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Pignon B, Wiernik E, Kab S, Matta J, Toussaint A, Löewe B, Horn M, Amad A, Fovet T, Gouraud C, Ouazana-Vedrines C, Pitron V, Goldberg M, Zins M, Lemogne C. Somatic Symptom Disorder-B criteria scale (SSD-12): Psychometric properties of the French version and associations with health outcomes in a population-based cross-sectional study. J Psychosom Res 2024; 176:111556. [PMID: 38056109 DOI: 10.1016/j.jpsychores.2023.111556] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/13/2023] [Accepted: 11/25/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE The 12-item Somatic Symptom Disorder-B Criteria Scale (SSD-12) is a self-reported questionnaire designed to assess the B criteria of the DSM-5 somatic symptom disorder. In this cross-sectional study, we aimed to examine the psychometric properties of the SSD-12 French version and associated health outcomes. METHODS Participants were volunteers from the population-based CONSTANCES cohort who reported at least one new symptom that occurred between March 2020 and January 2021. Depressive symptoms were measured with the Center for Epidemiologic Studies-Depression scale (CES-D). RESULTS A total of 18,796 participants completed the SSD-12. The scree plot was consistent with a 1-factor structure, while goodness-of-fit indices of the confirmatory factorial analyses and clinical interpretability were consistent with a 3-factor structure (excluding the item 7): 'Perceived severity', 'Perceived impairment', 'Negative expectations'. The Cronbach's α coefficients of the total and factors scores were 0.90, 0.88, 0.84 and 0.877, respectively. The total score was associated with depressive symptoms (Spearmann's rho: 0.32), self-rated health (-0.46), the number of persistent symptoms (0.32), and seeking medical consultation (odds ratio [95% confidence interval] for one interquartile range increase: 1.51 [1.48-1.54]). Among participants seeking medical consultation, those with higher SSD-12 scores were more likely to have their symptoms attributed to "stress/anxiety/depression" (1.32 [1.22-1.43]) and "psychosomatic origin" (1.25 [1.20-1.29]), and less to "COVID-19" (0.89 [0.85-0.93]). CONCLUSION While the SSD-12 French version can be used as a unidimensional tool, it also has a 3-factor structure, somewhat different from the DSM-5 theoretical structure, with high internal consistency and clinically meaningful associations with other health outcomes.
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Affiliation(s)
- Baptiste Pignon
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Emmanuel Wiernik
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Sofiane Kab
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Joane Matta
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Anne Toussaint
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löewe
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Mathilde Horn
- Univ Lille, Inserm, CHU de Lille, U1172, Lille Neuroscience & Cognition, 59000 Lille, France
| | - Ali Amad
- Univ Lille, Inserm, CHU de Lille, U1172, Lille Neuroscience & Cognition, 59000 Lille, France
| | - Thomas Fovet
- Univ Lille, Inserm, CHU de Lille, U1172, Lille Neuroscience & Cognition, 59000 Lille, France
| | - Clément Gouraud
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France; Centre du Sommeil et de la Vigilance-Pathologie professionnelle, APHP, Hôtel-Dieu, F-75004 Paris, France
| | - Charles Ouazana-Vedrines
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France; Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Victor Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France; Centre du Sommeil et de la Vigilance-Pathologie professionnelle, APHP, Hôtel-Dieu, F-75004 Paris, France
| | - Marcel Goldberg
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Marie Zins
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Cédric Lemogne
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France; Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
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van der Feltz-Cornelis CM, Sweetman J, van Eck van der Sluijs JF, Kamp CAD, de Vroege L, de Beurs E. Diagnostic accuracy of the Dutch version of the Somatic Symptom Disorder - B Criteria Scale (SSD-12) compared to the Whiteley Index (WI) and PHQ-15 in a clinical population. J Psychosom Res 2023; 173:111460. [PMID: 37607421 DOI: 10.1016/j.jpsychores.2023.111460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Somatic Symptom and Related Disorders(SSRD) are characterised by an intense focus on somatic symptoms that causes significant distress. A self-report scale developed to assess distress as symptom-related thoughts, feelings, and behaviors (SSD-12) has proved to be a reliable, valid and time-efficient measure for Somatic Symptom Disorder(SSD). This cross-sectional study aimed to compare the SSD-12 with psychiatric assessment as gold standard in a Dutch clinical population for SSRD compared to other widely used measures. METHODS Data were collected from adult patients visiting a specialised mental health outpatient clinic for SSRD in the Netherlands, between 2015 and 2017. Analyses included item evaluation, scale reliability, construct validity, diagnostic utility and cut points. Performance of SSD-12, Whiteley Index(WI) and PHQ-15 were compared in Receiver operating characteristics (ROC) curves. RESULTS 223 patients with SSD, Functional Neurological Disorder, Illness Anxiety(IA) and no SSRD participated. SSD-12 items were normally distributed; total scores correlated with measures of health anxiety, anxiety and depression. The optimal cut point for the SSD-12 was 22 (sensitivity 75.9%, specificity 63.6%). The ROC area under the curve for SSD-12 was 0.75 compared to 0.68 for the WI and 0.65 for the PHQ-15. Combinations of those questionnaires did not yield better results than for the SSD-12 alone. CONCLUSION The SSD-12 alone outperformed the WI and PHQ-15 and combined scales in effectively distinguishing SSRDs from other mental disorders. This may suggest that distress is a more accurate indicator of SSRD than earlier diagnostic criteria as operationalised in the WI and PHQ-15.
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Affiliation(s)
- C M van der Feltz-Cornelis
- MHARG, Department of Health Sciences, University of York, York, United Kingdom; Institute of Health Informatics, University College London, London, United Kingdom; Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands.
| | - J Sweetman
- MHARG, Department of Health Sciences, University of York, York, United Kingdom
| | - J F van Eck van der Sluijs
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands; Mentaal Beter, Utrecht, the Netherlands
| | - C A D Kamp
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands; Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands; Psychologiepraktijk Eline Biesheuvel, Alkmaar, the Netherlands
| | - L de Vroege
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands; Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - E de Beurs
- Clinical Psychology Department, Leiden University, Leiden, the Netherlands; Department of Research, Arkin GGZ, Amsterdam, the Netherlands
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Ma D, Lu W, Fritzsche K, Toussaint AC, Li T, Zhang L, Zhang Y, Chen H, Wu H, Ma X, Li W, Ren J, Leonhart R, Cao J, Wei J. Differences in psychometric characteristics of outpatients with somatic symptom disorder from general hospital biomedical (neurology/gastroenterology), traditional Chinese medicine, and psychosomatic settings. Front Psychiatry 2023; 14:1205824. [PMID: 37539331 PMCID: PMC10395119 DOI: 10.3389/fpsyt.2023.1205824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Objective The aim of this study is to investigate the psychometric characteristics of outpatients diagnosed with somatic symptom disorder (SSD) in biomedical, Traditional Chinese Medicine (TCM) and psychosomatic settings. Materials and methods A total of 697 participants who completed SCID-5 and questionnaires were presented in our former study, as 3 of them had missed questionnaire data, a total of 694 participants are presented in this study. A secondary analysis of the psychometric characteristics of Somatic Symptom Disorder-B Criteria Scale (SSD-12), Somatic Symptom Severity Scale of the Patient-Health Questionnaire (PHQ-15), Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) is done to compare differences among outpatients from the three settings of medical specialties. Results Based on the DSM-5 criteria, 90 out of 224 (40.2%) participants enrolled in biomedical departments (represented by neurology and gastroenterology departments), 44/231 (19.0%) in TCM departments, and 101/239 (42.3%) in the psychosomatic medicine departments were diagnosed with SSD. The scores of PHQ-15 in the biomedical, TCM and psychosomatic settings were 11.08 (± 4.54), 11.02 (± 5.27) and 13.26 (± 6.20); PHQ-9 were 10.43 (± 6.42), 11.20 (± 5.46) and 13.42 (± 7.32); GAD-7 were 8.52 (± 6.22), 9.57 (± 5.06) and 10.83 (± 6.24); SSD-12 were 22.26 (± 11.53), 22.98 (± 10.96) and 25.03 (± 11.54) respectively. The scores of PHQ-15, PHQ-9 and GAD-7 in SSD patients were significantly higher in psychosomatic departments than that in biomedical settings (p < 0.05). The cutoff point for SSD-12 was ≥16 in total patients; 16, 16, 17 in biomedical, TCM and psychosomatic settings, respectively. The cutoff point for PHQ-15 was found to be ≥8 in total patients; 8, 9, 11 in biomedical, TCM and psychosomatic settings, respectively. Conclusion SSD patients from psychosomatic departments had higher level of somatic symptom severity, depression and anxiety than from TCM and biomedical settings. In our specific sample, a cutoff point of ≥16 for SSD-12 could be recommended in all three settings. But the cutoff point of PHQ-15 differs much between different settings, which was ≥8, 9, and 11 in biomedical, TCM, and psychosomatic settings, respectively.
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Affiliation(s)
- Dandan Ma
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Lu
- Department of Psychosomatic Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital University, Beijing, China
| | - Kurt Fritzsche
- Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Medical Centre – University of Freiburg, Freiburg, Germany
| | - Anne Christin Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Tao Li
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lan Zhang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Yaoyin Zhang
- Department of Psychosomatic Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hua Chen
- Department of Psychological Medicine, Zhong Shan Hospital, Fudan University, Shanghai, China
| | - Heng Wu
- Department of Psychosomatic Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiquan Ma
- Department of Psychosomatic Medicine, Dongfang Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wentian Li
- Department of Clinic Psychology, Wuhan Mental Health Centre, Wuhan, China
| | - Jie Ren
- Department of Rehabilitation, General Hospital of Jincheng Anthracite Coal Mining Group Co. Ltd., Jincheng, China
| | - Rainer Leonhart
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Jinya Cao
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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