Top

BMC Psychiatry

Published in:

Open Access 01-12-2021 | Research article

Psychosomatic symptoms questionnaire (PSQ-39): a psychometric study among general population of Iranian adults

Authors: Zahra Heidari, Awat Feizi, Sara Rezaei, Hamidreza Roohafza, Peyman Adibi

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

Psychosomatic symptoms, characterized by physical-bodily complaints not fully explained by organic reasons, are highly prevalent. The present study aimed to culturally adapt and evaluate the psychometric properties of Psychosomatic Symptoms Questionnaire 39-item version (PSQ-39) among Iranian general adult population.

Methods

This study included 996 Persian-speaking people, living in Isfahan, Iran. The translation of the PSQ-39 was performed using the forward-backward method. Test-retest reliability was evaluated through Intraclass correlation (ICC) coefficient and internal consistency by using Cronbach’s α. Construct validity was investigated by using both exploratory (EFA) and confirmatory (CFA) factor analysis. Short Form Health Survey (SF-36) was used to assess divergent validity. Known-group validity was also assessed.

Results

The Persian version of the PSQ-39 showed excellent test-retest reliability in all domains (ICCs: 0.95–0.99). The computed Cronbach’s alpha coefficients for domains of PSQ-39 were in the range good to excellent. The PSQ-39 showed good known-group validity and differentiated patients from the general population (Area under the curve [AUC] of 0.78 (95% CI: 0.73, 0.84). Construct validity evaluated by EFA led to extraction of seven factors (Cardiorespiratory, musculoskeletal, psychological, gastrointestinal, general, body balance and Globus), and the CFA confirmed the adequacy of extracted factors by EFA (CFI = 0.91, TLI = 0.90, PCFI = 0.77, PNFI = 0.71, CMIN = 1413.18 (df = 654), CMIN/DF = 2.16, and RMSEA = 0.06). Significant negative correlations between all domains of PSQ and SF-36 revealed an acceptable divergent Validity.

Conclusions

The Persian version of the PSQ-39 is a reliable and valid questionnaire with applicability in a broad range of Persian language populations for assessing common psychosomatic symptoms in research as well as in clinical practice.

Available only for authorised users

Budtz-Lilly A, Fink P, Ørnbøl E, Vestergaard M, Moth G, Christensen KS, Rosendal M A new questionnaire to identify bodily distress in primary care: The “BDS checklist.” J Psychosom Res 2015;78:536–545. doi:https://doi.org/10.1016/j.jpsychores.2015.03.006, 6.

Morton LK, Elliott A, Thomas R, Cleland J, Deary V, Burton C. Developmental study of treatment fidelity, safety and acceptability of a symptoms clinic intervention delivered by general practitioners to patients with multiple medically unexplained symptoms. J Psychosom Res. 2016;84:37–43. https://doi.org/10.1016/j.jpsychores.2016.03.008.CrossRefPubMed

Haghighatdoost F, Feizi A, Esmaeilzadeh A, Hassanzadeh Keshteli A, Roohafza H, Afshar H, et al. Dietary patterns in relation with psychosomatic complaints profile: results from SEPAHAN study among a large sample of general adults. Nutr Neurosci. 2018;23(3):190–200. https://doi.org/10.1080/1028415X.2018.1485611.CrossRefPubMed

Toussaint A, Kroenke K, Baye F, Lourens S. Comparing the Patient Health Questionnaire – 15 and the Somatic Symptom Scale – 8 as measures of somatic symptom burden. J Psychosom Res. 2017;101:44–50. https://doi.org/10.1016/j.jpsychores.2017.08.002.CrossRefPubMed

Thortveit ET, Lorentzen ÅR, Ljøstad U, Mygland Å. Somatic symptoms and fatigue in a Norwegian population with high exposure to ticks. Ticks Tick Borne Dis. 2019;10(1):156–61. https://doi.org/10.1016/j.ttbdis.2018.09.012.CrossRefPubMed

Joustra ML, Janssens KAM, Schenk HM, Rosmalen JGM. The four-week time frame for somatic symptom questionnaires reflects subjective symptom burden best. J Psychosom Res. 2017;2018(104):16–21. https://doi.org/10.1016/j.jpsychores.2017.11.006.CrossRef

Zijlema WL, Stolk RP, Löwe B, Rief W, White PD, Rosmalen JGM. How to assess common somatic symptoms in large-scale studies: a systematic review of questionnaires. J Psychosom Res. 2013;74(6):459–68. https://doi.org/10.1016/j.jpsychores.2013.03.093.CrossRefPubMed

van Driel TJW, Hilderink PH, Hanssen DJC, de Boer P, Rosmalen JGM, Oude Voshaar RC. Assessment of somatization and medically unexplained symptoms in later life. Assessment. 2018;25(3):374–93. https://doi.org/10.1177/1073191117721740.CrossRefPubMed

Hinton DE, Kredlow MA, Bui E, Pollack MH, Hofmann SG. Treatment change of somatic symptoms and cultural syndromes among Cambodian refugees with PTSD. Depress Anxiety. 2012;29(2):148–55. https://doi.org/10.1002/da.20905.CrossRef

10.

Kocalevent R-D, Hinz A, Brähler E. Standardization of a screening instrument (PHQ-15) for somatization syndromes in the general population. BMC Psychiatr. 2013;13:1–8.CrossRef

11.

Gierk B, Kohlmann S, Kroenke K, Spangenberg L, Zenger M, Brähler E, et al. The somatic symptom scale–8 (SSS-8): a brief measure of somatic symptom burden. JAMA Intern Med. 2014;174(3):399–407. https://doi.org/10.1001/jamainternmed.2013.12179.CrossRefPubMed

12.

Derogatis LR, Unger R. Symptom checklist-90-revised. Corsini Encycl Psychol. 2010:1–2.

13.

Boulet J, Boss MW. Reliability and validity of the brief symptom inventory. Psychol Assess a J Consult Clin Psychol. 1991;3:433.

14.

Lacourt T, Houtveen J, van Doornen L. “Functional somatic syndromes, one or many?”: an answer by cluster analysis. J Psychosom Res. 2013;74(1):6–11. https://doi.org/10.1016/j.jpsychores.2012.09.013.CrossRefPubMed

15.

de Ruiter C, Garssen B, Rijken H, Kraaimaat F. The hyperventilation syndrome in panic disorder, agoraphobia and generalized anxiety disorder. Behav Res Ther. 1989;27(4):447–52. https://doi.org/10.1016/0005-7967(89)90015-6.CrossRefPubMed

16.

Ebrahimi A, Rief W, Mirshahzadeh P, Zanjani HA, Dehsorkhi HN, Roohafza H, et al. Psychometric properties of the Persian version of screening for somatic symptom Disorders-7 (SOMS-7). Iran J Psychiatry. 2018;13:264.PubMedPubMedCentral

17.

Abdolmohammadi K, Ghadiri Sourman Abadi F, Sadat Seyed Pourmand N, Falsafinejad MR. The validation of somatization inventory in the students of Tabriz Universities (Iran). Qom Univ Med Sci J. 2018;11:61–7.

18.

Goodarzi M, Ahmadi SM, Asle Zaker Lighvan M, Rahmati F, Molavi M, Mohammadi M. Investigating the psychometric properties of the 8-item somatic symptom scale in non-clinical sample of Iranian people. Pract Clin Psychol. 2020;8:57–64.CrossRef

19.

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25:3186–91.CrossRef

20.

Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The short form health survey (SF-36): translation and validation study of the Iranian version. Qual Life Res. 2005;14(3):875–82. https://doi.org/10.1007/s11136-004-1014-5.CrossRefPubMed

21.

Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol. 1993;46(12):1417–32. https://doi.org/10.1016/0895-4356(93)90142-N.CrossRefPubMed

22.

Lynn MR. Determination and quantification of content validity. Nurs Res. 1986;35(6):382–6. https://doi.org/10.1097/00006199-198611000-00017.CrossRefPubMed

23.

Cook DA, Beckman TJ. Current concepts in validity and reliability for psychometric instruments: theory and application. Am J Med. 2006;119:166–e7.CrossRefPubMed

24.

Tinsley HEA, Brown SD. Handbook of applied multivariate statistics and mathematical modeling. Academic press; 2000.

25.

Schreiber JB, Nora A, Stage FK, Barlow EA, King J. Reporting structural equation modeling and confirmatory factor analysis results: a review. J Educ Res. 2006;99(6):323–38. https://doi.org/10.3200/JOER.99.6.323-338.CrossRef

26.

Bolarinwa OA. Principles and methods of validity and reliability testing of questionnaires used in social and health science researches. Niger Postgrad Med J. 2015;22(4):195. https://doi.org/10.4103/1117-1936.173959.CrossRefPubMed

27.

Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42. https://doi.org/10.1016/j.jclinepi.2006.03.012.CrossRefPubMed

28.

Chen S-Y, Feng Z, Yi X. A general introduction to adjustment for multiple comparisons. J Thorac Dis. 2017;9(6):1725–9. https://doi.org/10.21037/jtd.2017.05.34.CrossRefPubMedPubMedCentral

29.

Eliasen M, Jørgensen T, Schröder A, Dantoft TM, Fink P, Poulsen CH, et al. Somatic symptom profiles in the general population: a latent class analysis in a Danish population-based health survey. Clin Epidemiol. 2017;9:421–33. https://doi.org/10.2147/CLEP.S137167.CrossRefPubMedPubMedCentral

30.

Eliasen M, Schröder A, Fink P, Kreiner S, Dantoft TM, Poulsen CH, et al. A step towards a new delimitation of functional somatic syndromes: a latent class analysis of symptoms in a population-based cohort study. J Psychosom Res. 2018;108:102–17. https://doi.org/10.1016/j.jpsychores.2018.03.002.CrossRefPubMed

31.

Heidari Z, Feizi A, Roohafza H, Keshteli AH, Adibi P. Somatoform symptoms profiles in relation to psychological disorders–a population classification analysis in a large sample of general adults. Psychiatry Res. 2017;254:173–8. https://doi.org/10.1016/j.psychres.2017.04.064.CrossRefPubMed

32.

Fink P, Toft T, Hansen MS, Ørnbøl E, Olesen F. Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients. Psychosom Med. 2007;69(1):30–9. https://doi.org/10.1097/PSY.0b013e31802e46eb.CrossRefPubMed

33.

Fava GA, Sonino N, Wise TN. The Psychosomatic Assessment. Strategies to Improve Clinical Practice. Adv Psychosom Med. 2012;32:1–18.PubMed

Title: Psychosomatic symptoms questionnaire (PSQ-39): a psychometric study among general population of Iranian adults
Authors: Zahra Heidari
Awat Feizi
Sara Rezaei
Hamidreza Roohafza
Peyman Adibi
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03278-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Psychosomatic symptoms questionnaire (PSQ-39): a psychometric study among general population of Iranian adults

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Is set-shifting and central coherence in anorexia nervosa influenced by body mass index, anxiety or depression? A systematic review

Understanding factors relevant to poor sleep and coping methods in people with schizophrenia

Interpersonal counselling versus perinatal-specific cognitive behavioural therapy for women with depression during pregnancy offered in routine psychological treatment services: a phase II randomised trial

Experiences of internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a qualitative study

A qualitative study of stakeholder views on the use of a digital app for supported self-management in early intervention services for psychosis

Associations of FKBP5 polymorphisms and methylation and parenting style with depressive symptoms among Chinese adolescents