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目的 探索三甲综合医院门诊躯体形式障碍(somatoform disorder,SFD)和躯体症状障碍(somatic symptom disorder,SSD)患者临床特征的差异.方法 采用方便取样法纳入消化内科、神经内科、中医科、精神科门诊候诊患者,完成患者健康问卷躯体症状群量表(Patient Health Questionnaire-15,PHQ-15),患者健康问卷抑郁量表(Patient Health Questionnare-9,PHQ-9),广泛性焦虑障碍量表(General Anxiey Disorder Scale,GAD-7),躯体症状障碍诊断B标准量表(Somatic Symptom Disorder-B Criteria Scale,SSD-12),世界卫生组织残疾评定方案2.0 (WHO Disability Assessment Schedule 2.0,WHO DAS 2.0)等自评问卷,并经结构化访谈得出SSD和SFD诊断,采用独立样本t检验分析并比较SSD和SFD患者的临床特征及差异.结果 699例受访者中,236例(33.8％)和431例(61.7％)分别被诊断为SSD和SFD,二者诊断一致性较低(Cohen κ=0.291 P＜0.01).SSD患者在PHQ-15[(12.01±5.54)分比(10.38±5.53)分,t=3.624]、PHQ-9[(11.84±6.76)分比(9.40±6.57)分,t=4.546]、GAD-7[(9.70±6.08)分比(7.34±5.92)分,t=4.871]、SSD-12[(23.60±11.43)分比(16.52±12.64)分,t=7.154]和WHO DAS 2.0[(22.65±8.52)分比(19.96±7.77)分,t=4.128]量表得分显著高于SFD患者,均P＜0.01.结论 SSD和SFD诊断一致性较低;相对于SFD患者,SSD患者在躯体症状负荷、焦虑抑郁情绪、与症状相关情绪、思维和行为问题、社会功能损害更严重.“,”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.