The combined associations of depression and anxiety symptoms on medical students’ suicide attitudes: a network analysis

Abstract

Although previous studies have examined the combined associations of depressive and anxiety symptoms on the suicide attitudes of medical students, the number of such investigations is extremely limited. These studies have predominantly employed correlational analyses to conduct a preliminary exploration, which fails to elucidate the intricate relationship between depressive and anxiety symptoms and suicide attitudes. Moreover, these approaches do not adequately identify the core symptoms or dimensions that influence suicide attitudes. The network analysis utilized in the present study addresses these limitations associated with correlational analyses. This study employed the Suicide Attitude Questionnaire, Self-Rating Depression Scale, and Self-Rating Anxiety Scale to investigate 1,667 first- and second-year medical students at a medical university. Regression analysis and network analysis were combined to explore the joint associations of depression and anxiety on medical students’ suicide attitudes. The results indicated that anxiety was significantly associated with suicide attitudes among medical students, while the dimension of depressive disorders (DD) exhibited the highest centrality in the interaction network of depression, anxiety, and suicide attitudes, serving as the core hub node with the most prominent connection strength to psychomotor disorders (PD). The study indicates that depression, anxiety, and suicide attitudes among medical students are characterized by complex multidimensional associations, with depressive disorders acting as the central hub in their interactions. These findings provide scientific evidence and specific targets for medical universities to implement precision mental health interventions, suicide prevention, and life education programs.