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World J Psychiatry. Oct 19, 2026; 16(10): 121129
Published online Oct 19, 2026. doi: 10.5498/wjp.121129
Published online Oct 19, 2026. doi: 10.5498/wjp.121129
Depression and anxiety in Chinese expatriate employees in Misan oilfield in Iraq: A structural equation modeling approach
Hong-Ye Liu, Department of Psychiatry, Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201999, China
Jing Du, Yi Fu, Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
Xing-Hua Xie, Shun Han, QHSE Department, China National Offshore Oil Corporation Iraq Limited, Beijing 100010, China
Chun-E Zhang, Department of Operations, HYGEA Health Management (Shanghai) Co., Ltd, Shanghai 200241, China
Mei-Hui Li, Labor Union Office, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
Qing-Wei Li, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
Co-first authors: Hong-Ye Liu and Jing Du.
Co-corresponding authors: Shun Han and Qing-Wei Li.
Author contributions: Li QW and Han S initiated, supervised, and reviewed the study and manuscript, contributed equally to this work as co-corresponding authors; Xie XH, Zhang CE, and Fu Y designed the questionnaire and collected data; Li MH supervised the study and collected data; Liu HY and Du J analyzed the data and wrote the manuscript, contributed equally to this work as co-first authors; all the authors have approved the manuscript.
AI contribution statement: No AI tools were used.
Supported by Shanghai Key Support Discipline, No. 2023ZDFC0502; Psychosomatic Medicine Project of Key Developing Disciplines of Shanghai Municipal Health Commission, No. 2019ZB0202; and Three-Year Initiative Plan for Strengthening Public Health System Construction in Shanghai, No. GWV-10.2-XD29.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Shanghai Tongji Hospital.
Informed consent statement: All study participants or their legal guardians provided written informed consent before enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: The datasets used in this study are available from the corresponding author upon reasonable request.
Corresponding author: Qing-Wei Li, MD, Chief Physician, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No. 600 South Wanping Road, Xuhui District, Shanghai 200030, China. lianocd@tongji.edu.cn
Received: April 22, 2026
Revised: May 20, 2026
Accepted: June 22, 2026
Published online: October 19, 2026
Processing time: 170 Days and 24 Hours
Revised: May 20, 2026
Accepted: June 22, 2026
Published online: October 19, 2026
Processing time: 170 Days and 24 Hours
Core Tip
Core Tip: This study reveals a high prevalence of depression and anxiety symptoms in Chinese expatriate oil industry workers in Iraq. Such symptoms are associated with modifiable factors including smoking, drinking alcohol, shift work and excessive overtime work. Importantly, structural equation model analysis revealed that local social environment and occupational stress in Iraq can affect mental health directly or indirectly, mainly through the mediating effect of job burnout. The above findings suggest that interventions targeting job burnout may help alleviate the adverse psychological impacts of harsh working environments on this population.