How to assess common somatic symptoms in large-scale studies: A systematic review of questionnaires

Zijlema, Wilma L.; Stolk, Ronald P.; Löwe, Bernd; Rief, Winfried; White, Peter D; Rosmalen, Judith

doi:10.1016/j.jpsychores.2013.03.093

Cited by 200 publications

(209 citation statements)

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“…With an index based on symptoms described in general terms, measuring the severity of symptoms and in a relatively short time span, our index met the requirements of Zijlema et al 5 review of functional somatic symptoms. By creating an index of symptoms, we can capture an underlying correlation between variables, while not losing statistical power.…”

Section: On the Methodsmentioning

confidence: 99%

“…Particularly, knowledge is lacking regarding health problems in the borderline between psyche and soma, such as functional somatic symptoms. These have been shown to be disabling and costly for individuals and society, 5 and constitute an issue of great public health importance.…”

Section: Introductionmentioning

confidence: 99%

“…This concept refers to physical symptoms, such as headaches, abdominal pain, musculoskeletal pain, dizziness and fatigue, which are closely related to anxiety and depression. 5,[18][19][20] However, they represent a separate dimension and are not fully explained by internalized mental health symptoms. 5,21 They have also been shown to be related to long-term mental health problems such as suicide.…”

Section: Introductionmentioning

confidence: 99%

“…5,[18][19][20] However, they represent a separate dimension and are not fully explained by internalized mental health symptoms. 5,21 They have also been shown to be related to long-term mental health problems such as suicide. 19 Functional somatic symptoms often differ between women and men; 18 in childhood the levels are similar for girls and boys, but from early adolescence onwards, girls and women generally report higher levels than boys and men.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Youth unemployment and functional somatic symptoms in adulthood: results from the Northern Swedish cohort

Brydsten

Hammarström

Strandh

et al. 2015

Eur J Public Health

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Section: On the Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Youth unemployment and functional somatic symptoms in adulthood: results from the Northern Swedish cohort

Brydsten

Hammarström

Strandh

et al. 2015

Eur J Public Health

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“…It consists of eight items and it has been largely validated (Gierk et al, 2014). It has a high content validity and high construct validity and high Cronbach’s α (Gierk et al, 2014; Zijema et al, 2013). …”

Section: Methodsmentioning

confidence: 99%

Transdiagnostic culturally adapted CBT with Farsi-speaking refugees: a pilot study

Kananian

Ayoughi

Farugie

et al. 2017

European Journal of Psychotraumatology

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Background: Approximately half of all asylum seekers suffer from trauma-related disorders requiring treatment, among them Posttraumatic Stress Disorder (PTSD), depression, anxiety, and somatic symptoms. There is a lack of easily accessible, low-threshold treatments taking the cultural background into account. Culturally Adapted CBT (CA CBT) is a well evaluated, transdiagnostic group intervention for refugees, using psychoeducation, meditation, and Yoga-like exercises. Objective: An uncontrolled pilot study with male Farsi-speaking refugees from Afghanistan and Iran was conducted to investigate feasibility with this ethnic group; a group for which no previous CBT trials have been reported. Method: The participants were nine Farsi-speaking, male refugees with M.I.N.I./DSM-IV diagnoses comprising PTSD, major depressive disorder, and anxiety disorders. Treatment components were adapted to the specific cultural framework of perception of symptoms, causes, ideas of healing, and local therapeutic processes. Before and after 12 weeks of treatment, the primary outcome was assessed using the General Health Questionnaire (GHQ-28). Secondary outcome measures were the Posttraumatic Checklist, Patient Health Questionnaire, Somatic Symptom Scale, World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Affective Style Questionnaire (ASQ), and Emotion Regulation Scale (ERS). Results: Seven participants completed treatment. In the completer analysis, improvements were found on almost all questionnaires. Large effect sizes were seen for the GHQ-28 (d = 2.0), WHOQOL-BREF scales (d = 1.0–2.3), ASQ tolerating subscale (d = 2.2), and ERS (d = 1.7). With respect to feasibility, cultural adaptation seemed to be a crucial means to promote effectiveness. Conclusion: CA CBT may reduce general psychopathological distress and improve quality of life. Improvement in emotion regulation strategies may mediate treatment effects. More support should be provided to enhance coping with the uncertainty of asylum status and stressful housing conditions. CA CBT appears to be a promising transdiagnostic treatment, serving as an initial low-threshold therapy in a stepped care approach.

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The Somatic Symptom Scale–8 (SSS-8)

et al. 2014

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are the core features of many medical diseases, and they are used to evaluate the severity and course of illness. The 8-item Somatic Symptom Scale (SSS-8) was recently developed as a brief, patient-reported outcome measure of somatic symptom burden, but its reliability, validity, and usefulness have not yet been tested. OBJECTIVE To investigate the reliability, validity, and severity categories as well as the reference scores of the SSS-8. DESIGN, SETTING, AND PARTICIPANTS A national, representative general-population survey was performed between June 15, 2012, and July 15, 2012, in Germany, including 2510 individuals older than 13 years. MAIN OUTCOMES AND MEASURES The SSS-8 mean (SD), item-total correlations, Cronbach α, factor structure, associations with measures of construct validity (Patient Health Questionnaire-2 depression scale, Generalized Anxiety Disorder-2 scale, visual analog scale for general health status, 12-month health care use), severity categories, and percentile rank reference scores. RESULTS The SSS-8 had excellent item characteristics and good reliability (Cronbach α = 0.81). The factor structure reflects gastrointestinal, pain, fatigue, and cardiopulmonary aspects of the general somatic symptom burden. Somatic symptom burden as measured by the SSS-8 was significantly associated with depression (r = 0.57 [95% CI, 0.54 to 0.60]), anxiety (r = 0.55 [95% CI, 0.52 to 0.58]), general health status (r = −0.24 [95% CI, −0.28 to −0.20]), and health care use (incidence rate ratio, 1.12 [95% CI, 1.10 to 1.14]). The SSS-8 severity categories were calculated in accordance with percentile ranks: no to minimal (0-3 points), low (4-7 points), medium (8-11 points), high (12-15 points), and very high (16-32 points) somatic symptom burden. For every SSS-8 severity category increase, there was a 53% (95% CI, 44% to 63%) increase in health care visits. CONCLUSIONS AND RELEVANCE The SSS-8 is a reliable and valid self-report measure of somatic symptom burden. Cutoff scores identify individuals with low, medium, high, and very high somatic symptom burden.

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How to assess common somatic symptoms in large-scale studies: A systematic review of questionnaires

Cited by 200 publications

References 76 publications

Youth unemployment and functional somatic symptoms in adulthood: results from the Northern Swedish cohort

Youth unemployment and functional somatic symptoms in adulthood: results from the Northern Swedish cohort

Transdiagnostic culturally adapted CBT with Farsi-speaking refugees: a pilot study

The Somatic Symptom Scale–8 (SSS-8)

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