OBJECTIVES: Stigma is common among community-dwelling patients with schizophrenia and has a profound negative impact on both psychiatric symptoms and quality of life. This study aims to explore the association between stigma and quality of life in this population and to examine the multiple mediating roles of anxiety and depression symptoms. METHODS: The multi-stage stratified cluster random sampling method was used to select the community-dwelling patients with schizophrenics in Chengdu, Sichuan Province, China. The questionnaire included general demographic characteristics, stigma question, the Generalized Anxiety Disorder-7 (GAD-7) scale, the Patient Health Questionnaire-9 (PHQ-9), and the 12-item Short Form Health Survey (SF-12). The SF-12 was used to measure quality of life, including physical health and mental health dimensions. A multiple mediation model was used to analyse the mediating effects of anxiety and depression symptoms together between stigma and quality of life. RESULTS: A total of 1 087 community patients with schizophrenia were included with a mean age of 50.68±12.73 years; 525 (48.30%) were male. Stigma was reported by 543 patients (49.95%). Anxiety symptoms were present in 292 patients (26.86%), and depression symptoms in 407 patients (37.44%). The physical health quality of life score was 72.01 ± 20.99, and the mental health quality of life score was 71.68 ± 19.38. Multiple mediation analysis showed that stigma directly affected quality of life, and also indirectly affected quality of life through anxiety and depression symptoms. Anxiety and depression jointly mediated 42.26% of the total effect of stigma on physical health quality of life and 47.51% on mental health quality of life. CONCLUSIONS Reducing stigma and preventing anxiety and depression symptoms in community-dwelling patients with schizophrenia can effectively improve their quality of life and support reintegration into society.
Humans ; Quality of Life ; Male ; Depression/psychology* ; Middle Aged ; Social Stigma ; Schizophrenia ; Female ; Anxiety/psychology* ; China ; Surveys and Questionnaires ; Adult ; Schizophrenic Psychology ; Independent Living ; Aged

ObjectiveTo understand the status of stigma and subjective well-being of patients with mental disorders and co-resident family members， to analyze the correlation between them， and to compare the impact of stigma upon the subjective well-being of patients and family members of the same household. MethodsPatients with mental disorders （n=154） and their families （n=154） who visited the outpatient department of a tertiary psychiatric hospital in Chengdu from October to November 2019 were selected， and four instruments were used for collecting the data， including self-designed demographic information questionnaire， self-designed disease-related information questionnaire， brief version of Internalized Stigma of Mental Illness Scale （ISMI-10） and Index of Well-Being Scale （IWB）. ResultsA total of 118 （76.62%） patients with mental disorders and 151 （98.05%） family members experienced stigma. The total score and each factors score in ISMI-10 of family members were higher than those of patients （P<0.01）， and the total score and each dimension score in IWB were lower than those of patients （P<0.01）. Pearson correlation analysis showed that ISMI-10 total score of patients and family members was negatively correlated with IWB total score （r=-0.600，-0.202， P<0.05 or 0.01）. After controlling demographic and disease-related variables， multiple linear regression analysis showed that the regression model of mental disorder patients achieved good fit effect （adjusted R²=0.457）， with statistical significance （F=26.746， P<0.01）， while the regression model of co-living family members was lack of fit （adjusted R²=0.035）. After controlling for family demographic variables， the model was at the statistical level （F=3.769， P<0.01）. ConclusionMental disorder patients have low illness stigma and high subjective well-being， whereas the opposite is true for family members. Moreover， there is a negative relationship between stigma and subjective well-being for both patients and family members， stigma is a significant factor affecting subjective well-being for people with mental disorders.

Objective Through testicular biopsy and detection of serum sex hormone levels in patients with azoospermia,to explore the relationship between spermatogenic function of testis,testicular volume and serum LH and FSH levels.Methods 80 cases of azoospermia patients adimitted from Jan.2012 to Dec.2014 were collected as the research object.Immunization method was used to detect the serum sex hormone leve,testis model was adopted to detect testicular volume,and routine disinfection was given to make testicular biopsy.According to testicular biopsy results,patients were divided into normal spermatogenic function group (group A),spermatogenic dysfunction group (group B),sertoli-cell-only syndrome group (group C);percutaneous sperm group (group D),and puncture azoospermia group (group E).At the same time,50 cases of healthy male were selected as the control group and they received sperm routine examination and sex hormone detection.Correlation between spermatogenic function of testis,testicular volume and serum LH and FSH levels were studied.Results Serum levels of LH and FSH had no significant difference among group A,group B and the control group (P＞0.05).Serum level of LH and FSH was significantly higher in group C than that in group A,group B and the control group,and the differences had statistical significance (P＜0.05).Serum level of LH and FSH in group D had no significant difference compared with that of the control group (P＞0.05).Serum level of LH and FSH in group E was significantly higher than that in group D and the control group,and the difference had statistical significance (P＜0.05).The level of LH and FSH was significantly higher in abnormal testicular group than that in normal testis group,and the difference had statistical significance (P＜0.05).Spearman correlation analysis showed that the spermatogenic function of testis was negatively correlated with serum LH and FSH levels (r=-0.473,-0.441,P＜0.05).Testicular volume was negatively correlated with serum LH and FSH levels(r=-0.643,-0.715,P＜0.05),and the difference had statistical significance.Conclusion The determination of serum LH and FSH levels has important clinical value for predicting testicular spermatogenic function in azoospermia patients,and can be used to guide clinical puncture and prognosis judgement.