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 explore the clinical characters of patients with somatic symptom disorder (SSD) in a tertiary general hospital.Methods 210 patients from the outpatient clinic of the mental health department,the traditional Chinese medicine department and the gastroenterology department,who fit the criteria after filling in a self-rating questionnaire,were evaluated by a diagnostic interview for somatic symptom disorder (SSD).The clinical characters of patients with SSD were compared among different departments,and with other patients without SSD.Results (1) 27.1％ (57/210) were diagnosed as SSD,with the age of (43± 13) years old,and 61.4％ (35/57) were female.The differences of the demographic characteristics and the lifestyle between the SSD and the non-SSD were not statistically significant.(2) 45.6％ (26/57) SSD patients had their duration of the somatic symptoms more than 2 years;29.2％(17/57) SSD patients went to see doctors more than 20 times within recent one year.46.8％ (22/47) SSD patients who had received any treatment within the past 6 months evaluated it as effective,and 44.7％(21/47) SSD patients evaluated it as satisfactory.(3)The SSD patients reported more severe symptoms than those without SSD since the score of PHQ15 in SSD patients was 1 1 compared 7 in non-SSD patients (Z=4.876,P＜0.001).The SSD patients were more disabled than those without SSD in all three departments with the DAS score 33,25,30 respectively (Z=5.429,P＜0.001),and the disability of SSD patients was similar to those non-SSD in the mental health clinic (Z=0.894,P=0.371).There were no statistical differences in lifestyle,treatment evaluation and self-rating questionnaire in the SSD patients among the three departments.Conclusion SSD is quite prevalent in outpatient clinics in general hospitals and exerts substantial negative impact to their mental and physical health,as well as the daily functioning.SSD deserves more attention and effort to be managed in consultation-liaison psychiatry.

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 explore the clinical characters of patients with somatic symptom disorder (SSD) in a tertiary general hospital.Methods 210 patients from the outpatient clinic of the mental health department,the traditional Chinese medicine department and the gastroenterology department,who fit the criteria after filling in a self-rating questionnaire,were evaluated by a diagnostic interview for somatic symptom disorder (SSD).The clinical characters of patients with SSD were compared among different departments,and with other patients without SSD.Results (1) 27.1％ (57/210) were diagnosed as SSD,with the age of (43± 13) years old,and 61.4％ (35/57) were female.The differences of the demographic characteristics and the lifestyle between the SSD and the non-SSD were not statistically significant.(2) 45.6％ (26/57) SSD patients had their duration of the somatic symptoms more than 2 years;29.2％(17/57) SSD patients went to see doctors more than 20 times within recent one year.46.8％ (22/47) SSD patients who had received any treatment within the past 6 months evaluated it as effective,and 44.7％(21/47) SSD patients evaluated it as satisfactory.(3)The SSD patients reported more severe symptoms than those without SSD since the score of PHQ15 in SSD patients was 1 1 compared 7 in non-SSD patients (Z=4.876,P＜0.001).The SSD patients were more disabled than those without SSD in all three departments with the DAS score 33,25,30 respectively (Z=5.429,P＜0.001),and the disability of SSD patients was similar to those non-SSD in the mental health clinic (Z=0.894,P=0.371).There were no statistical differences in lifestyle,treatment evaluation and self-rating questionnaire in the SSD patients among the three departments.Conclusion SSD is quite prevalent in outpatient clinics in general hospitals and exerts substantial negative impact to their mental and physical health,as well as the daily functioning.SSD deserves more attention and effort to be managed in consultation-liaison psychiatry.

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.