Objective · To investigate the interaction among stress-related negative feelings, depressive symptoms and shape concern of the patients with anorexia nervosa (AN), and the mediating effect of depressive symptoms between negative feelings and shape concern. Methods · A total of 110 AN patients who met the diagnostic criteria of the Diagnosis and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) were recruited and their stress-related negative feelings were measured with Perceived Stress Scale (PSS), depressive symptoms were measured with Beck Depression Inventory (BDI), and shape concern was measured with Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0). Pearson’s correlation test was used to examine the relation between the variables, and the Bootstrap method was used to test the mediating effect of depressive symptoms between negative feelings and shape concern. Results · Negative feelings of the AN patients were positively correlated with depressive symptoms and shape concern (r=0.537, r=0.729, both P=0.000), and depressive symptoms were positively correlated with shape concern (r=0.614, P=0.000). The mediating effect analysis showed that the mediating role of depressive symptoms between negative feelings and shape concern was 0.332 (95%CI 0.156-0.535), with the mediating effect ratio of 61.673%. Conclusion · The depressive symptoms of the AN patients may play a mediating effect between negative feelings and shape concern, and the mediating effect is greater than the direct effect.