Depression and anxiety in Chinese expatriate employees in Misan oilfield in Iraq: A structural equation modeling approach

doi:10.5498/wjp.121129

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Oct 19, 2026; 16(10): 121129
Published online Oct 19, 2026. doi: 10.5498/wjp.121129

Table 1 General characteristics of the participants, n (%)/mean ± SD

Latent variables	Category			Range		PHQ-9			GAD-7
Latent variables	Category			Range			Levene	F/r		Levene	F/r
Demographic characteristics
Sex	Male	802 (98.89)				3.44 ± 3.87	2.42	0.51	2.23 ± 3.24	5.26^b	2.55
Sex	Female	9 (1.11)				2.78 ± 2.17	2.42	0.51	1.11 ± 1.27	5.26^b	2.55
Age (years)	Total			21-59	40.03 ± 7.27			-0.07			-0.07
	18-25	23 (2.84)				4.3 ± 3.66	1.60	0.96	3.43 ± 3.65	2.63^b	2.20
	26-35	185 (22.81)				3.58 ± 3.65			2.35 ± 3.04
	36-45	409 (50.43)				3.35 ± 3.77			2.04 ± 3.13
	46-55	182 (22.44)				3.25 ± 3.92			2.19 ± 3.30
	56-60	12 (1.48)				4.92 ± 7.53			4.08 ± 5.95
Education	Junior high school and below	196 (24.17)				3.75 ± 5.04	13.01^c	3.45^b	2.55 ± 4.14	8.90^c	2.25
	High school/technical school	178 (21.95)				2.94 ± 3.78			1.80 ± 3.11
	Junior college^a^,^b	162 (19.98)				2.90 ± 2.91			1.98 ± 2.59
	Bachelor degree or above^a^,^b	275 (33.91)				3.83 ± 3.31			2.39 ± 2.86
Marriage	Single	61 (7.52)				4.18 ± 3.39	1.21	1.10	2.67 ± 3.22	1.28	0.46
	Love/engagement	24 (2.96)				4.04 ± 2.93			2.29 ± 2.20
	Married	707 (87.18)				3.34 ± 3.87			2.17 ± 3.23
	Divorce/widowhood	19 (2.34)				3.47 ± 5.18			2.32 ± 4.18
Children	Zero	107 (13.19)				4.26 ± 3.44	0.47	2.44	2.86 ± 3.25	1.44	1.98
	One	269 (33.17)				3.51 ± 4.06			2.17 ± 3.20
	Two	394 (48.58)				3.20 ± 3.78			2.13 ± 3.31
	Three or more	41 (5.06)				2.90 ± 3.97			1.63 ± 2.35
Smoking	Yes	431 (53.14)				3.70 ± 4.12	3.19	-2.11^b	2.35 ± 3.47	4.89^b	-1.32
Smoking	No	380 (46.86)				3.13 ± 3.50	3.19	-2.11^b	2.06 ± 2.93	4.89^b	-1.32
Drinking	Yes	256 (31.57)				4.07 ± 3.65	0.57	-3.24^c	2.64 ± 3.23	0.55	-2.58^b
Drinking	No	555 (68.43)				3.13 ± 3.91	0.57	-3.24^c	2.02 ± 3.21	0.55	-2.58^b
Exercise habit	Yes	722 (89.03)				3.42 ± 3.83	1.92	0.17	2.21 ± 3.23	2.00	0.24
Exercise habit	No	89 (10.97)				3.49 ± 4.00	1.92	0.17	2.29 ± 3.24	2.00	0.24
Job information
Vocational type	Manager	128 (15.78)				3.90 ± 3.65	0.91	1.47	2.84 ± 3.16	1.99	2.97
	Front-line workers	660 (81.38)				3.36 ± 3.92			2.11 ± 3.26
	Maintenance worker	23 (2.84)				2.70 ± 2.82			1.74 ± 2.07
Day and night shifts	Yes	252 (31.07)				3.30 ± 3.45	5.35^b	-0.69	1.85 ± 2.81	12.01^c	-2.31^b
Day and night shifts	No	559 (68.93)				3.49 ± 4.02	5.35^b	-0.69	2.38 ± 3.39	12.01^c	-2.31^b
Working days (current consecutive)				0-630	94.39 ± 101.23			0.04			0.05
Overtime hours/week (hour)			0-72	7.96 ± 9.72			0.14^c			0.13^c

^aP < 0.05, education level with a bachelor’s degree or above showed significantly higher Patient Health Questionnaire-9 scores than those with a junior college degree.

^bP < 0.05.

^cP < 0.01.

PHQ-9: Patient Health Questionnaire-9; GAD-7: Generalized Anxiety Disorder-7.

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Table 2 Descriptive statistics of the measured variables, mean ± SD

Latent variable	Range		Cronbach’s α	KMO	Bartlett’s test/χ² test	AVE	CR
PHQ-9	0-27	3.43 ± 3.85	0.89	0.92	3273.64^a	0.54	0.91
GAD-7	0-21	2.22 ± 3.23	0.92	0.93	3639.67^a	0.68	0.94
MBI-GS	0-55	18.22 ± 13.19	0.89	0.92	10333.69^a	0.71	0.97
COSS	17-66	39.07 ± 9.56	0.84	0.87	8311.17^a	0.70	0.97
ISP	0-25	4.98 ± 5.80	0.92	0.94	4781.64^a	0.6	0.94

^aP < 0.01.

PHQ: Patient Health Questionnaire-9; GAD-7: Generalized Anxiety Disorder-7; MBI-GS: Maslach Burnout Inventory General Survey; COSS: Core Occupational Stress Scale; ISP: Iraqi social pressure; KMO: Kaiser-Meyer-Olkin test; CR: Construct reliability; AVE: Average variance extracted.

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Table 3 Hypothetical model fit

	χ²	df	χ²/df	TLI	CFI	SRMR	RMSEA
Recommended criteria	-	-	< 3	> 0.9	> 0.9	< 0.05	< 0.08
Measurement model	1252.56	485.00	2.58	0.91	0.92	0.047	0.04
Hypothesized model	1863.86	485.00	3.84	0.90	0.91	0.047	0.06

TLI: Tucker-Lewis index; CFI: Comparative fit index; SRMR: Standardized root mean square residual; RMSEA: Root mean square error of approximation.

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Table 4 Standardized direct, indirect, and total effects

Pathways	Direct effect	Indirect effect	Total effect
Iraqi social environmental stress → depression	0.13^a	0.41^b	0.54^b
Occupational stress → depression	0.14^a	0.24^b	0.38^b
Job burnout → depression	0.57^b	-	0.57^b
Anxiety → depression	0.75^b	-	0.75^b
Iraqi social environmental stress → anxiety	0.03	0.47^b	-
Occupational stress → anxiety	0.08	0.32^b	-
Job burnout → anxiety	-0.04	0.49^b	-
Depression → anxiety	0.87^b	-	0.87^b
Iraqi social environmental stress → job burnout → depression	-	0.25^b	-
Iraqi social environmental stress → occupational stress → job burnout → depression	-	0.10^b	-
Occupational stress → job burnout → depression	-	0.24^b	-
Iraqi social environmental stress → depression → anxiety	-	0.11^b	-
Iraqi social environmental stress → job burnout → depression → anxiety	-	0.22^b	-
Iraqi social environmental stress → occupational stress → job burnout → depression → anxiety	-	0.08^b	-
Occupational stress → depression → anxiety	-	0.12^a	-
Occupational stress → job burnout → depression → anxiety	-	0.21^b	-
Job burnout → depression → anxiety	-	0.49^b	-

^aP < 0.05.

^bP < 0.01.

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Citation: Liu HY, Du J, Xie XH, Zhang CE, Fu Y, Li MH, Han S, Li QW. Depression and anxiety in Chinese expatriate employees in Misan oilfield in Iraq: A structural equation modeling approach. World J Psychiatry 2026; 16(10): 121129
URL: https://www.wjgnet.com/2220-3206/full/v16/i10/121129.htm
DOI: https://dx.doi.org/10.5498/wjp.121129

Liu HY, Du J, Xie XH, Zhang CE, Fu Y, Li MH, Han S, Li QW. Depression and anxiety in Chinese expatriate employees in Misan oilfield in Iraq: A structural equation modeling approach. World J Psychiatry 2026; 16(10): 121129 [DOI: 10.5498/wjp.121129]

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