"J Educ Psychol"},{"key":"3181_CR14","doi-asserted-by":"publisher","first-page":"116795","DOI":"10.1016\/j.socscimed.2024.116795","volume":"348","author":"S Chen","year":"2024","unstructured":"Chen S, Cardenas D, Zhou H, Reynolds KJ. Positive school climate and strong school identification as protective factors of adolescent mental health and learning engagement: a longitudinal investigation before and during covid-19. Soc Sci Med. 2024;348:116795.","journal-title":"Soc Sci Med"},{"key":"3181_CR15","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1111\/aphw.12332","volume":"14","author":"I Krifa","year":"2022","unstructured":"Krifa I, Hallez Q, van Zyl LE, Braham A, Sahli J, Nasr SB, et al. Effectiveness of an online positive psychology intervention among Tunisian healthcare students on mental health and study engagement during the covid-19 pandemic. Appl Psychol Health Well Being. 2022;14:1228\u20131254.","journal-title":"Appl Psychol Health Well Being"},{"key":"3181_CR16","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1002\/wps.20375","volume":"16","author":"D Borsboom","year":"2017","unstructured":"Borsboom D. A network theory of mental disorders. World Psychiatry. 2017;16:5\u201313.","journal-title":"World Psychiatry"},{"key":"3181_CR17","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1017\/S0033291714001809","volume":"45","author":"LF Bringmann","year":"2015","unstructured":"Bringmann LF, Lemmens LHJM, Huibers MJH, Borsboom D, Tuerlinckx F. Revealing the dynamic network structure of the Beck depression inventory-ii. Psychol Med. 2015;45:747\u2013757.","journal-title":"Psychol Med"},{"key":"3181_CR18","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1146\/annurev-clinpsy-050212-185608","volume":"9","author":"D Borsboom","year":"2013","unstructured":"Borsboom D, Cramer AOJ. Network analysis: an integrative approach to the structure of psychopathology. Ann Rev Clin Psychol. 2013;9:9:91\u2013121.","journal-title":"Ann Rev Clin Psychol"},{"key":"3181_CR19","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.jad.2023.04.065","volume":"333","author":"P Zhang","year":"2023","unstructured":"Zhang P, Wang L, Zhou Q, Dong X, Guo Y, Wang P, et al. A network analysis of anxiety and depression symptoms in Chinese disabled elderly. J Affect Disord. 2023;333:535\u2013542.","journal-title":"J Affect Disord"},{"key":"3181_CR20","doi-asserted-by":"publisher","first-page":"104809","DOI":"10.1016\/j.ijnurstu.2024.104809","volume":"156","author":"CS Lee","year":"2024","unstructured":"Lee CS, Chu SH, Dunne J, Spintzyk E, Locatelli G, Babicheva V, et al. Body listening in the link between symptoms and self-care management in cardiovascular disease: a cross-sectional correlational descriptive study. Int J Nurs Stud. 2024;156:104809.","journal-title":"Int J Nurs Stud"},{"key":"3181_CR21","doi-asserted-by":"publisher","first-page":"1402680","DOI":"10.3389\/fpsyt.2024.1402680","volume":"15","author":"C Sun","year":"2024","unstructured":"Sun C, Zhu Z, Zhang P, Wang L, Zhang Q, Guo Y, et al. Exploring the interconnections of anxiety, depression, sleep problems and health-promoting lifestyles among Chinese university students: a comprehensive network approach. Front Psychiatry. 2024;15:1402680.","journal-title":"Front Psychiatry"},{"key":"3181_CR22","doi-asserted-by":"publisher","first-page":"974697","DOI":"10.3389\/fpsyg.2022.974697","volume":"13","author":"M Abdolkarimi","year":"2022","unstructured":"Abdolkarimi M, Masoomi M, Lotfipur SS, Zakeri MA. The relationship between spiritual health and happiness in medical students during the covid-19 outbreak: a survey in southeastern Iran. Front Psychol. 2022;13:974697.","journal-title":"Front Psychol"},{"issue":"15","key":"3181_CR23","doi-asserted-by":"publisher","first-page":"4372","DOI":"10.3390\/jcm13154372","volume":"13","author":"J Regli","year":"2024","unstructured":"Regli J, Sadeghi-Bahmani D, Rigotti V, Stanga Z, Ulguer II, Fichter C, et al. Psychiatric characteristics, symptoms of insomnia and depression, emotion regulation, and social activity among Swiss medical students. J Clin Med. 2024;13(15):4372.","journal-title":"J Clin Med"},{"key":"3181_CR24","doi-asserted-by":"publisher","first-page":"685137","DOI":"10.3389\/fpsyg.2021.685137","volume":"12","author":"E Milasauskiene","year":"2021","unstructured":"Milasauskiene E, Burkauskas J, Podlipskyte A, Kiraly O, Demetrovics Z, Ambrasas L, et al. Compulsive internet use scale: psychometric properties and associations with sleeping patterns, mental health, and well-being in Lithuanian medical students during the coronavirus disease 2019 pandemic. Front Psychol. 2021;12:685137.","journal-title":"Front Psychol"},{"key":"3181_CR25","doi-asserted-by":"publisher","first-page":"1169957","DOI":"10.3389\/fpsyg.2023.1169957","volume":"14","author":"MR Sergi","year":"2023","unstructured":"Sergi MR, Picconi L, Saggino A, Fermani A, Bongelli R, Tommasi M. Psychometric properties of a new instrument for the measurement of the perceived quality of distance learning during the coronavirus disease 2019 (covid-19) pandemic. Front Psychol. 2023;14:1169957.","journal-title":"Front Psychol"},{"issue":"1","key":"3181_CR26","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1080\/09638237.2024.2390374","volume":"34","author":"N Castro Pecci Maddalena","year":"2025","unstructured":"Castro Pecci Maddalena N, Lamas Granero Lucchetti A, da Silva Ezequiel O, Lucchetti G. Factors associated with mental health and quality of life among Brazilian medical students: a three-year longitudinal study. J Ment Health. 2025;34(1):38\u201345.","journal-title":"J Ment Health"},{"issue":"1","key":"3181_CR27","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1186\/s12889-025-21697-5","volume":"25","author":"S Cen","year":"2025","unstructured":"Cen S, Zhao M, Wang F, Tang L. Gender differences in the relationship between mental health and academic performance among undergraduate students at a medical school in shanghai: a cross-sectional study. BMC Public Health. 2025;25(1):731.","journal-title":"BMC Public Health"},{"key":"3181_CR28","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.jad.2023.02.087","volume":"329","author":"W Wang","year":"2023","unstructured":"Wang W, Wang J, Zhang X, Pei Y, Tang J, Zhu Y, et al. Network connectivity between anxiety, depressive symptoms and psychological capital in Chinese university students during the covid-19 campus closure. J Affect Disord. 2023;329:11\u201318.","journal-title":"J Affect Disord"},{"key":"3181_CR29","doi-asserted-by":"publisher","first-page":"1533757","DOI":"10.3389\/fpsyt.2025.1533757","volume":"16","author":"J Luo","year":"2025","unstructured":"Luo J, Xu J, Lin Y, Chen Q. Understanding the complex network of anxiety, depression, sleep problems, and smartphone addiction among college Art students using network analysis. Front Psychiatry. 2025;16:1533757.","journal-title":"Front Psychiatry"},{"key":"3181_CR30","doi-asserted-by":"publisher","first-page":"1537935","DOI":"10.3389\/fpsyt.2025.1537935","volume":"16","author":"Y Mi","year":"2025","unstructured":"Mi Y, Ahn S, Ren L. Exploring the interconnections of loneliness, anxiety, and depression among nursing students: a network analysis approach. Front Psychiatry. 2025;16:1537935.","journal-title":"Front Psychiatry"},{"key":"3181_CR31","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams J. The phq-9 - validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606\u2013613.","journal-title":"J Gen Intern Med"},{"key":"3181_CR32","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1016\/S2213-2600(22)00126-6","volume":"10","author":"L Huang","year":"2022","unstructured":"Huang L, Li X, Gu X, Zhang H, Ren L, Guo L, et al. Health outcomes in people 2 years after surviving hospitalisation with covid-19: a longitudinal cohort study. Lancet Respir Med. 2022;10:863\u2013876.","journal-title":"Lancet Respir Med"},{"key":"3181_CR33","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","volume":"166","author":"RL Spitzer","year":"2006","unstructured":"Spitzer RL, Kroenke K, Williams JBW, Loewe B. A brief measure for assessing generalized anxiety disorder -: the gad-7. Arch Intern Med. 2006;166:1092\u20131097.","journal-title":"Arch Intern Med"},{"key":"3181_CR34","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.jad.2022.05.079","volume":"311","author":"X Huang","year":"2022","unstructured":"Huang X, Ma H, Wang X, Zhong J, Sheng D, Xu M. Equating the phq-9 and gad-7 to the Hads depression and anxiety subscales in patients with major depressive disorder. J Affect Disord. 2022;311:327\u2013335.","journal-title":"J Affect Disord"},{"key":"3181_CR35","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1177\/0022022102033005003","volume":"33","author":"WB Schaufeli","year":"2002","unstructured":"Schaufeli WB, Mart\u00ednez IM, Pinto AM, Salanova M, Bakker AB. Burnout and engagement in university students -: a cross-national study. J Cross Cult Psychol. 2002;33:464\u2013481.","journal-title":"J Cross Cult Psychol"},{"key":"3181_CR36","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.nedt.2016.11.017","volume":"49","author":"L Meng","year":"2017","unstructured":"Meng L, Jin Y. A confirmatory factor analysis of the Utrecht work engagement scale for students in a Chinese sample. Nurse Educ Today. 2017;49:129\u2013134.","journal-title":"Nurse Educ Today"},{"key":"3181_CR37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v048.i04","volume":"48","author":"S Epskamp","year":"2012","unstructured":"Epskamp S, Cramer AOJ, Waldorp LJ, Schmittmann VD, Borsboom D. Qgraph: network visualizations of relationships in psychometric data. J Stat Softw. 2012;48:1\u201318.","journal-title":"J Stat Softw"},{"key":"3181_CR38","doi-asserted-by":"publisher","first-page":"195","DOI":"10.3758\/s13428-017-0862-1","volume":"50","author":"S Epskamp","year":"2018","unstructured":"Epskamp S, Borsboom D, Fried EI. Estimating psychological networks and their accuracy: a tutorial paper. Behav Res Methods. 2018;50:195\u2013212.","journal-title":"Behav Res Methods"},{"key":"3181_CR39","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1111\/j.2517-6161.1996.tb02080.x","volume":"58","author":"R Tibshirani","year":"1996","unstructured":"Tibshirani R. Regression shrinkage and selection via the Lasso. J R Stat Soc Ser B Stat Methodol. 1996;58:267\u2013288.","journal-title":"J R Stat Soc Ser B Stat Methodol"},{"key":"3181_CR40","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1093\/biomet\/asn034","volume":"95","author":"J Chen","year":"2008","unstructured":"Chen J, Chen Z. Extended bayesian information criteria for model selection with large model spaces. Biometrika. 2008;95:759\u2013771.","journal-title":"Biometrika"},{"issue":"8","key":"3181_CR41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v093.i08","volume":"93","author":"JMB Haslbeck","year":"2020","unstructured":"Haslbeck JMB, Waldorp LJ. Mgm: estimating time-varying mixed graphical models in high-dimensional data. J Stat Softw. 2020;93(8):1\u201346.","journal-title":"J Stat Softw"},{"key":"3181_CR42","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1037\/abn0000181","volume":"125","author":"DJ Robinaugh","year":"2016","unstructured":"Robinaugh DJ, Millner AJ, Mcnally RJ. Identifying highly influential nodes in the complicated grief network. J Abnorm Psychol. 2016;125:747\u2013757.","journal-title":"J Abnorm Psychol"},{"key":"3181_CR43","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1080\/00273171.2019.1614898","volume":"56","author":"PJ Jones","year":"2021","unstructured":"Jones PJ, Ma R, Mcnally RJ. Bridge centrality: a network approach to Understanding comorbidity. Multivar Behav Res. 2021;56:353\u2013367.","journal-title":"Multivar Behav Res"},{"key":"3181_CR44","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.jad.2019.11.121","volume":"263","author":"WJ Gao","year":"2020","unstructured":"Gao WJ, Ping SQ, Liu XQ. Gender differences in depression, anxiety, and stress among college students: a longitudinal study from China. J Affect Disord. 2020;263:292\u2013300.","journal-title":"J Affect Disord"},{"key":"3181_CR45","doi-asserted-by":"publisher","first-page":"113521","DOI":"10.1016\/j.socscimed.2020.113521","volume":"265","author":"F Bu","year":"2020","unstructured":"Bu F, Steptoe A, Fancourt D. Loneliness during a strict lockdown: trajectories and predictors during the covid-19 pandemic in 38,217 united Kingdom adults. Soc Sci Med. 2020;265:113521.","journal-title":"Soc Sci Med"},{"key":"3181_CR46","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1037\/met0000476","volume":"28","author":"CD van Borkulo","year":"2023","unstructured":"van Borkulo CD, van Bork R, Boschloo L, Kossakowski JJ, Tio P, Schoevers RA, et al. Comparing network structures on three aspects: a permutation test. Psychol Methods. 2023;28:1273\u20131285.","journal-title":"Psychol Methods"},{"issue":"1","key":"3181_CR47","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1186\/s12888-023-05442-z","volume":"23","author":"J Huang","year":"2023","unstructured":"Huang J, Liu X. Anxiety, depression, and their comorbidity among Chinese college students during the covid-19 lockdown in the post-epidemic era: an online cross-sectional survey. BMC Psychiatry. 2023;23(1):923.","journal-title":"BMC Psychiatry"},{"key":"3181_CR48","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.jad.2023.08.026","volume":"340","author":"Z Hu","year":"2023","unstructured":"Hu Z, Li W, Ye Y, Zhang F, Liu H, Chen X, et al. Alterations of functional connectivity in young people with depression mediate the relationship between sleep quality and cognitive function. J Affect Disord. 2023;340:160\u2013166.","journal-title":"J Affect Disord"},{"key":"3181_CR49","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1001\/jamapsychiatry.2018.1941","volume":"75","author":"W Cheng","year":"2018","unstructured":"Cheng W, Rolls ET, Ruan H, Feng J. Functional connectivities in the brain that mediate the association between depressive problems and sleep quality. Jama Psychiatry. 2018;75:1052\u20131061.","journal-title":"Jama Psychiatry"},{"key":"3181_CR50","doi-asserted-by":"publisher","first-page":"7561","DOI":"10.1017\/S0033291723001290","volume":"53","author":"O Bekkevold","year":"2023","unstructured":"Bekkevold O, Damas JK, Brumpton BM, Asvold BO. The causal role of c-reactive protein and interleukin-6 on anxiety and depression symptoms and life satisfaction: Mendelian randomisation analyses in the Hunt study. Psychol Med. 2023;53:7561\u20137568.","journal-title":"Psychol Med"},{"key":"3181_CR51","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1001\/jamainternmed.2022.2194","volume":"182","author":"M Nguyen","year":"2022","unstructured":"Nguyen M, Chaudhry S, Desai MM, Chen C, Mason HRC, Mcdade WA, et al. Association of sociodemographic characteristics with Us medical student attrition. Jama Intern Med. 2022;182:917\u2013924.","journal-title":"Jama Intern Med"},{"key":"3181_CR52","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.jad.2023.09.034","volume":"344","author":"H Sun","year":"2024","unstructured":"Sun H, Zhao Y, Sha S, Li X, Si TL, Liu Y, et al. Depression and anxiety among caregivers of psychiatric patients during the late stage of the covid-19 pandemic: a perspective from network analysis. J Affect Disord. 2024;344:33\u201340.","journal-title":"J Affect Disord"},{"issue":"1","key":"3181_CR53","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1186\/s12888-021-03276-1","volume":"21","author":"L Ren","year":"2021","unstructured":"Ren L, Wang Y, Wu L, Wei Z, Cui L, Wei X, et al. Network structure of depression and anxiety symptoms in Chinese female nursing students. BMC Psychiatry. 2021;21(1):279.","journal-title":"BMC Psychiatry"},{"key":"3181_CR54","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.jad.2020.03.078","volume":"271","author":"S Park","year":"2020","unstructured":"Park S, Kim D. The centrality of depression and anxiety symptoms in major depressive disorder determined using a network analysis. J Affect Disord. 2020;271:19\u201326.","journal-title":"J Affect Disord"},{"key":"3181_CR55","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.jad.2023.05.013","volume":"335","author":"Y Zhang","year":"2023","unstructured":"Zhang Y, Luo M, Ouyang J, Chen Y, Xia H, Yang F, et al. The influence of changes in the Chinese covid-19 prevention and control policies on mental health of medical staff: a network analysis. J Affect Disord. 2023;335:10\u201317.","journal-title":"J Affect Disord"},{"issue":"1","key":"3181_CR56","doi-asserted-by":"publisher","first-page":"fcab297","DOI":"10.1093\/braincomms\/fcab297","volume":"4","author":"JB Badenoch","year":"2022","unstructured":"Badenoch JB, Rengasamy ER, Watson C, Jansen K, Chakraborty S, Sundaram RD, et al. Persistent neuropsychiatric symptoms after covid-19: a systematic review and meta-analysis. Brain Commun. 2022;4(1):fcab297.","journal-title":"Brain Commun"},{"issue":"6","key":"3181_CR57","doi-asserted-by":"publisher","first-page":"e28892","DOI":"10.2196\/28892","volume":"23","author":"DL Mack","year":"2021","unstructured":"Mack DL, Dasilva AW, Rogers C, Hedlund E, Murphy E, Vojdanovski V, et al. Mental health and behavior of college students during the covid-19 pandemic: longitudinal mobile smartphone and ecological momentary assessment study, part Ii. J Med Internet Res. 2021;23(6):e28892.","journal-title":"J Med Internet Res"},{"issue":"8","key":"3181_CR58","doi-asserted-by":"publisher","first-page":"1918","DOI":"10.1007\/s10964-024-01961-4","volume":"53","author":"C Zhang","year":"2024","unstructured":"Zhang C, Huang J, Xu W. Longitudinal relationships between depressive symptoms and generalized anxiety symptoms in adolescents: a cross-lagged network analysis. J Youth Adolesc. 2024;53(8):1918\u20131927.","journal-title":"J Youth Adolesc"},{"issue":"8","key":"3181_CR59","doi-asserted-by":"publisher","first-page":"4089","DOI":"10.3390\/ijerph18084089","volume":"18","author":"K Zhang","year":"2021","unstructured":"Zhang K, Peng Y, Zhang X, Li L. Psychological burden and experiences following exposure to covid-19: a qualitative and quantitative study of Chinese medical student volunteers. Int J Environ Res Public Health. 2021;18(8):4089.","journal-title":"Int J Environ Res Public Health"},{"key":"3181_CR60","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1186\/s12909-021-02955-7","volume":"21","author":"S Passemard","year":"2021","unstructured":"Passemard S, Faye A, Dubertret C, Peyre H, Vorms C, Boimare V, et al. Covid-19 crisis impact on the next generation of physicians: a survey of 800 medical students. Bmc Med Educ. 2021;21:529.","journal-title":"Bmc Med Educ"},{"key":"3181_CR61","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1186\/s12909-020-02462-1","volume":"21","author":"AJ Harries","year":"2021","unstructured":"Harries AJ, Lee C, Jones L, Rodriguez RM, Davis JA, Boysen-Osborn M, et al. Effects of the covid-19 pandemic on medical students: a multicenter quantitative study. Bmc Med Educ. 2021;21:529.","journal-title":"Bmc Med Educ"},{"key":"3181_CR62","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/j.jad.2022.12.051","volume":"328","author":"W Bai","year":"2023","unstructured":"Bai W, Xi H, Zhu Q, Ji M, Zhang H, Xiang B, et al. Network analysis of anxiety and depressive symptoms among nursing students during the covid-19 pandemic (294, Pg 753, 2021). J Affect Disord. 2023;328:355.","journal-title":"J Affect Disord"},{"key":"3181_CR63","doi-asserted-by":"publisher","first-page":"e47233","DOI":"10.2196\/47233","volume":"9","author":"J Li","year":"2023","unstructured":"Li J, Jin Y, Xu S, Wilson A, Chen C, Luo X, et al. Effects of bullying on anxiety, depression, and posttraumatic stress disorder among sexual minority youths: network analysis. Jmir Public Health Surveill. 2023;9:e47233.","journal-title":"Jmir Public Health Surveill"},{"key":"3181_CR64","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.jad.2012.08.010","volume":"145","author":"ML Reyes-Rodriguez","year":"2013","unstructured":"Reyes-Rodriguez ML, Riyera-Medina CL, Camara-Fuentes L, Suarez-Torres A, Bernal G. Depression symptoms and stressful life events among college students in Puerto Rico. J Affect Disord. 2013;145:324\u2013330.","journal-title":"J Affect Disord"},{"issue":"1","key":"3181_CR65","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1186\/s12888-022-04372-6","volume":"22","author":"FK Almarri","year":"2022","unstructured":"Almarri FK, Alaseem AM, Alanazi MS, Alyahya S, Alsanad NH, Alswayed KE, et al. Prevalence of Pharmacological and non - Pharmacological coping mechanisms for anxiety management during the covid-19 pandemic: investigating the transition to online learning among medical students. BMC Psychiatry. 2022;22(1):704.","journal-title":"BMC Psychiatry"},{"key":"3181_CR66","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1016\/j.neubiorev.2019.08.017","volume":"108","author":"F Dolcos","year":"2020","unstructured":"Dolcos F, Katsumi Y, Moore M, Berggren N, de Gelder B, Derakshan N, et al. Neural correlates of emotion-attention interactions: from perception, learning, and memory to social cognition, individual differences, and training interventions. Neurosci Biobehav Rev. 2020;108:559\u2013601.","journal-title":"Neurosci Biobehav Rev"},{"issue":"1","key":"3181_CR67","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1186\/s12909-024-05478-z","volume":"24","author":"J Sanchez","year":"2024","unstructured":"Sanchez J, Lesmes M, Rubio M, Gal B, Tutor AS. Enhancing academic performance and student engagement in health education: insights from work station learning activities (wsla). Bmc Med Educ. 2024;24(1):496.","journal-title":"Bmc Med Educ"},{"key":"3181_CR68","doi-asserted-by":"crossref","unstructured":"Hu Y, Fang C, Wu J, Mi L, Dai P. Investigating the interrelationship among academic emotions, classroom engagement, and self-efficacy in the context of Efl learning in smart classrooms in China. Aust J Psychol. 2024; 76(1):2300460.","DOI":"10.1080\/00049530.2023.2300460"},{"key":"3181_CR69","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1016\/j.jad.2024.09.116","volume":"368","author":"J Sinval","year":"2025","unstructured":"Sinval J, Oliveira P, Novais F, Almeida CM, Telles-Correia D. Exploring the impact of depression, anxiety, stress, academic engagement, and dropout intention on medical students\u2019 academic performance: a prospective study. J Affect Disord. 2025;368:665\u2013673.","journal-title":"J Affect Disord"},{"issue":"13","key":"3181_CR70","doi-asserted-by":"publisher","first-page":"7825","DOI":"10.3390\/ijerph19137825","volume":"19","author":"S Cao","year":"2022","unstructured":"Cao S, Geok SK, Roslan S, Qian S, Sun H, Lam SK, et al. Mindfulness-based interventions for the recovery of mental fatigue: a systematic review. Int J Environ Res Public Health. 2022;19(13):7825.","journal-title":"Int J Environ Res Public Health"},{"key":"3181_CR71","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1080\/14737175.2020.1804870","volume":"20","author":"F Cosci","year":"2020","unstructured":"Cosci F, Guidi J, Mansueto G, Fava GA. Psychotherapy in recurrent depression: efficacy, pitfalls, and recommendations. Expert Rev Neurother. 2020;20:1169\u20131175.","journal-title":"Expert Rev Neurother"},{"key":"3181_CR72","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1002\/wps.20038","volume":"12","author":"P Cuijpers","year":"2013","unstructured":"Cuijpers P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry. 2013;12:137\u2013148.","journal-title":"World Psychiatry"},{"key":"3181_CR73","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1002\/wps.20089","volume":"13","author":"P Cuijpers","year":"2014","unstructured":"Cuijpers P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry. 2014;13:56\u201367.","journal-title":"World Psychiatry"}],"container-title":["BMC Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40359-025-03181-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40359-025-03181-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40359-025-03181-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T05:01:33Z","timestamp":1757307693000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpsychology.biomedcentral.com\/articles\/10.1186\/s40359-025-03181-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,26]]},"references-count":73,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3181"],"URL":"https:\/\/doi.org\/10.1186\/s40359-025-03181-2","relation":{},"ISSN":["2050-7283"],"issn-type":[{"value":"2050-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,26]]},"assertion":[{"value":"2 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Our study adheres to the ethical principles set forth in the Declaration of Helsinki and has received approval from the Ethics Review Board of Zhengzhou University (ZZUIRB2022-06), including the approval of electronic consent procedures. Informed consent was obtained from all subjects participating in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"838"}}