Operationalization of diagnostic criteria of DSM-5 somatic symptom disorders

BMC Psychiatry

Research Article

Xia Hong¹  Jing Wei¹  Nana Xiong¹  Jing Jiang¹  Tao Li¹  Jinya Cao¹  Ricarda Mewes²  Kurt Fritzsche³  Xudong Zhao⁴  Yaoyin Zhang⁵  Rainer Schaefert⁶  Rainer Leonhart⁷  Lan Zhang⁸ 

[1] Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100730, Beijing, China;Department of Psychology, Philipps University of Marburg, Gutenbergstr. 18, 35032, Marburg, Germany;Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Freiburg, Freiburg, Germany;Department of Psychosomatic Medicine, Dongfang Hospital, School of Medicine, Tongji University, 200120, Shanghai, China;Department of Psychosomatic, Sichuan Provincial People’s Hospital, Chengdu, Sichuan, People’s Republic of China;Department of Psychosomatics, Medical Division, University Hospital Basel, Basel, Switzerland;Institute of Psychology, University of Freiburg, 79085, Freiburg, Germany;Mental Health Centre, West China Hospital, Sichuan University, 610041, Chengdu, Sichuan, People’s Republic of China;

关键词: DSM-5;    Somatic symptom disorder;    Somatoform disorders;    Multiple somatic symptoms;    China;   

DOI  :  10.1186/s12888-017-1526-5

 received in 2017-06-22, accepted in 2017-10-31,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to test the operationalization of DSM-5 somatic symptom disorder (SSD) psychological criteria among Chinese general hospital outpatients.MethodsThis 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.ResultsA 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.ConclusionsThe 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.

【 授权许可】

CC BY   
© The Author(s). 2017