Centre for Mental Health, Department of Medicine, Imperial College, London, UK.
Int J Soc Psychiatry. 2013 May;59(3):281-7. doi: 10.1177/0020764012438484. Epub 2012 Mar 20.
Medically unexplained symptoms are difficult to measure and in most cases the diagnosis is made either from independent data such as consultants' opinions or medical outcomes, or by proxy measures such as numbers of symptoms or consultations. A valid self-rated measure would be of value in assessing this highly prevalent condition.
To describe a new scale of nine items, the Schedule for Evaluation of Persistent Symptoms (SEPS), its properties, its internal consistency, its distribution in a sample of 470 medical patients, its relationship to social functioning and health anxiety (hypochondriasis), and its construct validity by comparing its results with an independent diagnostic examination of each patient's notes two years subsequent to assessment.
A prevalence study was carried out in 405 consenting medical patients in primary care, cardiology, respiratory medicine, gastroenterology and endocrine clinics, in which the SEPS scale, the Health Anxiety Inventory (HAI) and the Social Functioning Questionnaire (SFQ) were each completed.
The mean score on the SEPS scale in 470 patients was 13.4. Exploratory factor analysis revealed two main factors, one concerned focus on symptoms and the other on their attribution. Examination of all data showed a cut-off point of 14 as indicating the presence of pathological medically unexplained symptoms (MUS). Agreement between the consultants' diagnosis and pathological MUS scores was fairly good with a score of 14 or more on the SEPS showing sensitivity of 0.65 and negative predictive accuracy of 0.90.
It is concluded that the SEPS scale has potential value in screening patients with suspected medically unexplained symptoms.
医学无法解释的症状难以衡量，在大多数情况下，诊断要么来自独立数据，如顾问的意见或医疗结果，要么来自代理指标，如症状或咨询次数。有效的自我评估量表将有助于评估这种高度普遍的情况。
描述一种新的九项量表，即持续症状评估量表（SEPS），其特性、内部一致性、在 470 名医学患者样本中的分布、与社会功能和健康焦虑（疑病症）的关系，以及通过将其结果与每位患者的病历的独立诊断检查进行比较，来验证其结构有效性。
在初级保健、心脏病学、呼吸医学、胃肠病学和内分泌科的 405 名同意参与的医学患者中进行了一项患病率研究，其中每位患者都完成了 SEPS 量表、健康焦虑量表（HAI）和社会功能问卷（SFQ）。
在 470 名患者中，SEPS 量表的平均得分为 13.4。探索性因素分析揭示了两个主要因素，一个与关注症状有关，另一个与症状归因有关。对所有数据的检查表明，14 分是病理性医学无法解释的症状（MUS）的切点。顾问诊断和病理性 MUS 评分之间的一致性相当好，SEPS 评分达到 14 分或更高分的患者具有 0.65 的敏感性和 0.90 的阴性预测准确性。
SEPS 量表具有筛选疑似医学无法解释症状患者的潜力。
