Somatic Complaints in Primary Care: Further Examining the Validity of the Patient Health Questionnaire (PHQ-15)

Interian, Alejandro; Allen, Lesley A.; Gara, Michael A.; Escobar, Javier I.; Díaz-Martínez, Angélica M.

doi:10.1176/appi.psy.47.5.392

Cited by 97 publications

(75 citation statements)

References 29 publications

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“…4,13 Interian et al measured the convergent validity of the PHQ-15 with the Composite International Diagnostic Interview symptom count in patients with moderate to severe somatization. They found a signifi cantly lower validity in the Hispanic population.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Detecting Somatoform Disorders in Primary Care With the PHQ-15

Ravesteijn

Wittkampf

Lucassen

et al. 2009

The Annals of Family Medicine

171

125

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PURPOSE Because recognition and management of patients with somatoform disorders are diffi cult, we wanted to determine the specifi city, sensitivity, and the test-retest reliability of the 15-symptom Patient Health Questionnaire (PHQ-15) for detection of somatoform disorders in a high-risk primary care population. METHODSWe studied the performance of the PHQ-15 in comparison with the Structured Clinical Interview for the Diagnostic and Statistical Manual-IV Axis I disorders (SCID-I) as a reference standard. From January through September 2006, we approached patients for participation. This study was conducted in primary care settings in the Netherlands. Patients aged between 18 and 70 years were eligible if they belonged to 1 or more of the following groups: (1) patients with unexplained somatic complaints, (2) frequent attenders, and (3) patients with mental health problems. For the SCID-I interview we invited all patients with a PHQ-15 score of 6 or greater and a random sample of 30% of patients with a PHQ-15 score of less than 6. The primary study outcomes were the sensitivity and specifi city for the validity and the κ coeffi cient for the test-retest reliability.RESULTS Of 2,147 eligible patients, 906 (42%) participated (mean age 48 years, 62% female). At a cutoff level of 3 or more severe somatic symptoms during the past 4 weeks, sensitivity was 78% and specifi city 71%. The test-retest reliability was 0.60. CONCLUSIONSThe PHQ-15 is a valid and moderately reliable questionnaire for the detection of patients in a primary care setting at risk for somatoform disorders. INTRODUCTIONI n primary care 20% to 50% of all patients complaining of physical symptoms can be categorized as having medically unexplained symptoms.1,2 Earlier research shows that the criteria for somatoform disorders are met in 10% to 16% of all primary care patients. [3][4][5] Usually, the medically unexplained symptoms spontaneously resolve or improve by effective management. Sometimes the complaints persist, leading to functional impairment. 6 Somatoform disorders are a burden for both patients and family physicians. Patients with these disorders are at risk of overtesting and unnecessary treatment, 7,8 and the doctor-patient relationship is often diffi cult and strained.9 It is a challenge for physicians to improve their competence in recognizing and managing patients with somatoform disorders, and a screening questionnaire for somatoform disorders might be helpful.We wanted to test a screening questionnaire in a subgroup of patients for whom family physicians will most likely use the instrument. Because screening for early detection in a high-risk population is a key concept in family medicine, 10 we opted to screen the following population in the context of regular primary care: frequent attenders and patients who were identifi ed by their family physicians as having either mental health problems or unexplained somatic complaints. Hiske van 233 DE T EC T ING S O M ATOF OR M DIS OR DER SWe used the Dutch version of the Patient...

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Section: Strengths and Limitationsmentioning

confidence: 99%

“…4 Interian et al reproduced the high internal reliability and established the convergence of the PHQ-15 with the Composite International Diagnostic Interview. 13 Data on test-retest reliability of the PHQ-15, however, are still lacking.…”

Section: De T Ec T Ing S O M Atof or M Dis Or Der Smentioning

confidence: 99%

Detecting Somatoform Disorders in Primary Care With the PHQ-15

Ravesteijn

Wittkampf

Lucassen

et al. 2009

The Annals of Family Medicine

171

125

View full text Add to dashboard Cite

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“…The PHQ-15 has already been validated in primary-care settings. 19,20 The cognitive battery consisted of the Korean version of the minimental state examination (K-MMSE) for general cognitive function, 21 the Seoul verbal learning test (SVLT) for episodic memory and learning 22 and the Korean version of the frontal assessment battery (K-FAB) for frontal executive function. 23 The SVLT is the modified Korean version of the Hopkins verbal learning test, 24 and by performing the SVLT, scores of three trials and delayed recalls were recorded for the evaluation of learning and memory consolidation.…”

Section: Methodsmentioning

confidence: 99%

“…Erectile dysfunction was defined as an inability to attain and/or maintain a penile erection sufficient for satisfactory sexual performance. 17 The severity of erectile dysfunction was classified based on baseline IIEF erectile function domain score into mild (17)(18)(19)(20)(21), mild to moderate (12)(13)(14)(15)(16), moderate (8)(9)(10)(11) and severe (5-7). 18 The etiology of erectile dysfunction was determined by the study investigator based on patient history, as well as physical and laboratory examination findings.…”

Section: Subjectsmentioning

confidence: 99%

Effects of repeated dosing with Udenafil (Zydena) on cognition, somatization and erection in patients with erectile dysfunction: a pilot study

et al. 2011

Int J Impot Res

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The PDE5 inhibitors have recently been found to have cognitive-enhancing effects in animal models. To investigate the efficacy of repeated dosing with a PDE5 inhibitor on cognitive function and somatization in patients with erectile dysfunction, 27 patients with erectile dysfunction received udenafil (100 mg) at 3-day intervals for 2 months. The international index of erectile function-5 (IIEF-5), a cognitive battery (the Korean version of mini-mental state examination (K-MMSE), the frontal assessment battery (K-FAB), the Seoul verbal learning test) and a physical health questionnaire-15 (PHQ-15) were performed at baseline and at 2 months, following the administration of udenafil. The patients were divided on the basis of their IIEF-5 score into responders (change47) and non-responders. The mean IIEF-5 score was significantly increased after treatment (7.92±3.83 to 16.33±4.75, Po0.001). The scores of K-MMSE (27.03±1.58 to 28.07±1.57, P ¼ 0.001), K-FAB (13.65 ± 1.96 to 15.41 ± 1.85, Po0.001) and PHQ-15 (18.92 ± 4.96 to 17.63 ± 4.75, P ¼ 0.003) were significantly improved after treatment. In addition, the responders (n ¼ 16) had more improved cognitive function (r ¼ 0.603, P ¼ 0.001) and somatization (r ¼ À0.402, P ¼ 0.038) than non-responders (n ¼ 11). Repeated dosing with a PDE5 inhibitor seems to improve cognitive function and somatization, as well as erectile function in patients with erectile dysfunction.

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“…A partir de la puntuación alcanzada, los entrevistados se clasificaron según las cuatro categorías de intensidad propuestas por los autores del PHQ: mínima: 0-4; baja: 5-9; media: 10-14; y alta: 15-30. La consistencia interna del instrumento en su versión original en inglés, medida por el coeficiente α de Cronbach, fue de 0,80 (12), mientras que en un estudio donde se analizaron sus propiedades psicomé-tricas en una muestra con hispanos y no hispanos (n = 172) con altos niveles de síntomas médicamente inexplicables, la consistencia interna se mantuvo elevada en ambos grupos (α = 0,79) (13). También se ha informado una elevada consistencia interna en población mexicana (α = 0,77) (8).…”

Section: Materiales Y Métodosunclassified

Relación entre la depresión, la ansiedad y los síntomas psicosomáticos en una muestra de estudiantes universitarios del norte de México

Ramírez¹,

Hernández²,

Garcı́a-Campayo³

2009

Rev Panam Salud Publica

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Objetivo. Determinar la relación existente entre la ansiedad, la depresión y los síntomas psicosomáticos en una muestra de estudiantes universitarios del norte de Conclusiones. Se confirmó la relación directa entre la intensidad de los síntomas somáti-cos, la depresión y la ansiedad. Se recomienda incluir en los programas de prevención o tratamiento de cualquiera de estos tres trastornos a los otros dos. Se deben implementar programas específicos para los jóvenes universitarios.Ansiedad, depresión, trastornos psicosomáticos, estudiantes, México. RESUMENCuando una persona siente dolor o algún otro síntoma somático tiende a atribuirlo a alguna enfermedad, sin embargo, de las molestias que padecemos solo 5% se debe a enfermedades, mientras 70% está relacionada con causas naturales o ambientales y el 25% restante obedece a causas psicológicas (1). Farré y Fullana (2) confirmaron que hasta 80% de las personas sanas pueden haber experimentado en su vida molestias de Palabras clave Investigación original / Original researchGonzález Ramírez MT, Landero Hernández R, García-Campayo J. Relación entre la depresión, la ansiedad y los síntomas psicosomáticos en una muestra de estudiantes universitarios del norte de Mé-xico. Rev Panam Salud Publica. 2009;25(2):141-5.

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Somatic Complaints in Primary Care: Further Examining the Validity of the Patient Health Questionnaire (PHQ-15)

Cited by 97 publications

References 29 publications

Detecting Somatoform Disorders in Primary Care With the PHQ-15

Detecting Somatoform Disorders in Primary Care With the PHQ-15

Effects of repeated dosing with Udenafil (Zydena) on cognition, somatization and erection in patients with erectile dysfunction: a pilot study

Relación entre la depresión, la ansiedad y los síntomas psicosomáticos en una muestra de estudiantes universitarios del norte de México

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