Network analysis of somatic symptoms in Chinese patients with depressive disorder

Li, Yang; Jia, Shoumei; Cao, Bin; Chen, Li; Shi, Zhongying; Zhang, Hao

doi:10.3389/fpubh.2023.1079873

Cited by 6 publications

(1 citation statement)

References 38 publications

(44 reference statements)

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“…Depressive and somatic symptoms often occur simultaneously and interact with each other [ 30 , 31 ]. One study found that 17% of patients with SFD had a depressive disorder, and 54% of patients with depressive disorder had SFD [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Characteristics and economic burden of patients with somatoform disorders in Chinese general hospitals: a multicenter cross-sectional study

et al. 2023

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Background In China, patients with somatoform disorders (SFD) often seek medical treatment repeatedly in outpatient clinics of general hospitals, which increases unreasonable medical expenses. It is imperative to provide early screening to these patients and specialized treatment to reduce the unnecessary cost. This study aimed to screen patients with SFD in general hospitals using a new Chinese questionnaire and explore the characteristics and economic burden of these patients. Methods Patients (n = 1497) from the outpatient department of neurology, cardiology and gastroenterology of three large general hospitals were included. Participants were screened using a newly developed questionnaire, the Self-screening Questionnaire for Somatic Symptoms (SQSS), to identify the patients with SFD (total SQSS score ≥ 29 points). We compared the demographics and clinical information of patients with and without SFD. Logistic regression was used to explore potential factors related to medical expenses, visits to doctors and sick leave days taken. Results The frequency of detection of patients with SFD was 17.03%. There were significant differences in employment, doctor visits, symptom duration, medical expenses, sick leave days, PHQ-15 scores, and PHQ-9 scores between patients with SFD and without SFD. General nonspecific somatic symptoms were frequently present in patients with SFD. Several potential factors were associated with higher medical expenses, repeated doctor visits, and sick leave days taken in the regression analysis. Conclusion The findings indicate that patients with SFD are common in general hospitals, and their direct and indirect economic burden is higher than that of non-SFD patients, which indicates that more screening effort should be made to this group to early identify their problems. Certain characteristics were identified among patients with SFD and several factors were associated with negative consequences of SFD, all of which might be prevented by developing a preventive intervention program to reduce the economic burden of the patients.

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Section: Discussionmentioning

confidence: 99%

Characteristics and economic burden of patients with somatoform disorders in Chinese general hospitals: a multicenter cross-sectional study

et al. 2023

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Measurement Properties of the Patient Health Questionnaire–15 and Somatic Symptom Scale–8

Hybelius,

Kosic,

Salomonsson

et al. 2024

JAMA Netw Open

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ImportanceThe subjective experience of somatic symptoms is a key concern throughout the health care system. Valid and clinically useful instruments are needed.ObjectiveTo evaluate the measurement properties of 2 widespread patient-reported outcomes: the Patient Health Questionnaire–15 (PHQ-15) and Somatic Symptom Scale–8 (SSS-8).Data SourcesMedline, PsycINFO, and Web of Science were last searched February 1, 2024.Study SelectionEnglish-language studies reporting estimates pertaining to factor analysis, taxometric analysis, internal consistency, construct validity, mean scores in relevant groups, cutoffs, areas under the receiver operating characteristic curves (AUROCs), minimal clinically important difference, test-retest reliability, or sensitivity to change.Data Extraction and SynthesisSearch hits were reviewed by independent raters. Cronbach α, Pearson r, means, and between-group effect sizes indicative of sensitivity to change were pooled in random-effects meta-analysis. Study quality was assessed using 3 instruments. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 reporting guideline.Main Outcomes and MeasuresComprehensive overview of evidence pertaining to the measurement properties of the PHQ-15 and SSS-8.ResultsA total of 305 studies with 361 243 participants were included. Most concerned routine care (178 studies) and the general population (27 studies). In factor analyses, both scales reflected a combination of domain-specific factors (cardiopulmonary, fatigue, gastrointestinal, pain) and a general symptom burden factor. The pooled PHQ-15 α was 0.81 (95% CI, 0.80-0.82), but with low item-total correlations for items concerning menstrual problems, fainting spells, and sexual problems (item-total correlations &lt;0.40), and the SSS-8 α was 0.80 (0.77-0.83). Pooled correlations with other measures of somatic symptom burden were 0.71 (95% CI, 0.64-0.78) for the PHQ-15 and 0.82 (95% CI, 0.72-0.92) for the SSS-8. Reported AUROCs for identification of somatoform disorders ranged from 0.63 (95% CI, 0.50-0.76) to 0.79 (95% CI, 0.73-0.85) for the PHQ-15 and from 0.71 (95% CI, 0.66-0.77) to 0.73 (95% CI, 0.69-0.76) for the SSS-8. The minimal clinically important difference on both scales was 3 points. Test-retest reliability could not be pooled and was inconsistent for the PHQ-15 (PHQ-15: r = 0.65-0.93; ICC, 0.87; SSS-8: r = 0.996, ICC = 0.89). The PHQ-15 showed tentative sensitivity to change (g = 0.32; 95% CI, 0.08-0.56), but data for the SSS-8 were lacking.Conclusions and RelevanceIn this systematic review and meta-analysis, findings supported use of the PHQ-15 and SSS-8 for the assessment of symptom burden, but users should be aware of the complex, multifactorial structures of these scales. More evidence is needed concerning longitudinal measurement properties.

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Symptom network connectivity and interaction among people with HIV in China: secondary analysis based on a cross-sectional survey

Xie,

Liu,

Wang

et al. 2024

BMC Public Health

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Network analysis of somatic symptoms in Chinese patients with depressive disorder

Cited by 6 publications

References 38 publications

Characteristics and economic burden of patients with somatoform disorders in Chinese general hospitals: a multicenter cross-sectional study

Characteristics and economic burden of patients with somatoform disorders in Chinese general hospitals: a multicenter cross-sectional study

Measurement Properties of the Patient Health Questionnaire–15 and Somatic Symptom Scale–8

Symptom network connectivity and interaction among people with HIV in China: secondary analysis based on a cross-sectional survey

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