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 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 The purpose of this study was to compare the self-evaluation and doctor-patient orientation between medical students and residents before the courses in different communication sections,and gave guide to different objects for their targeted teaching.Methods We set a sample made of 331 medical students and 308 residents who were trained in Clinical communication skills course in Peking Union Medical College from Oct.2009 to Oct.2013.Before the course,they were investigated by two self-assessment questionnaires.One is communication skills and occupation practice confidence;the other is doctor-patient orientation.Their result data were analyzed and handled by SPSS 17.0 software,adopting an independent samples t test.Results The order of the different aspects of doctor patient communication skills was same in two groups,gathering complete history [(4.340 ± 0.756) vs.(4.050 ± 0.707)] first,and establishing good doctor patient relationship [(4.310 ±0.740) vs.(4.030 ±0.790)],discussing a therapeutic plan with patient [(4.050 ± 0.812) vs.(3.600 ± 0.823)],informing bad news [(3.850 ± 0.897) vs.(3.260 ± 0.907)] followed.According to the self-assessment,residents were more confident than medical students in all these aspects above mentioned and establishing good doctor patient relationship.The doctorpatient orientation scale indicated that the residents group is more inclined to doctor-centric mode than the medical students group.Conclusion This study suggested that the residents is more confident in doctorpatient communication skills than medical students,while is less inclined to patient-centric mode than them.The focus of the communication teaching is similarity in the distribution of the two groups.Medical students' communication curriculum needs to take into account the limited clinical experiences,and training for residents needs to emphasize the capacity of empathy and perspective-taking.

Humanistic doctor-patient communication is an essential capability for medical workers and is as impor -tant as medical technology .Its education has been getting more and more attention in recent years .However , the training and evaluation of humanistic doctor-patient communication as a practical other than theoretical capability has been difficult .A new method , clinical scenery drama , based on psychodrama and role theory , is developed by Dept.of Psychological Medicine , Peking Union Medical College Hospital from recent 10 years of medical doctor and student training .In clinical scenery drama , medical students are thrown to different roles to empathize with their feelings and conflicts , try to resolve clinical dilemma with humanistic communication technique besides medi-cal technology .Then the sharing and comments from teachers and observers help students to understand the situa -tion from other perspectives and think about other possible solutions .