Identifying and measuring the severity of somatic symptom disorder using the Self-reported Somatic Symptom Scale-China (SSS-CN): a research protocol for a diagnostic study

Abstract

IntroductionThe detection rate of somatic symptom disorder (SSD) in general hospitals is unsatisfactory. Self-report questionnaires that assess both somatic symptoms and psychological characteristics will improve the process of screening for SSD. The Somatic Symptom Scale-China (SSS-CN) questionnaire has been developed to meet this urgent clinical demand. The aim of this research is to validate the self-reported SSS-CN as a timely and practical instrument that can be used to identify SSD and to assess the severity of this disorder.Methods and analysisAt least 852 patients without organic disease but presenting physical discomfort will be recruited at a general hospital. Each patient will undergo aDiagnostic and Statistical Manual of Mental Disorders, 5th Edition(DSM-5)-guided physician diagnosis, including disease identification and severity assessment, as the reference standard. This research will compare the diagnostic performance of the SSS-CN for SSD, the Patient Health Questionnaire-15 (PHQ-15) and other SSD-related questionnaires. Statistical tests to measure the area under the curve (AUC) and volume under the surface of the receiver operating curve will be used to assess the accuracy of the SSD identification and the severity assessment, respectively. In addition to this standard diagnostic study, we will conduct follow-up investigations to explore the effectiveness of the SSS-CN in monitoring treatment effects.Ethics and disseminationEthical approval was obtained from the Renji Hospital Human Research Ethics Committee, approval number 2 015 016. The findings of this study will be disseminated via peer-reviewed journals and presented at international conferences.Trial registration numberNCT03513185.

Prevalence and characteristics of somatic symptom disorder in the elderly in a community-based population: a large-scale cross-sectional study in China

“…These physician assessments were used as the reference standard, and a cutoff value of 30 yielded an optimal sensitivity of 0.96 and specificity of 0.86. These findings were consistent with the research of Jiang et al [ 19 ]. Thus, SSS-CN scores ranging from 20 to 29, 30–39, 40–59 and ≥ 60 correspond to normal, mild, moderate and severe SSD, respectively.…”

“…To screen for SSD, we designed a prospective cross-sectional study to assess physical and psychological characteristics in elderly people from 105 communities in Shanghai, China. Differs from SSD-12 (focuses mainly on psychological feelings, which views somatic discomfort as a general concept, and focuses on the impact of the disease on the individual), we previously developed the Somatic Symptom Scale-China (SSS-CN) questionnaire, a somatic and psychological symptom scale based on the DSM-5 that can be used to assess a combination of psychological, behavioral, and somatic symptoms and which is designed to assess both presence and severity of symptoms [ 19 ]. We validated the reliability and validity of this instrument in a previous study [ 20 ].…”

Assessment of the structured clinical interview (SCID) for DSM-5 for somatic symptom disorder in general hospital outpatient clinics in China

“…The PHQ-15 was validated in Chinese for somatic symptoms [14,15]. The SSS-8 is a self-rating scale used to quantify the somatic symptom burden of patients in the past week and has been validated in Chinese patients [16]. The severity of depression and generalized anxiety were assessed using the 9-item depression scale PHQ-9 and the 7-item GAD-7, respectively.…”

Assessment of the Structured Clinical Interview (SCID) for DSM-5 for Somatic Symptom Disorder in General Hospital Outpatient Clinics in China

“…The PHQ-15 was validated in Chinese for somatic symptoms [14,15]. SSS-8 is a self-rating scale used to quantify the somatic symptom burden of patients in the past week and has been validated in Chinese [16]. The severity of depression and generalized anxiety were assessed using the 9-item depression scale PHQ-9 and the 7-item GAD-7, respectively.…”