Symptom Networks of Depression and Anxiety in Patients With a History of Hemorrhoids: Evidence From the UK Biobank
Author(s)
Zhiguang HUANG, Msc, Xinchang Liu, MS, Yan HE, Msc, Xinyao YI, MSc, zhenjie yu, Msc, Wai-kit Ming, MPH, PhD, MD.
City University of Hong Kong, Hong Kong, China.
City University of Hong Kong, Hong Kong, China.
OBJECTIVES: While hemorrhoidal disease carries substantial psychological burden, the symptom-level interplay between depression and anxiety remains uncharacterized. This network analysis aims to identify core symptoms driving psychosomatic interactions in hemorrhoid patients and test structural invariance across gender and time intervals to guide precision interventions.
METHODS: Using UK Biobank data from 10,482 hemorrhoid patients, we constructed Gaussian Graphical Models (GGMs) with PHQ-9/GAD-7 items. Centrality metrics (strength/betweenness/closeness) and network comparisons (gender/time interval subgroups) were analyzed via EBIC-glasso regularization and 1,000-bootstrap NetworkComparisonTest.
RESULTS: The stable network (CS-coefficient=0.75) featured "Sad mood" (PHQ2: strength=1.41), "Nervousness" (GAD1: strength=1.33), and "Too much worry" (GAD3: betweenness=2.54) as bridges between depression/anxiety communities. Gender-specific architectures emerged: women showed stronger "Anhedonia-Sad mood" links (diff=0.21,p<0.001), men exhibited enhanced "Appetite-Motor" connections (diff=0.18,p=0.003). No significant differences existed across time interval subgroups.
CONCLUSIONS: "Sad mood" and "Too much worry" represent pivotal treatment targets in hemorrhoid-related psychopathology. Gender-tailored strategies—emotion-focused therapies for women, behavioral activation for men—may disrupt pain-distress cycles. Network psychiatry principles could optimize proctological care for this underserved population.
METHODS: Using UK Biobank data from 10,482 hemorrhoid patients, we constructed Gaussian Graphical Models (GGMs) with PHQ-9/GAD-7 items. Centrality metrics (strength/betweenness/closeness) and network comparisons (gender/time interval subgroups) were analyzed via EBIC-glasso regularization and 1,000-bootstrap NetworkComparisonTest.
RESULTS: The stable network (CS-coefficient=0.75) featured "Sad mood" (PHQ2: strength=1.41), "Nervousness" (GAD1: strength=1.33), and "Too much worry" (GAD3: betweenness=2.54) as bridges between depression/anxiety communities. Gender-specific architectures emerged: women showed stronger "Anhedonia-Sad mood" links (diff=0.21,p<0.001), men exhibited enhanced "Appetite-Motor" connections (diff=0.18,p=0.003). No significant differences existed across time interval subgroups.
CONCLUSIONS: "Sad mood" and "Too much worry" represent pivotal treatment targets in hemorrhoid-related psychopathology. Gender-tailored strategies—emotion-focused therapies for women, behavioral activation for men—may disrupt pain-distress cycles. Network psychiatry principles could optimize proctological care for this underserved population.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD219
Topic Subcategory
Distributed Data & Research Networks
Disease
SDC: Mental Health (including addition)