Symptom comorbidity networks in psychiatry

Network theories of psychopathology suggest that psychopathology is the result of cyclic and causal relationships between individual symptoms, which may also be influenced by distinct environmental, biological or clinical factors. For example, a network framework might identify that a certain symptom (e.g. anxiety) triggers other symptoms (e.g. paranoia), that certain symptoms reinforce each other through feedback systems (e.g. sleep disturbance leading to worry, and worry leading to sleep disturbance), or indirectly through a third symptom (e.g. sleep disturbance influencing depression through worry), and that certain symptoms (e.g. inattention or arousal) may be particularly important, connecting to a number of different symptoms in a network. These models have important implications for understanding unique and causal relations between symptoms or other psychobiological factors, and for identifying potential symptoms for intervention.

Early-life adversity or childhood trauma is a well-known risk factor for psychopathology, including the development and course of psychotic disorders. Network analysis provides an advanced method to understand the relationship between different forms of early-life adversity and psychotic symptoms in young people.

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Further research and key questions

• Understand causal links between psychopathology and environmental factors, including childhood trauma and early-life adversity
• Identify modifiable risk and resilience factors that exert a causal influence on psychopathology