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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Operationalization of diagnostic criteria of DSM-5 somatic symptom disorders

Authors: Nana Xiong, Yaoyin Zhang, Jing Wei, Rainer Leonhart, Kurt Fritzsche, Ricarda Mewes, Xia Hong, Jinya Cao, Tao Li, Jing Jiang, Xudong Zhao, Lan Zhang, Rainer Schaefert

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

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.
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Metadata
Title
Operationalization of diagnostic criteria of DSM-5 somatic symptom disorders
Authors
Nana Xiong
Yaoyin Zhang
Jing Wei
Rainer Leonhart
Kurt Fritzsche
Ricarda Mewes
Xia Hong
Jinya Cao
Tao Li
Jing Jiang
Xudong Zhao
Lan Zhang
Rainer Schaefert
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1526-5

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