Operationalization of diagnostic criteria of DSM-5 somatic symptom disorders.
- Xiong N Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
- Zhang Y Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu, Sichuan, People's Republic of China.
- Wei J Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China. weijing@pumch.cn.
- Leonhart R Institute of Psychology, University of Freiburg, 79085, Freiburg, Germany.
- Fritzsche K Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Freiburg, Freiburg, Germany.
- Mewes R Department of Psychology, Philipps University of Marburg, Gutenbergstr. 18, 35032, Marburg, Germany.
- Hong X Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
- Cao J Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
- Li T Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
- Jiang J Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
- Zhao X Department of Psychosomatic Medicine, Dongfang Hospital, School of Medicine, Tongji University, Shanghai, 200120, China.
- Zhang L Mental Health Centre, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
- Schaefert R Department of Psychosomatics, Medical Division, University Hospital Basel, Basel, Switzerland.
- 2017-11-09
Published in:
- BMC psychiatry. - 2017
China
DSM-5
Multiple somatic symptoms
Somatic symptom disorder
Somatoform disorders
Adult
Ambulatory Care
Anxiety
Asian Continental Ancestry Group
China
Cross-Sectional Studies
Depression
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Male
Middle Aged
Outpatients
Quality of Life
Somatoform Disorders
Young Adult
English
BACKGROUND
The aim of this study was to test the operationalization of DSM-5 somatic symptom disorder (SSD) psychological criteria among Chinese general hospital outpatients.
METHODS
This multicenter, cross-sectional study enrolled 491 patients from 10 general hospital outpatient departments. The structured clinical "interview about cognitive, affective, and behavioral features associated with somatic complaints" was used to operationalize the SSD criteria B. For comparison, DSM-IV somatoform disorders were assessed with the Mini International Neuropsychiatric Interview plus. Cohen's к scores were given to illustrate the agreement of the diagnoses.
RESULTS
A three-structure model of the interview, within which items were classified as respectively assessing the cognitive (B1), affective (B2), and behavioral (B3) features, was examined. According to percentages of screening-positive persons and the receiver operator characteristic (ROC) analysis, a cut-off point of 2 was recommended for each subscale of the interview. With the operationalization, the frequency of DSM-5 SSD was estimated as 36.5% in our sample, and that of DSM-IV somatoform disorders was 8.2%. The agreement between them was small (Cohen's к = 0.152). Comparisons of sociodemographic features of SSD patients with different severity levels (mild, moderate, severe) showed that mild SSD patients were better-off in terms of financial and employment status, and that the severity subtypes were congruent with the level of depression, anxiety, quality of life impairment, and the frequency of doctor visits.
CONCLUSIONS
The operationalization of the diagnosis and severity specifications of SSD was valid, but the diagnostic agreement between DSM-5 SSD and DSM-IV somatoform disorders was small. The interpretation the SSD criteria should be made cautiously, so that the diagnosis would not became over-inclusive.
The aim of this study was to test the operationalization of DSM-5 somatic symptom disorder (SSD) psychological criteria among Chinese general hospital outpatients.
METHODS
This multicenter, cross-sectional study enrolled 491 patients from 10 general hospital outpatient departments. The structured clinical "interview about cognitive, affective, and behavioral features associated with somatic complaints" was used to operationalize the SSD criteria B. For comparison, DSM-IV somatoform disorders were assessed with the Mini International Neuropsychiatric Interview plus. Cohen's к scores were given to illustrate the agreement of the diagnoses.
RESULTS
A three-structure model of the interview, within which items were classified as respectively assessing the cognitive (B1), affective (B2), and behavioral (B3) features, was examined. According to percentages of screening-positive persons and the receiver operator characteristic (ROC) analysis, a cut-off point of 2 was recommended for each subscale of the interview. With the operationalization, the frequency of DSM-5 SSD was estimated as 36.5% in our sample, and that of DSM-IV somatoform disorders was 8.2%. The agreement between them was small (Cohen's к = 0.152). Comparisons of sociodemographic features of SSD patients with different severity levels (mild, moderate, severe) showed that mild SSD patients were better-off in terms of financial and employment status, and that the severity subtypes were congruent with the level of depression, anxiety, quality of life impairment, and the frequency of doctor visits.
CONCLUSIONS
The operationalization of the diagnosis and severity specifications of SSD was valid, but the diagnostic agreement between DSM-5 SSD and DSM-IV somatoform disorders was small. The interpretation the SSD criteria should be made cautiously, so that the diagnosis would not became over-inclusive.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1186/s12888-017-1526-5
- PMID 29115965
- Persistent URL
- https://sonar.ch/global/documents/17691
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