The effect of community stress and problems on psychopathology: A structural equation modeling study

This research aimed to estimate the effect of perceived social factors in the community stress and problems on the residents' psychopathology such as depression and suicidal behaviors. Subjects of this study were the informants (N=1618) in a psychological autopsy (PA) study with a case-control design. We interviewed two informants (a family member and a close friend) for 392 suicides and 416 living controls, which came from 16 rural counties randomly selected from three provinces of China. Community stress and problems were measured by the WHO SUPRE-MISS scale. Depression was measured by CES-D scale, and suicidal behavior was assessed by NCS-R scale. Multivariable liner and logistic regression models and the Structural Equation Modeling (SEM) were applied to probe the correlation of the depression and the suicidal behaviors with some major demographic variables as covariates. It was found that community stress and problems were directly associated with rural Chinese residents' depression (Path coefficient=0.127, P<0.001). There was no direct correlation between community stress and problem and suicidal behaviors, but community stress and problem can affect suicidal behaviors indirectly through depression. The path coefficient between depression and suicidal behaviors was 0.975. The current study predicts a new research viewpoint, that is, the depression is the intermediate between community stress and problem and suicidal behaviors. It might be an effective route to prevent depression directly and suicidal behaviors indirectly by reducing the community stress and problems.