Budtz-Lilly Anna, Fink Per, Ørnbøl Eva, Vestergaard Mogens, Moth Grete, Christensen Kaj Sparle, Rosendal Marianne
Research Unit for General Practice, Department of Public Health, Aarhus University, Denmark.
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark.
J Psychosom Res. 2015 Jun;78(6):536-45. doi: 10.1016/j.jpsychores.2015.03.006. Epub 2015 Mar 16.
Functional symptoms and disorders are common in primary care. Bodily distress syndrome (BDS) is a newly proposed clinical diagnosis for functional disorders. The BDS diagnosis is based on empirical research, and the symptoms stated in the BDS criteria have been translated into a self-report questionnaire called the BDS checklist. The aim of the present study was to investigate the psychometric properties of the checklist and to test the construct of BDS.
The 30-item BDS checklist was completed by 2480 adult primary care patients in a cross-sectional study on contact and disease patterns in Danish general practice. We performed (internal) validation analyses of the collected checklist data. We also performed factor and latent class analyses to identify both BDS symptom groups and BDS patient groups.
Internal validation analyses revealed acceptable and usable psychometric properties of the BDS checklist. The factor analyses identified the four distinct determining factors for BDS: cardiopulmonary, gastrointestinal, musculoskeletal and general symptoms. Results from factor and multi-trait analyses suggested a shortening of the BDS checklist (from 30 to 25 items). The latent class analyses resulted in three severity levels (no, moderate and severe BDS); the best fit index was found for a threshold of ≥4 symptoms in a symptom group.
The results provide empirical support for the previously described construct of BDS with four symptom groups and three patient groups. The BDS checklist is a self-report instrument that may be used for case finding in both clinical practice and in research.
功能症状和障碍在初级保健中很常见。身体不适综合征（BDS）是一种新提出的功能障碍临床诊断。BDS诊断基于实证研究，BDS标准中所述症状已被转化为一份名为BDS清单的自我报告问卷。本研究的目的是调查该清单的心理测量特性并检验BDS的结构。
在一项关于丹麦普通实践中接触和疾病模式的横断面研究中，2480名成年初级保健患者完成了包含30个条目的BDS清单。我们对收集到的清单数据进行了（内部）验证分析。我们还进行了因子分析和潜在类别分析，以识别BDS症状组和BDS患者组。
内部验证分析显示BDS清单具有可接受且可用的心理测量特性。因子分析确定了BDS的四个不同决定因素：心肺、胃肠道、肌肉骨骼和一般症状。因子分析和多特质分析结果表明BDS清单可缩短（从30项减至25项）。潜在类别分析得出三个严重程度级别（无、中度和重度BDS）；在一个症状组中，发现≥4个症状的阈值具有最佳拟合指数。
结果为先前描述的具有四个症状组和三个患者组的BDS结构提供了实证支持。BDS清单是一种自我报告工具，可用于临床实践和研究中的病例发现。
