Objective:To explore the adaptation process of the caregiving role of parents of children with autism spectrum disorder(ASD), and provide reference for targeted intervention strategies.Methods:Using purposive sampling, parents of children with ASD from the Pediatric Rehabilitation Center of Yangzhi Rehabilitation Hospital affiliated with Tongji University (Shanghai Sunshine Rehabilitation Center) were selected as study participants from October 2023 to May 2024.A qualitative research approach employing interpretative phenomenological analysis was adopted, with interviews conducted among 8 parents of children with ASD. Interview data were recorded, transcribed, and analyzed according to interpretative phenomenological analysis.Results:A total of 8 parents of children with ASD were interviewed, including 1 father and 7 mothers, aged 35-45 years. The process of stigma acceptance among parents of children with ASD as caregivers could be summarized into four themes: the acceptance journey of disease diagnosis; family responses to the impact of the disease; integration strategies across different living spaces; and mutual growth with the child through companionship and care.Conclusions:The diagnosis of ASD triggers intense emotional reactions in parents and leads to changes in family relationships and role functions. Collaborative efforts among healthcare institutions, schools, and community systems are necessary to empower parents of children with ASD, facilitating their adaptation to caregiving roles, enhancing their caregiving capabilities, and ultimately supporting better social integration for children with ASD.

Objective:To explore the adaptation process of the caregiving role of parents of children with autism spectrum disorder(ASD), and provide reference for targeted intervention strategies.Methods:Using purposive sampling, parents of children with ASD from the Pediatric Rehabilitation Center of Yangzhi Rehabilitation Hospital affiliated with Tongji University (Shanghai Sunshine Rehabilitation Center) were selected as study participants from October 2023 to May 2024.A qualitative research approach employing interpretative phenomenological analysis was adopted, with interviews conducted among 8 parents of children with ASD. Interview data were recorded, transcribed, and analyzed according to interpretative phenomenological analysis.Results:A total of 8 parents of children with ASD were interviewed, including 1 father and 7 mothers, aged 35-45 years. The process of stigma acceptance among parents of children with ASD as caregivers could be summarized into four themes: the acceptance journey of disease diagnosis; family responses to the impact of the disease; integration strategies across different living spaces; and mutual growth with the child through companionship and care.Conclusions:The diagnosis of ASD triggers intense emotional reactions in parents and leads to changes in family relationships and role functions. Collaborative efforts among healthcare institutions, schools, and community systems are necessary to empower parents of children with ASD, facilitating their adaptation to caregiving roles, enhancing their caregiving capabilities, and ultimately supporting better social integration for children with ASD.

Objective:To explore the quality of life and its influencing factors in patients with somatic symptom disorder (SSD).Methods:Patients were recruited from the outpatient departments of cardiology, neurology, gastroenterology, traditional Chinese medicine and psychiatry. SSD patients were included through structured interviews. Demographic data, lifestyle and medical treatment behavior, treatment satisfaction and subjective treatment effect were collected. Participant′s quality of life, severity of somatic symptoms, and thoughts, feelings, and behaviors associated to the somatic symptoms were evaluated by the 12-item medical outcomes study short form health survey (SF-12), Patient Health Questionnaire-15 (PHQ-15), and Somatic Symptom Disorder-B Criteria Scale (SSD-12). Patients were divided into high score group (SSD-12≥16, n=56) and low score group (SSD-12>16, n=180). T-test and Mann-Whitney U tests were used to compare the measurement data, and chi-square tests were used to compare the categorical data. Pearson correlation analysis and multiple linear regression was used to analyze the factors affecting the quality of life of SSD. Results:Compared to the low score group, patients in high score group were more worried about physical discomfort (1.0(0.5, 2.0) h/d vs. 3.0(1.0, 8.0) h/d, t=-4.6, P<0.01), less satisfied with the treatment ((3.4±1.4) score vs. (2.2±1.8) score, t=4.073, P<0.01), and had lower evaluation to the treatment effect ((3.3±1.4) score vs. (2.2±1.5) score, t=4.353, P<0.01). High score patients have a heavier physical and psychological burden and lower quality of life. Pearson correlation analysis showed that quality of life (SF-12) was strongly associated with depression ( r=-0.662, P<0.01) and symptom-related cognitive behavior ( r=-0.603, P<0.01), and it was weakly associated with somatic symptom severity ( r=-0.477, P<0.01). Multiple regression analysis showed that depressive and symptom-related cognitive behaviors had a significant influence on quality of life, which explained 58% of the overall variation ( P<0.05). Conclusion:Depressive level and thoughts, feelings, and behaviors associated to somatic symptoms are important factors affecting the quality of life of SSD patients. Increased attention and timely intervention should be provided to this population.

Objective:To explore the quality of life and its influencing factors in patients with somatic symptom disorder (SSD).Methods:Patients were recruited from the outpatient departments of cardiology, neurology, gastroenterology, traditional Chinese medicine and psychiatry. SSD patients were included through structured interviews. Demographic data, lifestyle and medical treatment behavior, treatment satisfaction and subjective treatment effect were collected. Participant′s quality of life, severity of somatic symptoms, and thoughts, feelings, and behaviors associated to the somatic symptoms were evaluated by the 12-item medical outcomes study short form health survey (SF-12), Patient Health Questionnaire-15 (PHQ-15), and Somatic Symptom Disorder-B Criteria Scale (SSD-12). Patients were divided into high score group (SSD-12≥16, n=56) and low score group (SSD-12>16, n=180). T-test and Mann-Whitney U tests were used to compare the measurement data, and chi-square tests were used to compare the categorical data. Pearson correlation analysis and multiple linear regression was used to analyze the factors affecting the quality of life of SSD. Results:Compared to the low score group, patients in high score group were more worried about physical discomfort (1.0(0.5, 2.0) h/d vs. 3.0(1.0, 8.0) h/d, t=-4.6, P<0.01), less satisfied with the treatment ((3.4±1.4) score vs. (2.2±1.8) score, t=4.073, P<0.01), and had lower evaluation to the treatment effect ((3.3±1.4) score vs. (2.2±1.5) score, t=4.353, P<0.01). High score patients have a heavier physical and psychological burden and lower quality of life. Pearson correlation analysis showed that quality of life (SF-12) was strongly associated with depression ( r=-0.662, P<0.01) and symptom-related cognitive behavior ( r=-0.603, P<0.01), and it was weakly associated with somatic symptom severity ( r=-0.477, P<0.01). Multiple regression analysis showed that depressive and symptom-related cognitive behaviors had a significant influence on quality of life, which explained 58% of the overall variation ( P<0.05). Conclusion:Depressive level and thoughts, feelings, and behaviors associated to somatic symptoms are important factors affecting the quality of life of SSD patients. Increased attention and timely intervention should be provided to this population.

Objective To explore the differences of clinical characteristics between the somatoform disorder (SFD) and somatic symptom disorder (SSD) in out-patient clinics of tertiary hospitals in China.Methods Patients in the out-patient waiting list of gastroenterology,neurology,traditional Chinese medicine and psychiatry departments were recruited by convenient sampling method,and screened by self-rating questionnaires,including Patient Health Questionnaire-15(PHQ-15),Patient Health Questionnare-9(PHQ-9),General Anxiey Disorder Scale (GAD-7),Somatic Symptom Disorder-B Criteria Scale (SSD-12),WHO Disability Assessment Schedule 2.0 (WHO DAS 2.0),etc,followed by structured interviews so that the diagnosis of SSD and SFD were finally confirmed.Various clinical features were compared between SSD and SFD patients by independent t-test.Results Among the 699 subjects,236 cases (33.8％) were diagnosed with SSD,and 431 cases (61.7％) were diagnosed with SFD.The diagnostic consistency between SSD and SFD was low (Cohen kappa coefficient=0.291,P＜0.01).The scores of PHQ-15 ((12.01±5.54) vs.(10.38±5.53),t=3.624),PHQ-9 ((11.84±6.76) vs.(9.40±6.57),t=4.546),GAD-7 ((9.70± 6.08) vs.(7.34±5.92),t=4.871),SSD-12 ((23.60± 11.43) vs.(16.52± 12.64),t=7.154) and WHO DAS 2.0 ((22.65±8.52) vs.(19.96±7.77),t=4.128) in SSD patient group were significantly higher than those in SFD patient group (P＜0.01).Conclusions The diagnostic consistency of SSD and SFD is low.Compared with SFD patients,SSD patients present with more somatic symptom load,anxiety and depression,symptom related emotions,thinking and behavior problems,and social function impairment,which might deserve more medical attention and appropriate interventions.

Objective To explore the differences of clinical characteristics between the somatoform disorder (SFD) and somatic symptom disorder (SSD) in out-patient clinics of tertiary hospitals in China.Methods Patients in the out-patient waiting list of gastroenterology,neurology,traditional Chinese medicine and psychiatry departments were recruited by convenient sampling method,and screened by self-rating questionnaires,including Patient Health Questionnaire-15(PHQ-15),Patient Health Questionnare-9(PHQ-9),General Anxiey Disorder Scale (GAD-7),Somatic Symptom Disorder-B Criteria Scale (SSD-12),WHO Disability Assessment Schedule 2.0 (WHO DAS 2.0),etc,followed by structured interviews so that the diagnosis of SSD and SFD were finally confirmed.Various clinical features were compared between SSD and SFD patients by independent t-test.Results Among the 699 subjects,236 cases (33.8％) were diagnosed with SSD,and 431 cases (61.7％) were diagnosed with SFD.The diagnostic consistency between SSD and SFD was low (Cohen kappa coefficient=0.291,P＜0.01).The scores of PHQ-15 ((12.01±5.54) vs.(10.38±5.53),t=3.624),PHQ-9 ((11.84±6.76) vs.(9.40±6.57),t=4.546),GAD-7 ((9.70± 6.08) vs.(7.34±5.92),t=4.871),SSD-12 ((23.60± 11.43) vs.(16.52± 12.64),t=7.154) and WHO DAS 2.0 ((22.65±8.52) vs.(19.96±7.77),t=4.128) in SSD patient group were significantly higher than those in SFD patient group (P＜0.01).Conclusions The diagnostic consistency of SSD and SFD is low.Compared with SFD patients,SSD patients present with more somatic symptom load,anxiety and depression,symptom related emotions,thinking and behavior problems,and social function impairment,which might deserve more medical attention and appropriate interventions.

Objective To evaluate the socioeconomic condition of somatoform disorders (SFD)and to explore the associated features with mental disability in outpatients with SFD in general hospital.Methods A cross-sectional study of SFD patients in 9 general hospitals of 5 cities was performed.Patients diagnosed with SFD (n=327) and well-defined medical condition (WDC)(n=119) were recruited from psychological outpatient department,Gastroenterology,neurology and traditional Chinese medicine outpatient department.WHO Disability Assessment Schedule 2.0 (WHO-DASII),Depression Scalse of the Patient Health Questionare (PHQ-9),Generalized Anxiety Disorder 7 Item Scale (GAD-7),Mini International Neuropsychiatric Interview and Self Made Socio-Demographic Questionare were employed to evaluate the participants.T-test and Pearson x2 test were used to analyze the social demographic and clinical measurements accordingly.Linear regression was carried out to explore the risk factors of SFD functional impairment.Results There were significant differences of the gender ratio between SFD and WDC(63.9％ (63/119) vs.52.9％(209/327),x2=4.53,P=0.03).There were more frequent utilization of medical care in SFD than in WDC (rate of more than 10 times on doctor-visits in the last 12 month:x2=31.55,P＜0.01).51.4％patients in SFD has the duration of disease longer than half-year,compared with 26.8％ in WDC (x2=44.71,P＜0.01).PHQ-9 in SFD group was higher than those in WDC(8.5±6.4 vs.6.9±5.9;t=2.33,P=0.02).And the mental disability significantly correlated to their health insurance condition,living in urban area or not,marital status,and the exercise habit in winter or summer (r=0.12,0.12,0.14,0.12,P＜0.05 or P＜0.01).Further more,living in rural area,anxiety and depression were the strong risk factors formental disability in SFD outpatients in these general hospitals.49.3％ variation (F=77.76,P＜0.01) of mental disability was explained by the model.Conclusion There is more affection symptoms in SFD patients than the WDC patients.And living in rural area,anxiety and depression statusare the risk factors for mental disability in SFD outpatients in the general hospitals.

Objective To evaluate the socioeconomic condition of somatoform disorders (SFD)and to explore the associated features with mental disability in outpatients with SFD in general hospital.Methods A cross-sectional study of SFD patients in 9 general hospitals of 5 cities was performed.Patients diagnosed with SFD (n=327) and well-defined medical condition (WDC)(n=119) were recruited from psychological outpatient department,Gastroenterology,neurology and traditional Chinese medicine outpatient department.WHO Disability Assessment Schedule 2.0 (WHO-DASII),Depression Scalse of the Patient Health Questionare (PHQ-9),Generalized Anxiety Disorder 7 Item Scale (GAD-7),Mini International Neuropsychiatric Interview and Self Made Socio-Demographic Questionare were employed to evaluate the participants.T-test and Pearson x2 test were used to analyze the social demographic and clinical measurements accordingly.Linear regression was carried out to explore the risk factors of SFD functional impairment.Results There were significant differences of the gender ratio between SFD and WDC(63.9％ (63/119) vs.52.9％(209/327),x2=4.53,P=0.03).There were more frequent utilization of medical care in SFD than in WDC (rate of more than 10 times on doctor-visits in the last 12 month:x2=31.55,P＜0.01).51.4％patients in SFD has the duration of disease longer than half-year,compared with 26.8％ in WDC (x2=44.71,P＜0.01).PHQ-9 in SFD group was higher than those in WDC(8.5±6.4 vs.6.9±5.9;t=2.33,P=0.02).And the mental disability significantly correlated to their health insurance condition,living in urban area or not,marital status,and the exercise habit in winter or summer (r=0.12,0.12,0.14,0.12,P＜0.05 or P＜0.01).Further more,living in rural area,anxiety and depression were the strong risk factors formental disability in SFD outpatients in these general hospitals.49.3％ variation (F=77.76,P＜0.01) of mental disability was explained by the model.Conclusion There is more affection symptoms in SFD patients than the WDC patients.And living in rural area,anxiety and depression statusare the risk factors for mental disability in SFD outpatients in the general hospitals.

ObjectiveTo investigate the prevalence of anxiety and depression among hepatitis B patients in Shanghai, China and related influencing factors. MethodsA cross-sectional survey was performed among 917 hepatitis B patients who were treated in Shanghai East Hospital, Tongji University, Shanghai Public Health Clinical Center, and Nanhua Hospital in Pudong New Area from June to December, 2016. The Hospital Anxiety and Depression Scale (HADS) and a self-designed social demography questionnaire were used for evaluation. The independent samples t-test and a one-way analysis of variance were used for comparison of continuous data between groups, and a multivariate linear regression analysis was used to analyze the correlation of anxiety and depression scores with demographic and socioeconomic factors. ResultsThe prevalence rates of anxiety and depression symptoms assessed by HADS were 87.6% and 90.7%, respectively. The severity of anxiety in hepatitis B patients was associated with age, family income, and educational level (F=3.518, 6.416, and 3322, all P＜0.05), and the severity of depression was associated with age, marital status, family income, occupation, and complications (F=2.904, t=2.242, F=22.840, F=9.235, F=11.870, t=2.246, all P＜0.05). High educational level, high income, and single status were risk factors for depression(all P＜005), and high income and the increase in age were significantly associated with anxiety(all P＜005). ConclusionAt present, the mental state of hepatitis B patients in Shanghai is not optimistic, with high prevalence rates of anxiety and depression. The results remind medical workers that they should pay attention to the mental health of hepatitis B patients.

Objective This study is to explore the association between self-differentiation and men-tal health among medical students. Methods Differentiation of self inventory-revised (DSI-R) and univer-sity personality inventory (UPI) were used to measure the self-differentiation and mental health of 526 med-ical students from Grade One to Grade Five at a comprehensive university in Shanghai. Result The mean score of DSI-R was (171.25±19.65). 32.2％ of participants had different levels of mental health prob-lems. Female students got higher score of DSI-R than male students (P=0.007). Statistically significant dif-ferences of medical students' self-differentiation were found among years of school attended (P=0.039). Sta-tistically significant differences of self-differentiation were also found between the first class and the third class of UPI (P<0.001) as well as the second class and the third class of UPI (P=0.004). Ordinal regression analysis indicated that self-differentiation was a risk factor for medical students' mental health (OR=1.036, P=0.000). Conclusion The average score of medical students' self-differentiation was higher than college students of other specialties. But their mental health condition was worse. Medical students with higher self-differentia-tion had worse mental health situation.