Suicide ideation and anhedonia among clinically stable adolescents with the recurrent depressive disorder during the COVID-19 pandemic: A network perspective

Background: Anhedonia is a suicide risk factor among adolescent patients with recurrent depressive disorder (depression hereafter). This study examined associations between suicidal ideation (SI) and residual depressive symptoms (RSD), including anhedonia, among clinically stable adolescents with depression.Method: A network analysis was performed to examine the association between RDS and SI among adolescents with depression. Node-specific predictive betweenness was computed to examine short paths between anhedonia and SI. Additionally, a Network Comparison Test (NCT) was conducted to examine gender differences in derived network model characteristics.Results: The network analysis identified close associations of PHQ9 (Suicide ideation) with PHQ1 (Anhe-donia) as well as some other RDS including PHQ6 (Guilt), PHQ2 (Sad mood) and PHQ8 (Motor distur-bances). Additionally, PHQ2 (Sad mood) and PHQ4 (Fatigue) were the main bridge nodes linking anhedonia and SI. Comparisons of network models did not find significant differences in network global strength or edge weights.Limitation: Causal relations between anhedonia and SI could not be determined due to the cross-sectional study design.Conclusions: SI was directly related to Anhedonia in addition to Guilt, Sad mood and Motor disturbances. Sad mood and Fatigue were the main bridge nodes linking Anhedonia and SI. To reduce the risk of SI among clin-ically stable adolescents with depression during the COVID-19 pandemic, specific RDS including Anhedonia, Guilt, Sad mood, Motor disturbances and Fatigue should be targeted in interventions.

Automated summary

This study found close associations between anhedonia and suicidal ideation (SI) among adolescent patients with recurrent depressive disorder (depression). Network analysis revealed that anhedonia was directly related to SI, as well as guilt, sad mood, and motor disturbances. Sad mood and fatigue were the main bridge nodes linking anhedonia and SI. This study is important for guiding interventions to reduce the risk of SI among clinically stable adolescents with depression during the COVID-19 pandemic.