title: Quality of doctor-patient relationship in patients with high somatic symptom severity in China.
abstract: BACKGROUND
  High somatic symptom severity (SSS) is associated with reduced health-related function and may affect doctor-patient interactions. This study aimed to explore the quality of the doctor-patient relationship (DPR) and its association with SSS in Chinese general hospitals outpatients.
  
  
  METHODS
  This multicenter cross-sectional study assessed the quality of DPR from both the doctor's and patient's perspective in general outpatients (n=484) from 10 departments of Psychosomatic Medicine (PM), Traditional Chinese Medicine (TCM), and Biomedicine (BM). SSS was assessed with the PHQ-15. The quality of the DPR was measured with the CARE, PDRQ-9, and DDPRQ-10 questionnaires. In addition, several standard instruments were used to assess psychosocial variables such as depression, anxiety, sense of coherence and quality of life.
  
  
  RESULTS
  From the doctor's perspective, patients with high SSS were rated as significantly more difficult than patients with low SSS. No differences were noted from the perspective of the patients. Patients from the TCM department rated the quality of their DPR significantly higher than those in BM and PM and were rated from doctor's perspective as less difficult than those in BM and PM. Multiple regression analysis revealed satisfaction of treatment, time of treatment and psychosocial variables, such as age, health related anxiety, depression, mental quality of life and sense of coherence as predictors for DPR.
  
  
  CONCLUSIONS
  PM and BM departments should learn from TCM departments to be empathic, to manage patients with high SSS and to establish long-term relationships with their patients.
authors: Department of Psychosomatic Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
authors: Heng
authors: H
authors: Wu
authors: Department of Psychosomatic Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
authors: Xudong
authors: X
authors: Zhao
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Freiburg, Germany. Electronic address: kurt.fritzsche@uniklinik-freiburg.de.
authors: Kurt
authors: K
authors: Fritzsche
authors: Institute of Psychology, University of Freiburg, Germany.
authors: Rainer
authors: R
authors: Leonhart
authors: Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany.
authors: Rainer
authors: R
authors: Schaefert
authors: Department of Psychological Medicine, Peking Union Medical College Hospital, PUMC, Beijing, China.
authors: Xiayuan
authors: X
authors: Sun
authors: Department of Psychosomatics and Psychotherapy, University of Gießen and Marburg GmbH, Gießen, Germany.
authors: Astrid
authors: A
authors: Larisch
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D002681:China; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D010817:Physician-Patient Relations; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index
keywords: Doctor–patient relationship; Somatic symptom severity; Somatoform disorders; Traditional Chinese medicine