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Bernd Löwe - One of the best experts on this subject based on the ideXlab platform.
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causal attributions for Somatic Symptom Disorder
Journal of Psychosomatic Research, 2020Co-Authors: Olaf Von Dem Knesebeck, Marco Lehmann, Bernd Löwe, Daniel LudeckeAbstract:Abstract Objectives Two research questions will be addressed: (1) What does the German public think about possible causes of Somatic Symptom Disorder (SSD) and are there differences in causal attributions according to Symptom and course of SSD? (2) Are causal attributions associated with beliefs about treatment and stigmatizing attitudes? Methods Two vignettes with Symptoms of SSD were used in a national telephone survey in Germany (N = 1004). Vignettes differed regarding main type of Symptom (pain vs. fatigue) and existence of an earlier Somatic disease (yes vs. no). Respondents were asked about their agreement with five causal beliefs (broken home, heredity, lack of willpower, work stress, and misinterpretation of body signals). Results About 90% of the respondents agreed that work stress is a possible cause of the SSD Symptoms. Agreement was significantly more pronounced in case of a person with fatigue and an earlier severe Somatic disease. A quarter endorsed lack of willpower as a possible cause. Lack of willpower was associated with a significant increase of desire for social distance in both vignettes. Work stress was associated with a significantly increased likelihood of positively evaluating the effectiveness of psychotherapy in both cases of SSD. Conclusions Public beliefs about causes of SSD are associated with stigma and treatment beliefs. Emphasising work stress as a cause may promote the belief that psychotherapy is effective for treatment of SSD.
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causal attributions for Somatic Symptom Disorder
Journal of Psychosomatic Research, 2020Co-Authors: Olaf Von Dem Knesebeck, Marco Lehmann, Bernd Löwe, Daniel LudeckeAbstract:Abstract Objectives Two research questions will be addressed: (1) What does the German public think about possible causes of Somatic Symptom Disorder (SSD) and are there differences in causal attributions according to Symptom and course of SSD? (2) Are causal attributions associated with beliefs about treatment and stigmatizing attitudes? Methods Two vignettes with Symptoms of SSD were used in a national telephone survey in Germany (N = 1004). Vignettes differed regarding main type of Symptom (pain vs. fatigue) and existence of an earlier Somatic disease (yes vs. no). Respondents were asked about their agreement with five causal beliefs (broken home, heredity, lack of willpower, work stress, and misinterpretation of body signals). Results About 90% of the respondents agreed that work stress is a possible cause of the SSD Symptoms. Agreement was significantly more pronounced in case of a person with fatigue and an earlier severe Somatic disease. A quarter endorsed lack of willpower as a possible cause. Lack of willpower was associated with a significant increase of desire for social distance in both vignettes. Work stress was associated with a significantly increased likelihood of positively evaluating the effectiveness of psychotherapy in both cases of SSD. Conclusions Public beliefs about causes of SSD are associated with stigma and treatment beliefs. Emphasising work stress as a cause may promote the belief that psychotherapy is effective for treatment of SSD.
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detecting dsm 5 Somatic Symptom Disorder criterion validity of the patient health questionnaire 15 phq 15 and the Somatic Symptom scale 8 sss 8 in combination with the Somatic Symptom Disorder b criteria scale ssd 12
Psychological Medicine, 2020Co-Authors: Anne Toussaint, Sebastian Kohlmann, Paul Husing, Bernd LöweAbstract:Background The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced Somatic Symptom and related Disorders (SSD) to improve the diagnosis of somatoform Disorders. It is unclear whether existing questionnaires are useful to identify patients with SSD. Our study investigates the diagnostic accuracy of the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Scale-8 (SSS-8) in combination with the Somatic Symptom Disorder – B Criteria Scale (SSD-12). Methods For this cross-sectional study, participants were recruited from a psychoSomatic outpatient clinic. PHQ-15, SSS-8, and SSD-12 were administered and compared with SSD criteria from a diagnostic interview. Sensitivity and specificity were calculated for optimal individual and combined cutpoints. Receiver operator curves were created and area under the curve (AUC) analyses assessed. Results Data of n = 372 patients [31.2% male, mean age: 39.3 years ( s.d. = 13.6)] were analyzed. A total of 56.2% fulfilled the SSD criteria. Diagnostic accuracy was moderate for each questionnaire (PHQ-15: AUC = 0.70; 95% CI = 0.65–0.76; SSS-8: AUC = 0.71; 95% CI = 0.66–0.77; SSD-12: AUC = 0.74; 95% CI = 0.69–0.80). Combining questionnaires improved diagnostic accuracy (PHQ-15 + SSD-12: AUC = 0.77; 95% CI = 0.72–0.82; SSS-8 + SSD-12: AUC = 0.79; 95% CI = 0.74–0.84). Optimal combined cutpoints were ⩾9 for the PHQ-15 or SSS-8, and ⩾23 for the SSD-12 (sensitivity and specificity = 69% and 70%). Conclusions The combination of the PHQ-15 or SSS-8 with the SSD-12 provides an easy-to-use and time- and cost-efficient opportunity to identify persons at risk for SSD. If systematically applied in routine care, effective screening and subsequent treatment might help to improve quality of life and reduce health care excess costs.
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General practitioners' views on the diagnostic innovations in DSM-5 Somatic Symptom Disorder - A focus group study
Journal of psychosomatic research, 2019Co-Authors: Marco Lehmann, Christina Jonas, Nadine Janis Pohontsch, Thomas Zimmermann, Martin Scherer, Bernd LöweAbstract:Abstract Background The innovations concerning the new diagnosis Somatic Symptom Disorder (SSD) in the DSM-5 include the introduction of psychological diagnostic criteria and the elimination of the need to exclude all potential Somatic causes of the Symptoms. Thus far, it is unknown how general practitioners (GPs) evaluate the innovations conceptually and regarding their applicability in primary care. Method We performed six focus groups with GPs. A semi-structured interview-guideline included a presentation of the innovations of SSD and questions about the innovations and their potential (dis-)advantages from the GPs' points of view. The material was analyzed using structuring qualitative content analysis. Results A total of 41 GPs participated (mean (sd) age = 51 (8.5) years, female = 17, male = 24). The GPs assessed that the diagnostic innovations could help them to focus on Symptom-related concerns and anxiety as core aspects of the patients' complaints. However, the meaning of the term excessive in the psychological diagnostic criteria (i.e., excessive worries, anxiety, time and energy) was ambiguous for the GPs. The GPs appreciated that a mental Disorder can be assigned in addition to a severe physical disease. The GPs found it unlikely that diagnostic workup of Somatic Symptoms would be cut short if the diagnostic criteria of SSD were fulfilled in a given patient. Conclusion Altogether, for the GPs, the advantages of the new diagnostic criteria for SSD outweighed the disadvantages. In particular, the newly included psychological criteria were seen as an important advancement in comparison to the previous need of merely excluding a physical disease.
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Somatic Symptom Disorder in the general population associations with medical status and health care utilization using the ssd 12
General Hospital Psychiatry, 2019Co-Authors: Willem J. Kop, Annekristin Toussaint, Floortje Mols, Bernd LöweAbstract:Abstract Objective Somatic Symptom Disorder (SSD) is characterized by excessive thoughts, feelings, and behaviors associated with physical Symptoms. DSM-5 criteria for SSD focus on these psychological features (criterion B) rather than the presence or absence of an identifiable medical Disorder. This study examines the role of medical Disorder in the assessment of SSD and associations of SSD with health care utilization. Method Participants (N = 448, mean age 46.7 ± 16.9 years, 53.8% women) were recruited from the general community and completed the SSD-12 to quantify DSM-5 Criterion B for SSD. Participants also provided demographic and medical background information. Results The SSD-12 total score was elevated in individuals with a major medical Disorder (N = 97: cardiovascular disease, cancer, pulmonary disease or other: SSD-12 = 11.6 ± 8.8), and also among those with medical conditions commonly treated in primary care (N = 46: e.g., migraine, asthma: SSD-12 = 8.3 ± 7.1), compared to those free of these Disorders (SSD-12 = 5.8 ± 7.0), which remained significant in age- and sex-adjusted models. Normative values are reported. High SSD-12 scores (≥15) were associated with more health care utilization (adjusted OR primary care visits = 3.35, 95%CI = 1.64–6.87). Conclusions The SSD-12 is a useful tool for the assessment of SSD. Medical comorbidity is associated with higher SSD-12 scores. Future studies are needed to determine whether SSD is more common in medical patients or whether correction of normative values is needed for screening purposes.
Anne Toussaint - One of the best experts on this subject based on the ideXlab platform.
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detecting dsm 5 Somatic Symptom Disorder criterion validity of the patient health questionnaire 15 phq 15 and the Somatic Symptom scale 8 sss 8 in combination with the Somatic Symptom Disorder b criteria scale ssd 12
Psychological Medicine, 2020Co-Authors: Anne Toussaint, Sebastian Kohlmann, Paul Husing, Bernd LöweAbstract:Background The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced Somatic Symptom and related Disorders (SSD) to improve the diagnosis of somatoform Disorders. It is unclear whether existing questionnaires are useful to identify patients with SSD. Our study investigates the diagnostic accuracy of the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Scale-8 (SSS-8) in combination with the Somatic Symptom Disorder – B Criteria Scale (SSD-12). Methods For this cross-sectional study, participants were recruited from a psychoSomatic outpatient clinic. PHQ-15, SSS-8, and SSD-12 were administered and compared with SSD criteria from a diagnostic interview. Sensitivity and specificity were calculated for optimal individual and combined cutpoints. Receiver operator curves were created and area under the curve (AUC) analyses assessed. Results Data of n = 372 patients [31.2% male, mean age: 39.3 years ( s.d. = 13.6)] were analyzed. A total of 56.2% fulfilled the SSD criteria. Diagnostic accuracy was moderate for each questionnaire (PHQ-15: AUC = 0.70; 95% CI = 0.65–0.76; SSS-8: AUC = 0.71; 95% CI = 0.66–0.77; SSD-12: AUC = 0.74; 95% CI = 0.69–0.80). Combining questionnaires improved diagnostic accuracy (PHQ-15 + SSD-12: AUC = 0.77; 95% CI = 0.72–0.82; SSS-8 + SSD-12: AUC = 0.79; 95% CI = 0.74–0.84). Optimal combined cutpoints were ⩾9 for the PHQ-15 or SSS-8, and ⩾23 for the SSD-12 (sensitivity and specificity = 69% and 70%). Conclusions The combination of the PHQ-15 or SSS-8 with the SSD-12 provides an easy-to-use and time- and cost-efficient opportunity to identify persons at risk for SSD. If systematically applied in routine care, effective screening and subsequent treatment might help to improve quality of life and reduce health care excess costs.
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comparing the diagnostic concepts of icd 10 somatoform Disorders and dsm 5 Somatic Symptom Disorders in patients from a psychoSomatic outpatient clinic
Journal of Psychosomatic Research, 2018Co-Authors: Paul Husing, Bernd Löwe, Anne ToussaintAbstract:Abstract Objective The reconceptualization of Somatic Symptom and related Disorders in DSM-5 led to numerous consequences in terms of prevalence and affected patient populations. The present study aimed to investigate frequencies of ICD-10 somatoform Disorders and DSM-5 Somatic Symptom Disorders, and how the respective diagnostic groups differ in terms of sociodemographic and psychopathological characteristics. It discusses the usefulness and reliability of the new diagnostic criteria. Method Patients from a German psychoSomatic outpatient clinic ( n = 438) completed self-report questionnaires on depression (PHQ-9), anxiety (GAD-7), Symptom burden (PHQ-15), psychological distress (SSD-12), and quality of life (SF-12). ICD-10 diagnoses were provided by treating clinicians, DSM-5 diagnoses were assessed via semi-structured telephone interviews. The prevalence of Somatic Symptom Disorders and their overlap with ICD-10 somatoform Disorders was evaluated. Comparisons between patients with either diagnosis were drawn. Results More than half of the sample ( n = 239, 54.6%) fulfilled the criteria for a Somatic Symptom Disorder. Compared to patients fulfilling ICD-10 criteria only, patients with a Somatic Symptom Disorder presented higher levels of Symptom related distress ( p = .045), health related anxiety ( p = .004), general anxiety ( p = .011), and lower mental health-related quality of life ( p = .015), while patients with ICD-10 somatoform Disorders reported a lower physical health-related quality of life ( p = .031). Conclusion DSM-5 criteria included more patients than ICD-10 somatoform Disorders in our sample. Patients diagnosed with a Somatic Symptom Disorder appear to be more severely impaired in terms of general and health-related anxiety and psychological distress associated to their Somatic Symptoms, especially when diagnosed with a severe form of Somatic Symptom Disorder.
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Validity and sensitivity to change of the Somatic Symptom Disorder-B Criteria Scale (SSD-12) in a clinical population.
General hospital psychiatry, 2018Co-Authors: Paul Husing, Bernd Löwe, Markus Bassler, Stella Koch, Anne ToussaintAbstract:Abstract Objective The SSD-12 is a brief self-report questionnaire to measure the psychological criteria of DSM-5 Somatic Symptom Disorder. This study examines its psychometric properties in a German inpatient sample from a psychoSomatic rehabilitation setting, and provides evidence to its sensitivity to change. Method Patients completed the SSD-12 and the Health49-subscale on somatoform complaints before and after receiving inpatient treatment. Therapists evaluated the psychological improvement of their patients at the end of treatment. Effect sizes (ES) and standardized response means (SRM) of pre- and post-SSD-12 mean changes were calculated for subgroups of patients who did or did not improve. Results SSD-12 scores at discharge were significantly lower compared to scores at admission for subgroups of patients who improved according to clinicians (t = 2976, df = 103, p = .004), and for patients who improved according to self-report (t = 5.059, df = 159, p Conclusion The SSD-12 shows sound psychometric properties and is useful and time-efficient for monitoring psychological burden associated with bothersome Somatic Symptoms. Its sensitivity to change over time could be documented.
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validity of the Somatic Symptom Disorder b criteria scale ssd 12 in primary care
Family Practice, 2018Co-Authors: Anne Toussaint, Bernhard Riedl, Simon Kehrer, Antonius Schneider, Bernd Löwe, Klaus LindeAbstract:Aim:The Somatic Symptom Disorder-B Criteria Scale (SSD-12) assesses the psychological features of DSM-5 Somatic Symptom Disorder. The purpose of the current study was to investigate the psychometric characteristics and validity of the 12-item instrument to demonstrate its suitability in primary care. Method:The study was designed as a cross-sectional survey set in five primary care practices from Munich, Germany (n = 501, 52.0% female, mean age 47 ± 16 years). Item and scale characteristics, as well as measures of reliability and validity, were determined. Results:The SSD-12 has good item characteristics and excellent reliability (Cronbach's α = 0.92). Confirmatory factor analyses provided evidence to support a general factor model of the SSD-12 in primary care (comparative fit index > 0.98, Tucker-Lewis index > 0.98, root mean square error of approximation = 0.090, 90% confidence interval: 0.078-0.102). SSD-12 total sum-score was significantly associated with Somatic Symptom burden (r = 0.48, P < 0.001), general anxiety (r = 0.54, P < 0.001) and depressive Symptoms (r = 0.60, P < 0.001). At the group level, SSD-12 scores could differentiate between different patient groups (e.g. with and without chronic illness). Conclusions:The SSD-12 appears to be a reliable, valid and time-efficient self-report measure of the psychological characteristics related to the experience of Somatic Symptoms which is suitable for primary care. Future research should evaluate its responsiveness to treatment and feasibility as a screening tool in different clinical settings.
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the Somatic Symptom Disorder b criteria scale ssd 12 factorial structure validity and population based norms
Journal of Psychosomatic Research, 2017Co-Authors: Anne Toussaint, Elmar Brähler, Bernd Löwe, Pascal JordanAbstract:Abstract Purpose The Somatic Symptom Disorder - B Criteria Scale (SSD-12) assesses the psychological features of DSM-5 Somatic Symptom Disorder (SSD). The present study investigates the dimensionality and psychometric properties in a general population sample and provides norm values. Method Test dimensionality was evaluated via confirmatory factor analysis and nonparametric item response theory. Correlational analyses and logistic regression models based on related measures (SSS 8, PHQ-2, GAD-2, Health Care Utilization) were used to derive predictive validity. Age and gender specific norms were derived via quantile regression. Results The SSD-12 has good item characteristics and excellent reliability (Cronbach's α = 0.95). Confirmatory factor analyses revealed a high correlation between the three proposed psychological subscales interpreted as cognitive, affective and behavioral aspects, indicating a general factor model of the SSD-12 in the general population (n = 2362, CFI = 0.99, TLI = 0.998, RMSEA = 0.09, 90% CI: 0.09–0.1). SSD-12 total sum-score was significantly associated with Somatic Symptom burden (r = 0.73, p Conclusion The SSD-12 is a reliable and valid self-report measure of the psychological characteristics of DSM-5 Somatic Symptom Disorder. The provided norms enable researchers and clinicians to compare SSD-12 scores with reference values of a general population sample.
Peter Henningsen - One of the best experts on this subject based on the ideXlab platform.
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prevalence and overlap of Somatic Symptom Disorder bodily distress syndrome and fibromyalgia syndrome in the german general population a cross sectional study
Journal of Psychosomatic Research, 2020Co-Authors: W Hauser, Bjarne Schmalbach, Elmar Brähler, Peter Henningsen, Frederick WolfeAbstract:Abstract Objective To study the prevalence and clinical characteristics of Somatic Symptom Disorder (SSD), Bodily Distress Syndrome (BDS) and fibromyalgia syndrome (FMS) and their overlap in the general German population. Methods A cross-sectional nationally representative population survey was performed. 2531 participants (mean age 48.8 ± 17.85 years, 53.3% women) completed the Somatic Symptom Scale SSS-8, the Bodily Distress Syndrome (BDS) 25 checklist, the Whiteley Index 7 (WI-7), the self-administered comorbidity questionnaire and the Michigan Body Map. Case definitions of SSD, BDS and FMS were assigned using established criteria. Results 4.5% of participants met the criteria of SSD (SSS – 8 at least one item “bothered very much” and WI- 7 total score ≥ 1). 9.6% met the criteria of single-organ BDS and 1.3% of multi-organ BDS. Prevalence of FMS according to 2016 criteria was 3.4%. 82.3% of FMS cases met any BDS criteria.28.1% of FMS cases satisfied SSD criteria. 28.8% of any BDS cases met the criteria of SSD. 75.1% of SSD cases met the criteria of any BDS. FMS cases reported the highest amount of Somatic and psychological Symptom burden and health anxieties. There were no differences in age and gender between any BDS and SSD cases. SSD cases reported worse general health and more fibromyalgia-related variables than any BDS cases. Conclusions In the general population, there is a substantial overlap between FMS and BDS, but not of FMS and SSD, and not of SSD and any BDS. Case definitions of the three Disorders partially captured different groups in the general population.
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Management of Somatic Symptom Disorder.
Dialogues in clinical neuroscience, 2018Co-Authors: Peter HenningsenAbstract:This review paper gives an overview of the management of Somatic Symptom Disorder. It starts with a description of the clinical problem of patients with persistent bodily distress, discusses classificatory, epidemiological, and etiological issues and then describes the evidence and practical principles of dealing with these patients who are often seen as "difficult" to treat. It is concluded that the best-suited approach is stepped care with close cooperation of primary care, a Somatic specialist, and mental health care professionals operating on the basis of a biopsychosocial model of integrating Somatic as well as psychosocial determinants of distress and therapeutic factors.
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core outcome domains for clinical trials on Somatic Symptom Disorder bodily distress Disorder and functional Somatic syndromes european network on Somatic Symptom Disorders recommendations
Psychosomatic Medicine, 2017Co-Authors: Winfried Rief, Maria Kleinstauber, Lisbeth Frostholm, Christopher R Burton, Ulrik F Malt, Judith G M Rosmalen, Alexandra Martin, Bernd Löwe, Peter Henningsen, Andreas SchroderAbstract:Objective: The harmonization of core outcome domains in clinical trials facilitates comparison and pooling of data, and simplifies the preparation and review of research projects, and comparison of risks and benefits of treatments. Therefore we provide recommendations for the core outcome domains that should be considered in clinical trials on the efficacy and effectiveness of interventions for Somatic Symptom Disorder, bodily distress Disorder, and functional Somatic syndromes. Methods: The European Network on Somatic Symptom Disorders group (EURONET-SOMA) of more than 20 experts in the field met twice in Hamburg to discuss issues of assessment and intervention research in Somatic Symptom Disorder, bodily distress Disorder, and functional Somatic syndromes. The consensus meetings identified core outcome domains that should be considered in clinical trials evaluating treatments for Somatic Symptom Disorder and associated functional Somatic syndromes. Results: The following core domains should be considered when defining ascertainment methods in clinical trials: (1) classification of Somatic Symptom Disorder/bodily distress Disorder, associated functional Somatic syndromes, and comorbid mental Disorders (using structured clinical interviews), duration of Symptoms, medical morbidity, and prior treatments (2) location, intensity, and interference of Somatic Symptoms, (3) associated psychobehavioral features and biological markers, (4) illness consequences (quality of life, disability, health care utilization, health care costs), (5) global improvement, treatment satisfaction, and (6) unwanted negative effects. Conclusions: The proposed criteria are intended to improve synergies of clinical trials and to facilitate decision making when comparing different treatment approaches. These recommendations should not result in inflexible guidelines, but increase consistency across investigations in this field.
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development and validation of the Somatic Symptom Disorder b criteria scale ssd 12
Psychosomatic Medicine, 2016Co-Authors: Annekristin Toussaint, Benjamin Gierk, Katharina Voigt, Annabel Herzog, Alexandra M. Murray, Kurt Kroenke, Winfried Rief, Peter Henningsen, Bernd LöweAbstract:To develop and validate a new self-report questionnaire for the assessment of the psychological features of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Somatic Symptom Disorder.The Somatic Symptom Disorder-B Criteria Scale (SSD-12) was developed in several steps from an initial pool of 98 items. The SSD-12 is composed of 12 items; each of the three psychological subcriteria is measured by four items. In a cross-sectional study, the SSD-12 was administered to 698 patients (65.8% female, mean [standard deviation] age = 38.79 [14.15] years) from a psychoSomatic outpatient clinic. Item and scale characteristics as well as measures of reliability and validity were determined.The SSD-12 has good item characteristics and excellent reliability (Cronbach α =.95). Confirmatory factor analyses suggested that a three-factorial structure that reflects the three psychological criteria interpreted as cognitive, affective, and behavioral aspects (n = 663, Comparative Fit Index > 0.99, Tucker-Lewis Index > 0.99, Root Mean Square Error of Approximation = 0.06, 90% confidence interval = 0.01-0.08). SSD-12 total sum score was significantly associated with Somatic Symptom burden (r = 0.47, p <.001) and health anxiety (r = 0.71, p <.001), and moderately associated with general anxiety (r = 0.35, p <.001) and depressive Symptoms (r = 0.22, p <.001). Patients with a higher SSD-12 psychological Symptom burden reported higher general physical and mental health impairment and significantly higher health care use.The SSD-12 is the first self-report questionnaire that operationalizes the new psychological characteristics of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Somatic Symptom Disorder. Initial assessment indicates that the SSD-12 has sufficient reliability and validity to warrant further testing in both research and clinical settings.
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Development and Validation of the Somatic Symptom Disorder-B Criteria Scale (SSD-12).
Psychosomatic medicine, 2016Co-Authors: Annekristin Toussaint, Benjamin Gierk, Katharina Voigt, Annabel Herzog, Alexandra M. Murray, Kurt Kroenke, Winfried Rief, Peter Henningsen, Bernd LöweAbstract:ABSTRACTObjectiveTo develop and validate a new self-report questionnaire for the assessment of the psychological features of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Somatic Symptom Disorder.MethodsThe Somatic Symptom Disorder–B Criteria Scale (SSD-12) was developed in se
Winfried Rief - One of the best experts on this subject based on the ideXlab platform.
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core outcome domains for clinical trials on Somatic Symptom Disorder bodily distress Disorder and functional Somatic syndromes european network on Somatic Symptom Disorders recommendations
Psychosomatic Medicine, 2017Co-Authors: Winfried Rief, Maria Kleinstauber, Lisbeth Frostholm, Christopher R Burton, Ulrik F Malt, Judith G M Rosmalen, Alexandra Martin, Bernd Löwe, Peter Henningsen, Andreas SchroderAbstract:Objective: The harmonization of core outcome domains in clinical trials facilitates comparison and pooling of data, and simplifies the preparation and review of research projects, and comparison of risks and benefits of treatments. Therefore we provide recommendations for the core outcome domains that should be considered in clinical trials on the efficacy and effectiveness of interventions for Somatic Symptom Disorder, bodily distress Disorder, and functional Somatic syndromes. Methods: The European Network on Somatic Symptom Disorders group (EURONET-SOMA) of more than 20 experts in the field met twice in Hamburg to discuss issues of assessment and intervention research in Somatic Symptom Disorder, bodily distress Disorder, and functional Somatic syndromes. The consensus meetings identified core outcome domains that should be considered in clinical trials evaluating treatments for Somatic Symptom Disorder and associated functional Somatic syndromes. Results: The following core domains should be considered when defining ascertainment methods in clinical trials: (1) classification of Somatic Symptom Disorder/bodily distress Disorder, associated functional Somatic syndromes, and comorbid mental Disorders (using structured clinical interviews), duration of Symptoms, medical morbidity, and prior treatments (2) location, intensity, and interference of Somatic Symptoms, (3) associated psychobehavioral features and biological markers, (4) illness consequences (quality of life, disability, health care utilization, health care costs), (5) global improvement, treatment satisfaction, and (6) unwanted negative effects. Conclusions: The proposed criteria are intended to improve synergies of clinical trials and to facilitate decision making when comparing different treatment approaches. These recommendations should not result in inflexible guidelines, but increase consistency across investigations in this field.
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Screening for DSM-5 Somatic Symptom Disorder: Diagnostic Accuracy of Self-Report Measures Within a Population Sample.
Psychosomatic medicine, 2017Co-Authors: Johannes A C Laferton, Winfried Rief, Elmar Brähler, Nikola Stenzel, Kristina Klaus, Ricarda MewesAbstract:OBJECTIVE The new DSM-5 Somatic Symptom Disorder was introduced to improve the diagnosis of persons experiencing what used to be called somatoform Disorders. So far, it is unclear whether existing self-report measures are useful to detect the new Somatic Symptom Disorder. This study investigates the diagnostic accuracy of three self-report questionnaires that measure Somatic complaints (15 item Patient Health Questionnaire [PHQ-15]) and psychological features (7-item Whiteley Index [WI-7]; Scale for Assessing Illness Behavior [SAIB]), in detecting Somatic Symptom Disorder. METHODS A nationally representative general population survey was performed resulting in 250 participants (minimum age = 14 years. 12.8% participation rate). Assessment took place at baseline and 12-month follow-up. Individual and combined diagnostic accuracy of the PHQ-15, WI-7, and SAIB in detecting Somatic Symptom Disorder was evaluated using the area under the curve (AUC) of a receiver operating characteristic. RESULTS Diagnostic accuracy was adequate to good for each individual questionnaire (PHQ-15: AUC = 0.79, p < .001, 95% confidence interval [CI] = 0.73-0.85; WI-7: AUC = 0.76, p < .001, 95% CI = 0.69-0.83; SAIB: AUC = 0.77, p < .001, 95% CI = 0.71-0.83). Combining the PHQ-15 and the WI-7 slightly improved diagnostic accuracy (AUC = 0.82, p < .001, 95% CI = 0.77-0.88), as did the combination of all three questionnaires (AUC = 0.85, p < .001, 95% CI = 0.79-0.90). CONCLUSIONS The PHQ-15, WI-7, and SAIB are useful screening instruments to detect persons at risk for Somatic Symptom Disorder, and a combination of these three instruments slightly improves diagnostic accuracy. Their use in routine care will lead to improved detection rates.
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development and validation of the Somatic Symptom Disorder b criteria scale ssd 12
Psychosomatic Medicine, 2016Co-Authors: Annekristin Toussaint, Benjamin Gierk, Katharina Voigt, Annabel Herzog, Alexandra M. Murray, Kurt Kroenke, Winfried Rief, Peter Henningsen, Bernd LöweAbstract:To develop and validate a new self-report questionnaire for the assessment of the psychological features of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Somatic Symptom Disorder.The Somatic Symptom Disorder-B Criteria Scale (SSD-12) was developed in several steps from an initial pool of 98 items. The SSD-12 is composed of 12 items; each of the three psychological subcriteria is measured by four items. In a cross-sectional study, the SSD-12 was administered to 698 patients (65.8% female, mean [standard deviation] age = 38.79 [14.15] years) from a psychoSomatic outpatient clinic. Item and scale characteristics as well as measures of reliability and validity were determined.The SSD-12 has good item characteristics and excellent reliability (Cronbach α =.95). Confirmatory factor analyses suggested that a three-factorial structure that reflects the three psychological criteria interpreted as cognitive, affective, and behavioral aspects (n = 663, Comparative Fit Index > 0.99, Tucker-Lewis Index > 0.99, Root Mean Square Error of Approximation = 0.06, 90% confidence interval = 0.01-0.08). SSD-12 total sum score was significantly associated with Somatic Symptom burden (r = 0.47, p <.001) and health anxiety (r = 0.71, p <.001), and moderately associated with general anxiety (r = 0.35, p <.001) and depressive Symptoms (r = 0.22, p <.001). Patients with a higher SSD-12 psychological Symptom burden reported higher general physical and mental health impairment and significantly higher health care use.The SSD-12 is the first self-report questionnaire that operationalizes the new psychological characteristics of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Somatic Symptom Disorder. Initial assessment indicates that the SSD-12 has sufficient reliability and validity to warrant further testing in both research and clinical settings.
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Development and Validation of the Somatic Symptom Disorder-B Criteria Scale (SSD-12).
Psychosomatic medicine, 2016Co-Authors: Annekristin Toussaint, Benjamin Gierk, Katharina Voigt, Annabel Herzog, Alexandra M. Murray, Kurt Kroenke, Winfried Rief, Peter Henningsen, Bernd LöweAbstract:ABSTRACTObjectiveTo develop and validate a new self-report questionnaire for the assessment of the psychological features of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Somatic Symptom Disorder.MethodsThe Somatic Symptom Disorder–B Criteria Scale (SSD-12) was developed in se
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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, 2014Co-Authors: Winfried Rief, Alexandra MartinAbstract:The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) changed the term “somatoform Disorders” to “Somatic Symptom and related Disorders” and further modified diagnostic labels and criteria. We review evidence for the validity of the new criteria, specifically of Somatic Symptom Disorder (SSD), and present a critical discussion of unsolved and new problems. We also provide an update of mechanisms and interventions that have been empirically evaluated in somatoform Disorders. For many mechanisms, it is unclear whether their role can be easily transposed to SSD. Therefore more research is needed on the similarities and differences between medically unexplained and medically explained conditions. To overcome the obvious shortcomings of the current classification, we offer a modification of this DSM-5 section as well as a crossover system to apply these criteria for Somatic Symptom and related Disorders. This proposal allows working with DSM-5 but also continuing successful lin...
Annekristin Toussaint - One of the best experts on this subject based on the ideXlab platform.
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Somatic Symptom Disorder in the general population associations with medical status and health care utilization using the ssd 12
General Hospital Psychiatry, 2019Co-Authors: Willem J. Kop, Annekristin Toussaint, Floortje Mols, Bernd LöweAbstract:Abstract Objective Somatic Symptom Disorder (SSD) is characterized by excessive thoughts, feelings, and behaviors associated with physical Symptoms. DSM-5 criteria for SSD focus on these psychological features (criterion B) rather than the presence or absence of an identifiable medical Disorder. This study examines the role of medical Disorder in the assessment of SSD and associations of SSD with health care utilization. Method Participants (N = 448, mean age 46.7 ± 16.9 years, 53.8% women) were recruited from the general community and completed the SSD-12 to quantify DSM-5 Criterion B for SSD. Participants also provided demographic and medical background information. Results The SSD-12 total score was elevated in individuals with a major medical Disorder (N = 97: cardiovascular disease, cancer, pulmonary disease or other: SSD-12 = 11.6 ± 8.8), and also among those with medical conditions commonly treated in primary care (N = 46: e.g., migraine, asthma: SSD-12 = 8.3 ± 7.1), compared to those free of these Disorders (SSD-12 = 5.8 ± 7.0), which remained significant in age- and sex-adjusted models. Normative values are reported. High SSD-12 scores (≥15) were associated with more health care utilization (adjusted OR primary care visits = 3.35, 95%CI = 1.64–6.87). Conclusions The SSD-12 is a useful tool for the assessment of SSD. Medical comorbidity is associated with higher SSD-12 scores. Future studies are needed to determine whether SSD is more common in medical patients or whether correction of normative values is needed for screening purposes.
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development and validation of the Somatic Symptom Disorder b criteria scale ssd 12
Psychosomatic Medicine, 2016Co-Authors: Annekristin Toussaint, Benjamin Gierk, Katharina Voigt, Annabel Herzog, Alexandra M. Murray, Kurt Kroenke, Winfried Rief, Peter Henningsen, Bernd LöweAbstract:To develop and validate a new self-report questionnaire for the assessment of the psychological features of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Somatic Symptom Disorder.The Somatic Symptom Disorder-B Criteria Scale (SSD-12) was developed in several steps from an initial pool of 98 items. The SSD-12 is composed of 12 items; each of the three psychological subcriteria is measured by four items. In a cross-sectional study, the SSD-12 was administered to 698 patients (65.8% female, mean [standard deviation] age = 38.79 [14.15] years) from a psychoSomatic outpatient clinic. Item and scale characteristics as well as measures of reliability and validity were determined.The SSD-12 has good item characteristics and excellent reliability (Cronbach α =.95). Confirmatory factor analyses suggested that a three-factorial structure that reflects the three psychological criteria interpreted as cognitive, affective, and behavioral aspects (n = 663, Comparative Fit Index > 0.99, Tucker-Lewis Index > 0.99, Root Mean Square Error of Approximation = 0.06, 90% confidence interval = 0.01-0.08). SSD-12 total sum score was significantly associated with Somatic Symptom burden (r = 0.47, p <.001) and health anxiety (r = 0.71, p <.001), and moderately associated with general anxiety (r = 0.35, p <.001) and depressive Symptoms (r = 0.22, p <.001). Patients with a higher SSD-12 psychological Symptom burden reported higher general physical and mental health impairment and significantly higher health care use.The SSD-12 is the first self-report questionnaire that operationalizes the new psychological characteristics of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Somatic Symptom Disorder. Initial assessment indicates that the SSD-12 has sufficient reliability and validity to warrant further testing in both research and clinical settings.
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Development and Validation of the Somatic Symptom Disorder-B Criteria Scale (SSD-12).
Psychosomatic medicine, 2016Co-Authors: Annekristin Toussaint, Benjamin Gierk, Katharina Voigt, Annabel Herzog, Alexandra M. Murray, Kurt Kroenke, Winfried Rief, Peter Henningsen, Bernd LöweAbstract:ABSTRACTObjectiveTo develop and validate a new self-report questionnaire for the assessment of the psychological features of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Somatic Symptom Disorder.MethodsThe Somatic Symptom Disorder–B Criteria Scale (SSD-12) was developed in se