Evidence map›Paper›PMID 42604203›Full record

ArticleNeuropsychiatric disease and treatment2026

Cross-Sectional Associations of Insomnia, Social Dysfunction, Suicidality, and Depressive Symptoms in Rural Adults with Schizophrenia: A Sex-Stratified Analysis.

Yuting Wang, Zhaoyang Cheng, Xiaoping Yuan, Yanling Liao, Su-Qi Song, Huanzhong Liu, Kai Zhang

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Article in Neuropsychiatric disease and treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

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7 authors.

Yuting Wang *Department of Psychiatry, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.ORCID 0009-0004-9962-8160
Zhaoyang Cheng *Department of Psychiatry, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Xiaoping YuanDepartment of Psychiatry, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Yanling Liao *Huainan Fourth People's Hospital, Huainan, People's Republic of China.
Su-Qi SongDepartment of Psychiatry, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.ORCID 0009-0003-2698-4765
Huanzhong LiuDepartment of Psychiatry, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Kai ZhangDepartment of Psychiatry, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Insomnia, social dysfunction, suicidality, and depressive symptoms commonly co-occur in schizophrenia. Their joint cross-sectional associations and potential sex differences among rural adults with schizophrenia remain unclear. Methods: This multicenter cross-sectional study included 931 rural adults with schizophrenia in Chaohu, China. Depressive symptoms, insomnia severity, social dysfunction, and suicidality were assessed using the Patient Health Questionnaire-9, Insomnia Severity Index, Social Disability Screening Schedule, and a composite suicidality score, respectively. Sex-stratified logistic regression and exploratory indirect-association analyses with 5,000 bootstrap resamples were conducted. A sensitivity analysis used a non-overlapping Patient Health Questionnaire-7 score excluding the sleep and suicidality items. Results: Of 931 participants, 457 were male and 474 were female. Female participants had higher depressive-symptom, insomnia, suicidality, and social-dysfunction scores than male participants (all P≤0.005). In both sex-stratified models, higher insomnia, suicidality, and social-dysfunction scores were associated with greater odds of at least mild depressive symptoms. In the exploratory model, insomnia severity was directly associated with depressive-symptom score (b=0.388, 95% bootstrap confidence interval [CI], 0.345-0.431). Indirect associations via social dysfunction (0.042, 95% CI, 0.028-0.057) and suicidality (0.038, 95% CI, 0.021-0.058) were supported, whereas the serial indirect association was not (0.002, 95% CI, -0.0001 to 0.005). Sex did not moderate the indirect associations. Conclusion: Women reported higher symptom and social-dysfunction scores than men, but sex did not moderate the estimated indirect associations. Insomnia, social dysfunction, suicidality, and depressive symptoms formed a clinically relevant cross-sectional pattern; however, temporal ordering and causality cannot be inferred. Longitudinal studies with non-overlapping measures and broader clinical covariates are needed.

Indexed as

depressive symptomsinsomniarural Chinaschizophreniasocial functioningsuicidality

Identifiers

PMID42604203
PMCPMC13477152

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.