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Backgrounds Insomnia is frequent in schizophrenia and is found to be negatively affected by stressful life events, psychotic symptoms and depressive disorder, while the relationship among the four remains understudied in community-dwelling patients with schizophrenia. Objective To analyze the effect of stressful life events on insomnia in community-dwelling patients with schizophrenia, and to explore the mediation effect of psychotic symptoms and depression, so as to provide references for the intervention of insomnia in community-dwelling patients with schizophrenia. Methods From April to June 2023, a sample of 1 105 patients with schizophrenia attending 48 community health centers in Chengdu, Sichuan province and fulfilling the International Classification of Diseases, tenth edition (ICD-10）diagnostic criteria were included. All subjects were assessed using Stressful Life Event Scale (SLEs), Athens Insomnia Scale (AIS), Psychosis Screening Questionnaire (PSQ), and Patient Health Questionnaire Depression Scale (PHQ-9). Spearman correlation analysis was used to determine the correlation among the scales. Then the mediation model was constructed using Smart PLS 4. 0, and tested with partial least squares algorithm and Bootstrap techniques. Results 332 patients (30. 05%） with community schizophrenia were found to have insomnia. AIS scores in patients with schizophrenia were positively correlated with the scores on SLEs, PSQ and PHQ-9 (r=0. 165, 0. 322, 0. 554, P<0. 01). Stressful life events indirectly contributed to insomnia through both separate mediation path and chained mediation path of psychotic symptoms and depressive disorder, and the indirect effect size of 0. 102, 0. 372 and 0. 190 was obtained, accounting for 10. 46%, 38. 15% and 19. 49%, respectively. Conclusion The stressful life events not only directly exert an impact on insomnia, but also indirectly contribute to insomnia through both the separate and chained mediation effect of psychotic symptoms and depressive disorder. [ABSTRACT FROM AUTHOR]

This article gives a review on domestic and foreign researches on the non-drug intervention for patients with perimenopausal depression published from 2012 to 2022, so as to provide a reference for clinical treatment and nursing. Currently, pharmacotherapy is the mainstay of treatment for perimenopausal depression, while many existing problems remain to be solved such as the variation in treatment effect and the difficulty in maintaining emotional stability. however, high safety and relatively low cost are the characteristics of non-drug intervention, so this article expounds on the non-drug intervention measures for perimenopausal depression, such as music therapy, dietary therapy, exercise therapy, acupuncture therapy and repetitive transcranial magnetic stimulation （rTMS）. [ABSTRACT FROM AUTHOR]