Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-25T07:07:44.221Z Has data issue: false hasContentIssue false
  • English
  • Français

Medium- and long-term prognostic validity of competing classification proposals for the former somatoform disorders

Published online by Cambridge University Press:  09 February 2017

S. Schumacher ,
W. Rief ,
K. Klaus ,
E. Brähler  and
R. Mewes
S. Schumacher*
Affiliation:
Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
W. Rief
Affiliation:
Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
K. Klaus
Affiliation:
Department of Clinical Biopsychology, University of Marburg, Marburg, Germany
E. Brähler
Affiliation:
Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center, Mainz, Germany
R. Mewes
Affiliation:
Department of Clinical Biopsychology, University of Marburg, Marburg, Germany
*
*Address for correspondence: S. Schumacher, Ph.D., Division of Clinical Psychological Intervention, Freie Universität Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

DSM-5 introduced a fundamental revision of the category of somatoform disorders, which resulted in the new somatic symptom disorder (SSD) and related disorders. However, prognostic validity of SSD remains unclear, while other classification proposals, such as bodily distress disorder (BDD) or polysymptomatic distress disorder (PSDD), might be promising alternatives for the new ICD-11. Therefore, the comparison of the different approaches concerning long-term prognosis of disorder-relevant factors is of special interest.

Method

In a longitudinal design (baseline, 1-year, and 4-year follow-up), the three proposals (SSD, BDD, PSDD) were compared in an age-representative sample of the German general population (N = 321). To this end, the baseline sample was divided into three independent pairs of groups (with/without SSD, with/without BDD, with/without PSDD). It was tested how well each approach differentiated with regard to medium- and long-term healthcare utilization, number of symptoms, and impairment.

Results

Criteria for BDD distinguished best with regard to future healthcare utilization resulting in a large-sized effect (f = 0.44) for the difference between persons with and without BDD, while SSD and PSDD revealed only medium-sized effects (f = 0.28 and f = 0.32) between subjects with and without diagnosis. The three proposals distinguished equally well with regard to future subjective impairment (between f = 0.39 and f = 0.41) and the number of reported symptoms (between f = 0.77 and f = 0.83).

Conclusion

In accordance with our data regarding prognostic validity, the current draft of the WHO group is based on the BDD proposal. However, existing limitations and weaknesses of the present proposal for the ICD-11 are further discussed.

Keywords

Classification criteriaICD-11prognostic validitysomatoform disorders
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 10 , July 2017 , pp. 1719 - 1732
Copyright
Copyright © Cambridge University Press 2017 

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

Al-Windi, A (2005). The influence of complaint symptoms on healthcare utilisation, medicine use, and sickness absence. A comparison between retrospective and prospective utilisation. Journal of Psychosomatic Research 59, 139–146.Google Scholar
APA (1980). Diagnostic and Statistical Manual of Mental Disorders – III. American Psychiatric Publishing: Washington, DC.Google Scholar
APA (2013). Diagnostic and Statistical Manual of Mental Disorders – 5. American Psychiatric Publishing: Arlington, VA.Google Scholar
Budtz-Lilly, A, Vestergaard, M, Fink, P, Carlsen, AH, Rosendal, M (2015). The prognosis of bodily distress syndrome: a cohort study in primary care. General Hospital Psychiatry 37, 560–566.CrossRefGoogle ScholarPubMed
Cohen, J (1992). A power primer. Psychological Bulletin 112, 155–159.Google Scholar
Creed, F, Guthrie, E, Fink, P, Henningsen, P, Rief, W, Sharpe, M, White, P (2010). Is there a better term than ‘medically unexplained symptoms’? Journal of Psychosomatic Research 68, 5–8.Google Scholar
Dimsdale, JE, Creed, F, Escobar, J, Sharpe, M, Wulsin, L, Barsky, A, Lee, S, Irwin, MR, Levenson, J (2013). Somatic symptom disorder: an important change in DSM. Journal of Psychosomatic Research 75, 223–228.Google Scholar
Escobar, JI, Rubiostipec, M, Canino, G, Karno, M (1989). Somatic symptom index (SSI) – a new and abridged somatization construct – prevalence and epidemiological correlates in 2 large community samples. Journal of Nervous and Mental Disease 177, 140–146.CrossRefGoogle Scholar
Fink, P, Schroder, A (2010). One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders. Journal of Psychosomatic Research 68, 415–426.Google Scholar
Fink, P, Sorensen, L, Engberg, M, Holm, M, Munk-Jorgensen, P (1999). Somatization in primary care. Prevalence, health care utilization, and general practitioner recognition. Psychosomatics 40, 330–338.CrossRefGoogle ScholarPubMed
Fink, P, Toft, T, Hansen, MS, Ornbol, E, Olesen, F (2007). Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients. Psychosomatic Medicine 69, 30–39.Google Scholar
Frances, A (2013). The new somatic symptom disorder in DSM-5 risks mislabeling many people as mentally ill. British Medical Journal 346, f1580.Google Scholar
Frances, AJ, Nardo, JM (2013). ICD-11 should not repeat the mistakes made by DSM-5. British Journal of Psychiatry 203, 1–2.Google Scholar
Gureje, O (2015). Classification of somatic syndromes in ICD-11. Current Opinion in Psychiatry 28, 345–349.Google Scholar
Hausteiner-Wiehle, C, Henningsen, P (2012). Somatoform disorders: discussion on conceptual and diagnostic issues. Nervenarzt 83, 1097–1105.Google Scholar
Hiller, W, Rief, W, Brahler, E (2006). Somatization in the population: from mild bodily misperceptions to disabling symptoms. Social Psychiatry and Psychiatric Epidemiology 41, 704–712.CrossRefGoogle ScholarPubMed
Khan, AA, Khan, A, Harezlak, J, Tu, W, Kroenke, K (2003). Somatic symptoms in primary care: etiology and outcome. Psychosomatics 44, 471–478.CrossRefGoogle ScholarPubMed
Klaus, K, Rief, W, Brahler, E, Martin, A, Glaesmer, H, Mewes, R (2013). The distinction between ‘medically unexplained’ and ‘medically explained’ in the context of somatoform disorders. International Journal of Behavioral Medicine 20, 161–171.CrossRefGoogle ScholarPubMed
Klaus, K, Rief, W, Brahler, E, Martin, A, Glaesmer, H, Mewes, R (2015). Validating psychological classification criteria in the context of somatoform disorders: a one- and four-year follow-up. Journal of Abnormal Psychology 124, 1092–1101.CrossRefGoogle ScholarPubMed
Körber, S, Frieser, D, Steinbrecher, N, Hiller, W (2011). Classification characteristics of the patient health questionnaire-15 for screening somatoform disorders in a primary care setting. Journal of Psychosomatic Research 71, 142–147.Google Scholar
Kroenke, K, Spitzer, RL, Williams, JB (2002). The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine 64, 258–266.Google Scholar
Leiknes, KA, Finset, A, Moum, T, Sandanger, I (2006). Methodological issues concerning lifetime medically unexplained and medically explained symptoms of the composite international diagnostic interview: a prospective 11-year follow-up study. Journal of Psychosomatic Research 61, 169–179.Google Scholar
Lowe, B, Mundt, C, Herzog, W, Brunner, R, Backenstrass, M, Kronmuller, K, Henningsen, P (2008). Validity of current somatoform disorder diagnoses: perspectives for classification in DSM-V and ICD-11. Psychopathology 41, 4–9.CrossRefGoogle ScholarPubMed
Martin, A, Buech, A, Schwenk, C, Rief, W (2007). Memory bias for health-related information in somatoform disorders. Journal of Psychosomatic Research 63, 663–671.Google Scholar
Mayou, R (2014). Is the DSM-5 chapter on somatic symptom disorder any better than DSM-IV somatoform disorder? British Journal of Psychiatry 204, 418–419.Google Scholar
McFarlane, AC, Ellis, N, Barton, C, Browne, D, Van Hooff, M (2008). The conundrum of medically unexplained symptoms: questions to consider. Psychosomatics 49, 369–377.Google Scholar
Rief, W (2013). A commentary on: somatic symptom disorder: an important change in DSM. Journal of Psychosomatic Research 75, 584.Google Scholar
Rief, W, Isaac, M (2014). The future of somatoform disorders: somatic symptom disorder, bodily distress disorder or functional syndromes? Current Opinion in Psychiatry 27, 315–319.Google Scholar
Rief, W, Martin, A (2014). How to use the new DSM-5 somatic symptom disorder diagnosis in research and practice: a critical evaluation and a proposal for modifications. Annual Review of Clinical Psychology 10, 339–367.Google Scholar
Rief, W, Mewes, R, Martin, A, Glaesmer, H, Braehler, E (2010). Are psychological features useful in classifying patients with somatic symptoms? Psychosomatic Medicine 72, 648–655.Google Scholar
Rief, W, Mewes, R, Martin, A, Glaesmer, H, Brahler, E (2011). Evaluating new proposals for the psychiatric classification of patients with multiple somatic symptoms. Psychosomatic Medicine 73, 760–768.Google Scholar
Schumacher, S, Rief, W, Brahler, E, Martin, A, Glaesmer, H, Mewes, R (2013). Disagreement in doctor's and patient's rating about medically unexplained symptoms and health care use. International Journal of Behavioral Medicine 20, 30–37.Google Scholar
Steinbrecher, N, Koerber, S, Frieser, D, Hiller, W (2011). The prevalence of medically unexplained symptoms in primary care. Psychosomatics 52, 263–271.Google Scholar
Voigt, K, Wollburg, E, Weinmann, N, Herzog, A, Meyer, B, Langs, G, Lowe, B (2012). Predictive validity and clinical utility of DSM-5 somatic symptom disorder – comparison with DSM-IV somatoform disorders and additional criteria for consideration. Journal of Psychosomatic Research 73, 345–350.CrossRefGoogle ScholarPubMed
Wollburg, E, Voigt, K, Braukhaus, C, Herzog, A, Lowe, B (2013). Construct validity and descriptive validity of somatoform disorders in light of proposed changes for the DSM-5. Journal of Psychosomatic Research 74, 18–24.CrossRefGoogle ScholarPubMed