Screening for DSM-5 Somatic Symptom Disorder: Diagnostic Accuracy of Self-Report Measures Within a Population Sample. Issue 9 (November 2017)

• Record Type: Journal Article
• Authors: Laferton, Johannes A.C.; Stenzel, Nikola M.; Rief, Winfried; Klaus, Kristina; Brähler, Elmar; Mewes, Ricarda
• Is Part Of: Psychosomatic medicine. Volume 79:Issue 9(2017)
• Publication Date: 2017-11
• Subjects: diagnostic accuracy -- PHQ-15 -- SAIB -- screening -- somatic symptom disorder -- WI-7 -- AUC = area under the curve -- CI = confidence interval -- DLR = diagnostic likelihood ratio -- DSM = Diagnostic and Statistical Manual of Mental Disorders -- NPV = negative predictive value -- PHQ-15 = 15-item Patient Health Questionnaire -- PPV = positive predictive value -- ROC = receiver operating characteristic -- SAIB = Scale for Assessing Illness Behavior -- SCID = Structured Clinical Interview for DSM-IV -- SSD = somatic symptom disorder -- WI-7 = 7-item Whiteley Index; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000000530
• Languages: English
• ISSNs: 0033-3174

Abstract

ABSTRACT: Objective: The new DSM-5 somatic symptom disorder was introduced to improve the diagnosis of persons experiencing what used to be called somatoform disorders. So far, it is unclear whether existing self-report measures are useful to detect the new somatic symptom disorder. This study investigates the diagnostic accuracy of three self-report questionnaires that measure somatic complaints (15 item Patient Health Questionnaire [PHQ-15]) and psychological features (7-item Whiteley Index [WI-7]; Scale for Assessing Illness Behavior [SAIB]), in detecting somatic symptom disorder. Methods: A nationally representative general population survey was performed resulting in 250 participants (minimum age = 14 years. 12.8% participation rate). Assessment took place at baseline and 12-month follow-up. Individual and combined diagnostic accuracy of the PHQ-15, WI-7, and SAIB in detecting somatic symptom disorder was evaluated using the area under the curve (AUC) of a receiver operating characteristic. Results: Diagnostic accuracy was adequate to good for each individual questionnaire (PHQ-15: AUC = 0.79, p < .001, 95% confidence interval [CI] = 0.73–0.85; WI-7: AUC = 0.76, p < .001, 95% CI = 0.69–0.83; SAIB: AUC = 0.77, p < .001, 95% CI = 0.71–0.83). Combining the PHQ-15 and the WI-7 slightly improved diagnostic accuracy (AUC = 0.82, p < .001, 95% CI = 0.77–0.88), as did the combination of all three questionnaires (AUC = 0.85, p < .001, 95% CI = 0.79–0.90). Conclusions: The PHQ-15, WI-7, and SAIB are useful screening instruments to detect persons at risk for somatic symptom disorder, and a combination of these three instruments slightly improves diagnostic accuracy. Their use in routine care will lead to improved detection rates. Abstract : Supplemental digital content is available in the text.