Department of Psychology, University of Bologna, Bologna, Italy.
Department of Psychology, University of Bologna, Bologna, Italy.
Psychiatry Res. 2020 Sep;291:113233. doi: 10.1016/j.psychres.2020.113233. Epub 2020 Jun 15.
Psychosocial problems are highly prevalent among primary care (PC) patients, but they often remain undetected using traditional classification systems. The aim of the present study was to test the incremental validity of the revised version of the Diagnostic Criteria for Psychosomatic Research (DCPR-R), in addition to standard psychiatric assessment based on DSM-5, with regard to the prediction of psychosocial functioning of PC patients. Two-hundred PC patients were consecutively recruited. A comprehensive assessment was performed using two clinical interviews and three self-rating questionnaires (the PsychoSocial Index [PSI], the Short-Form Health Survey [SF-12] and the Illness Attitude Scales [IAS]) for the assessment of psychopathology and psychosocial functioning. Adding the DCPR-R to DSM-5, the amount of explained variance significantly increased by 9% to 16% in the PSI subscales, by 13% in the SF-12 mental component summary, and by 2% to 6% in the IAS scales. The joint use of DCPR-R and DSM-5 thus significantly increased the prediction of psychosocial functioning of primary care patients. These findings further support the use of the DCPR-R in PC settings, particularly in patients who do not satisfy DSM-5 criteria and yet present with high psychological distress, maladaptive illness behavior, impaired psychological well-being and quality of life.
心理社会问题在初级保健(PC)患者中非常普遍,但使用传统的分类系统往往无法发现这些问题。本研究的目的是测试修订版的身心研究诊断标准(DCPR-R)除了基于 DSM-5 的标准精神病学评估之外,在预测 PC 患者的心理社会功能方面的增量有效性。连续招募了 200 名 PC 患者。使用两种临床访谈和三种自我评估问卷(心理社会指数 [PSI]、简短健康调查 [SF-12] 和疾病态度量表 [IAS])对 200 名 PC 患者进行全面评估,以评估精神病理学和心理社会功能。将 DCPR-R 添加到 DSM-5 中,PSI 子量表的解释方差显著增加了 9%至 16%,SF-12 心理成分综合评分增加了 13%,IAS 量表增加了 2%至 6%。因此,DCPR-R 和 DSM-5 的联合使用显著提高了初级保健患者心理社会功能的预测能力。这些发现进一步支持了 DCPR-R 在 PC 环境中的使用,特别是在那些不符合 DSM-5 标准但表现出高度心理困扰、适应不良的疾病行为、心理健康受损和生活质量下降的患者中。