This study investigated the psychometric properties of the Strengths and Difficulties Questionnaire when it was applied to a sample of 443 outpatients in China. Included in the sample were 88 adolescents diagnosed with depression, 96 with schizophrenia, 98 with generalized anxiety, 70 with OCD, and 91 with ADHD. Each patient and one of their parents completed the SDQ at intake. Confirmatory Factor Analyses provided limited support for the proposed five factor structure of the scale over other models. Internal reliabilities of the subscales for both self and parent report were weak, and inter-rater agreement between self- and parent-report was moderate. The specificity and sensitivity for the Total Difficulties scores were weak. Overall, these findings suggest that the use of the SDQ in clinical samples in China may be limited.This study investigated the psychometric properties of the Strengths and Difficulties Questionnaire when it was applied to a sample of 443 outpatients in China. Included in the sample were 88 adolescents diagnosed with depression, 96 with schizophrenia, 98 with generalized anxiety, 70 with OCD, and 91 with ADHD. Each patient and one of their parents completed the SDQ at intake. Confirmatory Factor Analyses provided limited support for the proposed five factor structure of the scale over other models. Internal reliabilities of the subscales for both self and parent report were weak, and inter-rater agreement between self- and parent-report was moderate. The specificity and sensitivity for the Total Difficulties scores were weak. Overall, these findings suggest that the use of the SDQ in clinical samples in China may be limited.