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

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.