Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-22T08:49:57.389Z Has data issue: false hasContentIssue false
  • English
  • Français

Multisomatoform Disorder: Agreement Between Patient and Physician Report of Criterion Symptom Explanation

Published online by Cambridge University Press:  07 November 2014

Kathryn M. Rost ,
W. Perry Dickinson ,
L. Miriam Dickinson  and
Robert C. Smith
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To determine the level of agreement between patients and expert physicians in whether criterion multisomatoform (MSD) symptoms are explained.

Methods

We systematically collected reports from 280 primary care patients about whether they had suffered from any of 15 criterion MSD symptoms in the past month and whether they had received a medical explanation from a physician for positive criterion symptoms. The research team compared MSD symptom diagnoses derived from patient report with MSD symptom diagnoses derived from an expert physician report.

Results

MSD symptom diagnoses derived from patient report had 98.7% sensitivity, 97.9% specificity, 89.3% positive predictive value, and 99.7% negative predictive value compared with MSD symptom diagnoses derived from an expert physician report. Analysis demonstrated that 15.0% of patients met symptom criteria for MSD, according to patient and physician report; 83.0% failed to meet symptom criteria for MSD, according to patient and physician report; 1.8% of patients met symptom criteria for MSD, according to patient report but not physician report, while 0.2% met symptom criteria for MSD according to physician report but not by patient report.

Conclusion

Patients demonstrated high agreement with a physician expert in somatization about whether criterion MSD symptoms are explained, suggesting revised screeners may accurately identify somatizing patients.

Type
Original Research
Information
CNS Spectrums , Volume 11 , Issue 5 , May 2006 , pp. 383 - 389
Copyright
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Dickinson, WP, Dickinson, LM, deGruy, FV, et al.The somatization in primary care study: a tale of three diagnoses. Gen Hosp Psychiatry. 2003;25:1–7.CrossRefGoogle ScholarPubMed
2.Kroenke, K, Spitzer, RL, deGruy, F 3rd, et al.Multisomatoform disorder. An alternative to undifferentiated somatoform disorder for the somatizing patient, in primary care. Arch Gen Psychiatry. 1997;54:352–358.CrossRefGoogle ScholarPubMed
3.Dickinson, WP, Dickinson, LM, deGruy, FV, Main, DS, Candib, LM, Rost, K. A randomized clinical trial of a care recommendation letter intervention for somatization in primary care. Ann Fam Med. 2003;1:228–235.CrossRefGoogle ScholarPubMed
4.American Psychiatric Association. Unexplained physical symptoms algorithm. In: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: Primary Care Version (DSM-IV-PC). Washington, DC: American Psychiatric Association: 1995:65–75.Google Scholar
5.Kroenke, K, Swindle, R. Cognitive-behavioral therapy for somatization and symptom syndromes: a critical review of controlled clinical trials. Psychother Psychosom. 2000;69:205–215.CrossRefGoogle ScholarPubMed
6.Neumeyer-Gromen, A, Lampert, T, Stark, K, Kallischnigg, G. Disease management programs for depression: a systematic review and meta-analysis of randomized controlled trials. Med Care. 2004;42:1211–1221.CrossRefGoogle ScholarPubMed
7.Smith, RC, Gardiner, JC, Armatti, S, et al.Screening for high utilizing somatizing patients using a prediction rule derived from the management information system of an HMO: a preliminary study. Med Care. 2001;39:968–978.CrossRefGoogle ScholarPubMed
8.Noyes, R Jr, Langbehn, DR, Happel, RL, Sieren, LR, Muller, BA. Health Attitude Survey. A scale for assessing somatizing patients. Psychosomatics. 1999;40:470–478.CrossRefGoogle ScholarPubMed
9.Kroenke, K, Spitzer, RL, deGruy, FV 3rd, Swindle, R. A symptom checklist to screen for somatoform disorders in primary care. Psychosomatics. 1998;39:263–272.CrossRefGoogle ScholarPubMed
10.Swartz, M, Hughes, D, George, L, Blazer, D, Landerman, R, Bucholz, K. Developing a screening index for community studies of somatization disorder. J Psychiatr Res. 1986;20:335–343.CrossRefGoogle ScholarPubMed
11.Othmer, E, DeSouza, C. A screening test for somatization disorder (hysteria). Am J Psychiatry. 1985;142:1146–1149.Google ScholarPubMed
12.Somatoform Disorders Schedule, ver 2.0. Geneva, Switzerland: World Health Organization: 1994.Google Scholar
13.Derogatis, LR, Melisaratos, N. The brief symptom inventory: an introductory report. Psychol Med. 1983;13:595–605.CrossRefGoogle ScholarPubMed
14.Schilte, AF, Portegijs, PJ, Blankenstein, AH, Knottnerus, JA. Somatisation in primary care: clinical judgement and standardised measurement compared. Soc Psychiatry Psychiatr Epidemiol. 2000;35:276–282.CrossRefGoogle ScholarPubMed
15.Peveler, R, Kilkenny, L, Kinmonth, AL. Medically unexplained physical symptoms in primary care: a comparison of self-report screening questionnaires and clinical opinion. J Psychosom Res. 1997;42:245–252.CrossRefGoogle ScholarPubMed
16.Robins, L, Helzer, J, Cottier, L, Goldring, E. NIMH Diagnostic Interview Schedule. 3rd ver. rev: 1989.Google Scholar
17.Jay, SJ, Aaron, LA, Buchwald, D. Tobacco use and chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Arch Intern Med. 2000;160:2398–2401.CrossRefGoogle ScholarPubMed
18.Hiller, W, Cuntz, U, Rief, W, Fichter, MM. Searching for a gastrointestinal subgroup within the somatoform disorders. Psychosomatics. 2001;42:14–20.CrossRefGoogle ScholarPubMed
19.Stanley, IM, Peters, S, Ssalmon, P. A primary care perspective on prevailing assumptions about persistent medically unexplained physical symptoms. Int J Psychiatr Med. 2002;32:125–140.CrossRefGoogle ScholarPubMed
20.Stewart, DE. The changing faces of somatization. Psychosomatics. 1990;31:153–158.CrossRefGoogle ScholarPubMed
21.Wessely, S, Nimnuan, C, Sharpe, M. Functional somatic syndromes: one or many? Lancet. 1999;354:936–939.CrossRefGoogle ScholarPubMed
22.Barsky, AJ, Borus, JF. Functional somatic syndromes. Ann Intern Med. 1999;130:910–921.CrossRefGoogle ScholarPubMed
23.Rees, DC, Olujohungbe, AD, Parker, NE, et al.Guidelines for the management of the acute painful crisis in sickle cell disease. Br J Haematol. 2003;120:744–752.CrossRefGoogle ScholarPubMed
24.Smith, RC, Korban, E, Kanj, M, et al.A method for rating charts to identify and classify patients with medically unexplained symptoms. Psychother Psychosom. 2004;73:36–42.CrossRefGoogle ScholarPubMed
25.Villasenor, Y, Waitzkin, H. Limitations of a structured psychiatric diagnostic instrument in assessing somatization among Latino patients in primary care. Med Care. 1999;37:637–646.CrossRefGoogle ScholarPubMed