{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T06:19:21Z","timestamp":1783059561302,"version":"3.54.6"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"\n Objective<\/jats:title>\n To examine the current status of social functioning and its associated factors among patients with severe mental illness (SMI) in Minhang District, Shanghai, and to provide evidence for community-based rehabilitation interventions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A district-wide population-based cross-sectional survey was conducted in 2022 among all registered patients with SMI in Minhang District, Shanghai. Social functioning, perceived social support, anxiety symptoms, and depressive symptoms were assessed using the Social Disability Screening Schedule (SDSS), the Perceived Social Support Scale (PSSS), the Generalized Anxiety Disorder 7-item scale (GAD-7), and the Patient Health Questionnaire 9-item scale (PHQ-9), respectively. Univariate comparisons were performed using t-tests and ANOVA, with Bonferroni correction for\n post-hoc<\/jats:italic>\n comparisons. Multiple linear regression, adjusted for age and gender, was used to examine factors independently associated with social functioning; multicollinearity was assessed using variance inflation factors (VIF).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 3510 eligible patients were included. The prevalence of social dysfunction was 36.6%, with social interaction as the most severely affected domain. Depressive symptoms were more prevalent than anxiety symptoms, and 11.3% of patients had comorbid anxiety and depressive symptoms. After adjusting for age and gender, more severe depressive symptoms were independently and positively associated with social dysfunction (\n P &lt;<\/jats:italic>\n 0.001), whereas higher perceived social support was independently and negatively associated with social dysfunction (\n P &lt;<\/jats:italic>\n 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Clinical significance<\/jats:title>\n More severe depressive symptoms were associated with greater social dysfunction among patients with SMI, while higher social support was associated with better social functioning. Routine screening and timely intervention for depressive symptoms may be considered in community mental health management.<\/jats:p>\n <\/jats:sec>\n \n Methodological innovation<\/jats:title>\n This district-wide census using standardized clinical assessments provides a replicable model for regional mental health surveys in other large cities in China.<\/jats:p>\n <\/jats:sec>\n \n Public health value<\/jats:title>\n Integrating depressive symptom screening into routine follow-up may help improve the efficiency of regional mental health services and promote social functioning recovery among patients with SMI.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1864002","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T05:40:40Z","timestamp":1783057240000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A cross-sectional study on social functioning and its associated factors among patients with severe mental illness in Minhang District, Shanghai"],"prefix":"10.3389","volume":"17","author":[{"given":"Jing","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Shanghai Minhang Mental Health Center","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Shanghai Minhang Mental Health Center","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Infectious Disease and Biosecurity, Fudan University","place":["Shanghai, China"]},{"name":"Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihua","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Shanghai Minhang Mental Health Center","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weibo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Shanghai Minhang Mental Health Center","place":["Shanghai, China"]},{"name":"Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine\/National Medical Center for Mental Disorders","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"B1","article-title":"Mental health law of the people\u2019s republic of China","year":"2012"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.1674-6554.2011.05.031","article-title":"Reliability and validity of the rating scale for social function impairment in patients with mental disorders","volume":"20","author":"Li","year":"2011","journal-title":"Chin J Behav Med Brain Sci"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.16128\/j.cnki.1005-3611.2005.01.025","article-title":"Correlation study of stress response with social support, life events and coping styles in medical staff","volume":"13","author":"Zhong","year":"2005","journal-title":"Chin J Clin Psychol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1000-6729.2013.03.001","article-title":"Reliability and validity of the Chinese version of the Generalized Anxiety Disorder Scale in traditional Chinese medicine internal medicine outpatients","volume":"27","author":"Zeng","year":"2013","journal-title":"Chin Ment Health J"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1657696","article-title":"Psychometric validation of the Patient Health Questionnaire-9 in Chinese adolescent and adult psychiatric inpatient populations","volume":"16","author":"Li","year":"2025","journal-title":"Front Psychiatry"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1007-614x.2024.07.049","article-title":"Analysis of influencing factors of social function impairment in convalescent schizophrenia patients","volume":"40","author":"Cui","year":"2024","journal-title":"China Community Doctors"},{"key":"B7","article-title":"Current situation investigation and countermeasure suggestions of community rehabilitation institutions for mental patients in Shanghai","author":"Li","year":"2005","journal-title":"Shanghai Arch Psychiatry"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1648957","article-title":"Schizophrenia spectrum stigma in healthcare: a systematic review","volume":"16","author":"Kruse","year":"2025","journal-title":"Front Psychiatry"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.16190\/j.cnki.45-1211\/r.2024.08.012","article-title":"Social alienation and its influencing factors in young and middle-aged schizophrenia patients in remission stage","volume":"41","author":"Xu","year":"2024","journal-title":"J Guangxi Med Univ"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1002-3429.2024.06.014","article-title":"Study of chain-mediating pathway, social anxiety and stigma in mindful-ness and cognition in schizophrenia patients","volume":"37","author":"Peng","year":"2024","journal-title":"Clin Misdiagn Misther"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1177\/00207640241245932","article-title":"A longitudinal study on the effects of social support on self-stigma, psychiatric symptoms, and personal and social functioning in community patients with severe mental illnesses in China","volume":"70","author":"Ma","year":"2024","journal-title":"Int J Soc Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2024.01.023","article-title":"Examining the effects of diagnostic awareness, positive symptoms, and negative symptoms on stigmatizing attitudes and social exclusion towards schizophrenia","volume":"264","author":"Zedan","year":"2024","journal-title":"Schizophr Res"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000001829","article-title":"The relationship between societal stigma and general self-efficacy in adults with self-reported mental health conditions: A serial mediation analysis","volume":"213","author":"Pan","year":"2025","journal-title":"J Nerv Ment Dis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.schres.2022.05.016","article-title":"Social exclusion in psychotic disorders: An interactional processing model","volume":"244","author":"Best","year":"2022","journal-title":"Schizophr Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"sbae226","DOI":"10.1093\/schbul\/sbae226","article-title":"Deciding to be left alone after being left out: behavioral responses to social exclusion in schizophrenia","volume":"52","author":"Weittenhiller","year":"2026","journal-title":"Schizophr Bull"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2023.103616","article-title":"The motivation and pleasure deficits but not expressivity affects social functioning through cognitive function in male patients with schizophrenia: A structural equation model","volume":"85","author":"Cai","year":"2023","journal-title":"Asian J Psychiatry"},{"key":"B17","doi-asserted-by":"publisher","first-page":"afad161","DOI":"10.1093\/ageing\/afad161","article-title":"New horizons in schizophrenia in older people","volume":"52","author":"Meesters","year":"2023","journal-title":"Age Ageing"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbad069","article-title":"Age-related social cognitive performance in individuals with psychotic disorders and their first-degree relatives","volume":"49","author":"Velthorst","year":"2023","journal-title":"Schizophr Bull"},{"key":"B19","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.schres.2021.11.010","article-title":"Changes in social functioning over the course of psychotic disorders-A meta-analysis","volume":"239","author":"de Winter","year":"2022","journal-title":"Schizophr Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1177\/00207640241311031","article-title":"Implementation of the modified NAVIGATE program for early schizophrenia in Shanghai through the specialized hospital and community integration: A comparative study","volume":"71","author":"Wang","year":"2025","journal-title":"Int J Soc Psychiatry"},{"key":"B21","volume-title":"Social Function Status and its Influencing Factors in Follow-Up Outpatients With Schizophrenia","author":"Xu","year":"2016"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.13479\/j.cnki.jip.2024.06.052","article-title":"Current status of social function and its influencing factors in elderly patients with schizophrenia","volume":"51","author":"Lu","year":"2024","journal-title":"Int J Psychiatry"},{"key":"B23","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1186\/s12888-025-07421-y","article-title":"A cross-sectional analysis of the community-based management and treatment status of SMI patients in Eastern China","volume":"25","author":"Duan","year":"2025","journal-title":"BMC Psychiatry"},{"key":"B24","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.schres.2024.08.021","article-title":"Long-term quality of life and social disconnection 20 years after a first episode psychosis, results from the 20-year follow-up of the OPUS trial","volume":"274","author":"Starzer","year":"2024","journal-title":"Schizophr Res"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1556927","article-title":"Recovery-based suicide prevention","volume":"16","author":"O'Connor","year":"2025","journal-title":"Front Psychiatry"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00243-1","article-title":"Family interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis","volume":"9","author":"Rodolico","year":"2022","journal-title":"Lancet Psychiatry"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852925100461","article-title":"Do antipsychotics work in people with schizophrenia? A review of outcomes and effect sizes","volume":"30","author":"Correll","year":"2025","journal-title":"CNS Spectr"},{"key":"B28","doi-asserted-by":"publisher","first-page":"102314","DOI":"10.1016\/j.ajp.2020.10231","article-title":"Benefits of social cognitive skills training within routine community mental health services: Evidence from a non-randomized parallel controlled study","volume":"54","author":"Lim","year":"2020","journal-title":"Asian J Psychiatry"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1864002\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T05:40:45Z","timestamp":1783057245000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1864002\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":28,"alternative-id":["10.3389\/fpsyt.2026.1864002"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1864002","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]},"article-number":"1864002"}}