Central and bridge symptoms of anxiety, depression, and fear of disease progression in Saudi patients with chronic diseases: A network analysis

Anxiety, depression, and fear of disease progression commonly co-occur in patients with chronic diseases, yet, to our knowledge, no previous study has used network analysis to identify the central and bridge symptoms linking these domains in Saudi patients. This study examined symptom interrelationships in 271 Saudi patients with chronic diseases recruited from multiple health centers in Jeddah and Riyadh. Participants completed the PHQ-9, GAD-7, and the Fear of Progression Questionnaire–Short Form. Network analysis showed that nervousness/anxiety, little interest or pleasure in doing things, and fear of being unable to pursue hobbies were the most central symptoms. The main bridge symptoms were restlessness, fear that something awful might happen, inability to control worry, and little interest or pleasure in doing things. Elevated depressive, anxiety, and fear of disease progression symptoms were reported by 55.7%, 56.8%, and 88.5% of participants, respectively. These findings identify potential symptom-level intervention targets.