Abstract
BACKGROUND: Bus drivers face complex work challenges and high infection risks, particularly heightened during the COVID-19 pandemic, which significantly affects their mental health. This study used network analysis to conduct a longitudinal follow-up of the psychological symptom network of bus drivers, utilizing the Symptom Checklist-90-Revised (SCL-90-R). DESIGN: A repeated-measures self-controlled observational design was used to survey 1,600 intercity bus drivers in a city in southern Anhui, China, in September 2022 and January 2023, respectively, and participant data were analyzed using regularized partial correlation network analysis. RESULTS: A total of 1134 (74.56%) completed the two surveys, 1121 (98.9%) were male, with a mean age of 47.3 ± 6.27 years, and all had junior high school education and above. The results showed a significant reduction in the severity of psychological symptoms among bus drivers the second time around. Anxiety remained the core symptom in the network; however, depression emerged as a secondary core symptom following the relaxation of policies related to COVID-19. Additionally, the weights of significant edges in the symptom network also changed. CONCLUSION: Although this study lacked causal inference and relied on self-reported symptoms, it reveals changes in bus drivers' psychological symptom networks under two psychological physical examinations, highlighting the implications of COVID-19 and subsequent policy changes for future research and intervention to improve mental health among this population.