Ma Dandan, Lu Wei, Fritzsche Kurt, Toussaint Anne Christin, Li Tao, Zhang Lan, Zhang Yaoyin, Chen Hua, Wu Heng, Ma Xiquan, Li Wentian, Ren Jie, Leonhart Rainer, Cao Jinya, Wei Jing
Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Psychosomatic Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital University, Beijing, China.
Front Psychiatry. 2023 Jul 19;14:1205824. doi: 10.3389/fpsyt.2023.1205824. eCollection 2023.
The aim of this study is to investigate the psychometric characteristics of outpatients diagnosed with somatic symptom disorder (SSD) in biomedical, Traditional Chinese Medicine (TCM) and psychosomatic settings.
A total of 697 participants who completed SCID-5 and questionnaires were presented in our former study, as 3 of them had missed questionnaire data, a total of 694 participants are presented in this study. A secondary analysis of the psychometric characteristics of Somatic Symptom Disorder-B Criteria Scale (SSD-12), Somatic Symptom Severity Scale of the Patient-Health Questionnaire (PHQ-15), Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) is done to compare differences among outpatients from the three settings of medical specialties.
Based on the DSM-5 criteria, 90 out of 224 (40.2%) participants enrolled in biomedical departments (represented by neurology and gastroenterology departments), 44/231 (19.0%) in TCM departments, and 101/239 (42.3%) in the psychosomatic medicine departments were diagnosed with SSD. The scores of PHQ-15 in the biomedical, TCM and psychosomatic settings were 11.08 (± 4.54), 11.02 (± 5.27) and 13.26 (± 6.20); PHQ-9 were 10.43 (± 6.42), 11.20 (± 5.46) and 13.42 (± 7.32); GAD-7 were 8.52 (± 6.22), 9.57 (± 5.06) and 10.83 (± 6.24); SSD-12 were 22.26 (± 11.53), 22.98 (± 10.96) and 25.03 (± 11.54) respectively. The scores of PHQ-15, PHQ-9 and GAD-7 in SSD patients were significantly higher in psychosomatic departments than that in biomedical settings ( < 0.05). The cutoff point for SSD-12 was ≥16 in total patients; 16, 16, 17 in biomedical, TCM and psychosomatic settings, respectively. The cutoff point for PHQ-15 was found to be ≥8 in total patients; 8, 9, 11 in biomedical, TCM and psychosomatic settings, respectively.
SSD patients from psychosomatic departments had higher level of somatic symptom severity, depression and anxiety than from TCM and biomedical settings. In our specific sample, a cutoff point of ≥16 for SSD-12 could be recommended in all three settings. But the cutoff point of PHQ-15 differs much between different settings, which was ≥8, 9, and 11 in biomedical, TCM, and psychosomatic settings, respectively.
本研究旨在调查在生物医学、中医和心身医学环境中被诊断为躯体症状障碍(SSD)的门诊患者的心理测量特征。
在我们之前的研究中,共有697名完成了SCID-5和问卷的参与者,由于其中3人缺失问卷数据,本研究共纳入694名参与者。对躯体症状障碍-B标准量表(SSD-12)、患者健康问卷躯体症状严重程度量表(PHQ-15)、患者健康问卷-9(PHQ-9)和广泛性焦虑障碍-7(GAD-7)的心理测量特征进行二次分析,以比较来自三个医学专业环境的门诊患者之间的差异。
根据《精神疾病诊断与统计手册》第5版(DSM-5)标准,在以神经内科和消化内科为代表的生物医学科室登记的224名参与者中,有90名(40.2%)被诊断为SSD;中医科室的231名参与者中有44名(19.0%);心身医学科室的239名参与者中有101名(42.3%)。生物医学、中医和心身医学环境中PHQ-15的得分分别为11.08(±4.54)、11.02(±5.27)和13.26(±6.20);PHQ-9分别为10.43(±6.42)、11.20(±5.46)和13.42(±7.32);GAD-7分别为8.52(±6.22)、9.57(±5.06)和10.83(±6.24);SSD-12分别为22.26(±11.53)、22.98(±10.96)和25.03(±11.54)。心身医学科室中SSD患者的PHQ-15、PHQ-9和GAD-7得分显著高于生物医学环境中的患者(P<0.05)。SSD-12在所有患者中的截断点为≥16;在生物医学、中医和心身医学环境中分别为16、16、17。PHQ-15在所有患者中的截断点为≥8;在生物医学、中医和心身医学环境中分别为8、9、11。
与中医和生物医学环境中的患者相比,心身医学科室的SSD患者具有更高水平的躯体症状严重程度、抑郁和焦虑。在我们的特定样本中,所有三种环境下均可推荐SSD-12的截断点≥16。但PHQ-15的截断点在不同环境之间差异很大,在生物医学、中医和心身医学环境中分别为≥8、9和11。