| Backgrounds Insomnia is a common symptom in patients with schizophrenia. Negative life events, psychotic symptoms, and depression in patients may have a negative impact on insomnia. However, the relationship between the four needs to be further explored in community-based schizophrenia patients. Objective To analyse the effects of negative life events on insomnia in community schizophrenia patients, and to explore the chain-mediated roles of psychotic symptoms and depression in the relationship between the two, so as to provide a reference basis for the intervention of insomnia in community schizophrenia patients. Methods From April to June 2023, 1 105 patients with schizophrenia under the management of 48 community health centres in Chengdu, Sichuan Province were included. The Short-Life Event Scale (SLEs), the Athens Insomnia Scale (AIS), the Psychosis Screening Questionnaire (PSQ), and Patients’ Health Questionnaire Depression Scale-9 item (PHQ-9) were used for assessment. Pearson's correlation analysis was used to examine the correlation of the scale scores, and partial least squares and Bootstrap methods were used to test for mediating effects. Results Insomnia was detected in 332 (30.05%) community schizophrenic patients. AIS scores were positively correlated with SLEs score, PSQ score, and PHQ-9 score in patients with schizophrenia (r=0.165、0.322、0.554, P<0.01). Psychotic symptoms and depression partially mediate between negative life events and insomnia. Indirect effect values were 0.102 and 0.372, with effect shares of 10.46% and 38.15%, respectively. Psychotic symptoms and depression as chain mediators between negative life events and insomnia in community schizophrenics (chained path effect value was 0.190, and accounted for 19.49 %). Conclusion The negative life events causes an impact on insomnia both directly and indirectly through the chain mediating effect of Psychotic symptoms and depression. |