Network analysis of depression and anxiety symptoms and their associations with psychological help-seeking delay among Chinese university students

Abstract

Network analysis provides a novel approach to examining associations among mental health symptoms. This study explored the network structure of depression and anxiety symptoms and their relationship with psychological help-seeking delay among Chinese university students. 823 students completed the 20-item General Health Questionnaire and the Help-Seeking Delay Scale. Centrality and bridge centrality indices identified central and bridge symptoms, and stability was assessed via case-dropping bootstrap. Overwhelm, Restless and tension, and Mental strain were the most central symptoms. Perceiving life-as-battle (GHQ-D6) and feeling overwhelmed (GHQ-A5) emerged as key bridge symptoms. Irritability affects sleep (GHQ-A2), Overwhelm (GHQ-A5), and Mental strain (GHQ-A4) were strongly associated with delayed help-seeking. These findings suggest that anxiety-related symptoms, particularly Overwhelm, may be critical intervention targets for students with comorbid depression and anxiety. From a network perspective, anxiety symptoms may play a relatively stronger role than depressive symptoms in understanding psychological help-seeking delays in university populations.