AccScience Publishing / JCBP / Online First / DOI: 10.36922/jcbp.1813
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CASE REPORT

Effective prediction of somatic symptom disorder–B criteria in China: A case report

Jashin In1 ,  Yixiao Chen1 ,  Rainer Leonhart2 ,  Jing Wei3 ,  Lan Zhang4 ,  Yaoyin Zhang5 ,  Hua Chen6 ,  Xiquan Ma7 ,  Wentian Li8 ,  Jie Ren9 ,  Wei Lu10 ,  Kurt Fritzsche11† ,  Zheng Lu1† ,  Heng Wu1*†
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1 Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
2 Institute of Psychology, University of Freiburg, Freiburg, Germany
3 Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
4 Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
5 Department of Psychosomatic Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
6 Department of Psychological Medicine, Zhong Shan Hospital, Fudan University, Shanghai, China
7 Department of Psychosomatic Medicine, School of Medicine, Dongfang Hospital, Tongji University, Shanghai, China
8 Department of Clinical Psychology, Wuhan Mental Health Center, Wuhan, China
9 Department of Rehabilitation, General Hospital of Jincheng Anthracite Coal Mining Group Co. Ltd., Jincheng, China
10 Department of Psychosomatic Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital University, Beijing, China
11 Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
JCBP 2024, 2(1), 1813 https://doi.org/10.36922/jcbp.1813
Submitted: 12 September 2023 | Accepted: 23 November 2023 | Published: 17 January 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

According to the diagnostic criteria for somatic symptom disorder (SSD) outlined in the Diagnostic and Statistical Manual of Mental Disorders-5th (DSM-5), there is a necessity for a rapid, simple, and effective diagnostic tool in the outpatient setting to predict the SSD–B criteria. This study aims to evaluate the screening diagnostic value of combining the duration of concern about physical discomfort per day with the Whiteley Index-8 (WI-8) scale. In a previous multicenter cross-sectional study, patients were recruited from outpatient clinics in general hospitals (n = 699). In this comparative study, we recruited an additional 100 patients from a psychosomatic outpatient unit. Receiver operating curve (ROC) analysis was applied to obtain the optimal cutoff value for the time spent worrying about physical discomfort per day and the WI-8 scale. The analysis of both datasets reveals significant differences in the amount of time spent on symptoms per day between the groups. In the previous multicenter study, patients in the high-score group expressed more concern about physical discomfort than those in the low-score group (4.5 ± 4.8 h/day [h/d] vs. 0.9 ± 1.9 h/d; t = 13.943; P < 0.01). In the current comparative study (n = 100), the high-score group spent 5.3 ± 4.2 h/d worrying about physical symptoms, while the low-score group spent 2.3 ± 3.7 h/d. ROC curve analysis indicated that the cutoff value for time in the previous multicenter study was 1.25 h (area under the ROC curve [AUC] = 0.839), and the WI-8 scale score was 19 (AUC = 0.907). Combining the two increased the AUC–0.921 (P < 0.001). The cutoff value for time in the comparative study was 1.9 h (AUC = 0.801), and the WI-8 scale score was 11 (AUC = 0.925). Combining the two increased the AUC to 0.935 (P < 0.001). The combination of time and the WI-8 scale offers a simple, cost-effective, rapid, and direct method for clinical doctors to screen for somatic symptom disorders–B criteria.

Keywords
Somatic symptom disorder
Psychological criteria
Symptom-related behavior
Reference score
Somatic Symptom Disorder–B Criteria Scale
Receiver operating curve
Funding
National Natural Science Foundation of China Youth Fund
Conflict of interest
The authors declare they have no competing interests.
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Journal of Clinical and Basic Psychosomatics, Electronic ISSN: 2972-4414 Print ISSN: 3060-8562, Published by AccScience Publishing
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