Original ArticlesThe Role of Depressive Symptoms in Suicide Attempt in Rural ChinaJiang, Zhuoye PhD*; Liu, Yanzheng MD†; Zhang, Jie PhD†‡; Lamis, Dorian A. PhD§Author Information *University of Science and Technology Beijing, College of Humanities and Social Sciences, Beijing; †Shandong University School of Public Health Center for Suicide Prevention Research, Jinan, Shandong, China; ‡State University of New York Buffalo State, New York; and §Emory University School of Medicine, Atlanta, Georgia. Send reprint requests to Jie Zhang, PhD, Department of Sociology, State University of New York College at Buffalo, 1300 Elmwood Ave, Buffalo, NY 14222. E-mail: [email protected]. The research was supported by the US National Institute of Mental Health: R01 MH068560. The Journal of Nervous and Mental Disease: July 2019 - Volume 207 - Issue 7 - p 561-568 doi: 10.1097/NMD.0000000000001006 Buy Metrics Abstract Depression is a well-established predictor of suicidal behaviors, yet its effects among Chinese rural suicide attempters are understudied. In this study, we examined the role of depressive symptoms with other common risk factors, such as impulsivity, among medically serious suicide attempters. A case-controlled study was conducted in 13 rural counties in China. Medically serious suicide attempters (n = 791) and 791 nonsuicidal controls matched for sex and age range (±3 years) in the same location were recruited and interviewed to obtain information with regard to demographics, depressive symptom severity, and psychological strain measures. Both depressive symptoms, assessed with the Center for Epidemiological Studies Depression Scale, and psychological strains predicted suicide attempt risk, and psychological strains significantly predicted depressive symptoms. Depressive symptoms fully mediated the relations between value strain, deprivation strain, and suicide attempt risk, and partially mediated the associations among aspiration strain, coping strain, and suicide attempt risk. The reduction of psychological strains may help decrease both depression and suicidal behaviors. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.