Clinimetric Assessment in Psychosomatic Medicine

Abstract

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Clinimetric properties of the diagnostic criteria for psychosomatic research among the elderly

“…The results overall highlight that DCPR‐R‐SSI is a clinimetric clinically useful and innovative tool to comprehensively assess psychosomatic syndromes in the elderly, thus allowing to catch what may otherwise remain underdiagnosed among elderly subjects more often than in the general population (Dehoust et al, 2017; Galeazzi et al, 2004; Mansueto et al, 2022; Wijeratne et al, 2003) due to unsuitable and mislabelling usual taxonomy (Cosci & Fava, 2016, 2019; Frances & Chapman, 2013), and above all due to the overlap between psychosomatic symptoms and age‐related complaints (Dehoust et al, 2013; Mansueto et al, 2022; Wijeratne & Hickie, 2001). Psychosomatic syndromes are usually under detected among elderly with rates ranging from 1.5% (Lyness et al, 1999) to 13% (Leiknes et al, 2007), but when DCPR were applied, the rate raised up to 60% (Mansueto et al, 2022).…”

“…Possible explanations are (a) the poor clinical utility of the current nosography (e.g. Diagnostic and Statistical Manual of Mental Disorders‐5 [DSM‐5]) (Cosci & Fava, 2016; Rapoport, 2014), which does not include psychosocial aspects affecting medical conditions (Cosci & Fava, 2016, 2019; Guidi et al, 2013; Hanel et al, 2009; Piolanti et al, 2019; Vanheule et al, 2014) even though they play a role in the causation, development, and healing process of physical disease (Basińska & Wozniewicz, 2016; Schulz & Albert, 2009); (b) elderly often has physical symptoms related to poor physical health, which might be erroneously interpreted as somatic symptom disorders (Rapoport, 2014); (c) psychological manifestations, such as demoralization and irritable mood, which pertain to the sphere of mood dysregulation, are at risk of being inappropriately diagnosed as major depressive or adjustment disorder (De Figueiredo, 1993, 2013; Marsa et al, 2020; Salazar et al, 2015; Woźniewicz & Cosci, 2023) also in old adults.…”

Clinical utility of the Diagnostic Criteria for Psychosomatic Research for a comprehensive assessment of the elderly

“…An implication in clinical practice is that elderly patients with DCPR syndrome and DSM‐5 diagnosis can be more comprehensively examined if DCPR‐R are used as a complementary tool to DSM and that elderly patients with DCPR syndromes and no DSM‐5 diagnosis can receive an adequate clinical attention, and care, only if the assessment with DCPR‐R is implemented. Particularly striking is the lack of DSM diagnoses under the rubric of somatic symptom and related disorders, providing further evidence of the clinical inadequacy of the DSM‐5 classification in the psychosomatic realm (Cosci & Fava, 2016, 2019).…”

“…It was estimated that around 59% of the subjects in community samples has at least one psychosomatic syndrome, which is associated with increased stress, psychological distress and decreased psychological well‐being (Mangelli et al, 2006). Notwithstanding this, psychosomatic syndromes are often unacknowledged and undiagnosed (Dehoust et al, 2017; Wijeratne et al, 2003), since their assessment is commonly based on a customary clinical taxonomy (e.g., DSM), which is clinically inadequate (Cosci & Fava, 2016, 2019). Psychosomatic syndromes are particularly understudied in the elderly (Andreas et al, 2021; Mangelli et al, 2006; Wijeratne et al, 2003; Wijeratne & Hickie, 2001).…”