Network Analysis of Burnout, Depression, and Insomnia Among Iranian Nurses Publisher



Kharatzadeh H ; Farahani H ; Khorasani P
Source: Journal of Workplace Behavioral Health Published:2026

Abstract

Although burnout, depression, and insomnia are three common concurrent psychological complaints among nurses, the interrelation between symptoms of these mental problems is unknown. This cross-sectional study was dedicated to investigating the symptom connection of burnout, depression, and insomnia among Iranian nurses through network analysis. Burnout, depression, and insomnia symptoms were assessed in 1,114 nurses using the Maslach Burnout Inventory (MBI), Patient Health Questionnaire (PHQ-9), and Insomnia Severity Index (ISI-7). The identification of central nodes was achieved through expected influence, while bridge expected influence facilitated the detection of bridges. Prevalence of moderate to high levels of depression (PHQ-9 ≥ 10), insomnia (ISI-7 ≥ 15), emotional exhaustion (≥ 18), inefficacy (≥ 9), and depersonalization (≥ 6) were 40.2%, 37%, 63.3%, 96.4%, and 44.1%, respectively. “Emotional exhaustion,” “sleep dissatisfaction,” “guilty,” “sleep problems,” and “worry about sleep” were identified as the most impactful nodes. Also, “sleep problems,” “emotional exhaustion,” “sleep dissatisfaction,” and “fatigue” were the key bridges linking burnout, depression, and insomnia. As such, these symptoms could be potential priority targets for integrated interventions aimed at reducing the overall burden of comorbid burnout, depression, and insomnia in nurses. © 2026 Taylor & Francis Group, LLC.