Objective: This study aims to verify the reliability and validity of the Chinese version of the Psychosocial Adaptation Questionnaire (PSAQ-CSD) in patients with chronic urticaria (CU), to assess their psychosocial adaptation levels. Methods: The study involved 102 confirmed cases of chronic urticaria. The PSAQ-CSD was translated and culturally adapted for Chinese use, followed by a pre-survey validation. Exploratory factor analysis and Cronbach’s α coefficient were used to test the construct validity, internal consistency reliability, and criterion-related validity of the scale. Results: The Cronbach’s α coefficient for the Chinese version of the PSAQ-CSD was 0.930, indicating good internal consistency. Exploratory factor analysis showed a KMO value of 0.848 and a cumulative variance contribution rate of 65.142%, consistent with the original scale structure. Criterion-related validity analysis revealed strong correlations between the PSAQ-CSD and the CU-Q2oL scale in emotional, self-cognitive, and social dimensions. All correlations were statistically significant, P < 0.05. Conclusion: The Chinese version of the PSAQ-CSD demonstrates good reliability and validity in patients with chronic urticaria, making it an effective tool for assessing psychosocial adaptation. It can comprehensively reflect patients’ emotional states, self-cognition, and social adaptation, providing a theoretical basis for clinical intervention and psychological support. Future research should expand the sample size and consider more cultural and social factors to enhance the application range and accuracy of the scale.