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Purpose to assess the subjective concordance on psychological service needs in hospitalized patients between patients and doctors in China. Methods A cross-sectional study was performed in one day. All hospitalized inpatients from selected departments of West China Hospital were recruited as potential participants. A questionnaire set including demographic variables as well as the PHQ-9 and GAD-7 questionnaires were completed by the included patients. They and their doctors in-charge were asked whether they perceived the patients need psychological services.. Results the overall response rate in patients was 84.25% and the final sample consisted of 1273 patients. Among those, 605 patients (47.53%) believed that they needed psychological services, whereas only 345 patients (27.10%) were in need for psychological services according to the evaluation of their doctors. Kappa statistics showed that the concordance rate between patients and doctors was low in the total patient group (kappa=0.055) as well as in the group of patients with significant depression or anxiety (kappa=0.080). A logistic regression analysis showed that the ward where the patients were treated at the time was related to a consistent recognition of psychological needs(OR=1.667). Conclusion The concordance between psychological service needs perceived by patients and evaluated by doctors in Chinese inpatients was low. Therefore, it seems necessary to develop some effective strategies to improve the detection rate, such as the use of screening-instruments and the training of health professionals in the detection of psycho-social distress.