Abstract OBJECTIVE: To investigate the clinical characteristics, treatment and misdiagnosis of patients with depression in outpatient clinics with somatic complaints. METHODS: Clinical, scale and efficacy analyses were performed on 132 patients who were referred to our psychiatric outpatient clinic with somatic complaints and who had a HAMD score of ≥18 and an SDS score of ≥60 (standard score) on the Hamilton Depression Inventory and met the CCMD-3 diagnostic criteria for depression (Chinese Classification and Diagnostic Criteria for Mental Disorders, 4th edition). Results: The HAMD, SDS and HAMA scores of 132 depressed patients with somatic complaints and sleep disorders decreased significantly after 6 weeks of paroxetine treatment compared with those before treatment (P<0.01). Conclusion: Identification, diagnosis, and appropriate antidepressant treatment of outpatients with depression presenting with somatic complaints can effectively alleviate depressive symptoms and somatic discomfort, reduce unnecessary tests and treatments, and facilitate early recovery and improve the quality of life of patients. Keywords Depression, somatic complaints Depression has received increasing attention because of its high prevalence and suicide risk. However, due to the somatization of depression, more than half of the patients do not complain of psychological symptoms, but seek consultation in general hospitals with various somatic complaints, thus not receiving proper diagnosis and management. These patients are often misdiagnosed and then receive unnecessary medical examination and treatment. Therefore, early identification of somatization of depression is important for early diagnosis and treatment. In this paper, we analyze the clinical characteristics of 132 cases of depression with somatic complaints. 1. Subjects and methods 1.1 Subjects Source of cases 132 patients with depression who came to the Department of Psychiatry of our hospital from June 2007 to September 2010 with somatic complaints in non-psychiatric departments, but with poor treatment results after multiple examinations. Inclusion criteria: 1. Meeting the CCMD-3 diagnostic criteria for depression. 2, Hamilton depression scale HAMD ≥ 18 points, depression self-rating scale SDS score ≥ 60 points (standard score). 3, Exclude depressive disorders caused by organic diseases. 4, No previous systematic antidepressant treatment. 1.2 Methods Daily morning dose of paroxetine 20 mg was administered for 6 weeks. The HAMD, SDS and HAMA scores were taken once before and after treatment, and a small dose of benzodiazepines was added before bedtime for those with poor sleep. Efficacy evaluation criteria: The efficacy was judged according to the HAMD reduction rate. The reduction rate of ≥75% was considered as cured, ≥50% was considered as significant improvement, ≥25% was considered as progress, <25% was considered as ineffective, and the apparent efficiency was calculated by cured and significant improvement. 1.3. Statistical treatment All data were processed with SPSS13.0 software, and P<0.05 was considered significant difference. 2. Results 2.1 General information Among 132 cases, there were 54 males and 78 females. The age was 15-71 years old, with an average of (43+5) years old. Educational level: 18 cases in elementary school, 56 cases in junior high and high school, and 58 cases in college or above. Occupation: 34 cases of workers, 30 cases of farmers, 42 cases of cadres, and 28 cases of others. The onset of disease was mostly chronic for 10 months-15 years, with an average of 4.3±3.4 years, including 57 cases of more than 2 years, and the number of visits ranged from 5 to 16 times, with an average of 12.3±2.8 times.