Somatic Symptom Disorder, Medically Unexplained Symptoms, Somatoform Disorders, Functional Neurological Disorder: How <i>DSM-</i>5 Got It Wrong

Scamvougeras, Anton; Howard, Andrew

doi:10.1177/0706743720912858

Cited by 14 publications

(8 citation statements)

References 23 publications

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“…For the diagnosis of SSD, we used an in-depth diagnostic interview based on the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) criteria and operationalizations used in earlier studies (3,39). Although the DSM-5 abandoned the distinction between medically explained and not (fully) medically explained symptoms, it was recommended to further account for these differences in research studies (40)(41)(42). The difference might be particularly meaningful with regard to the assessment of psychological factors, such as catastrophizing, health anxiety, negative affectivity, or behavioral avoidance, as being (in)appropriate or excessive.…”

Section: Methodsmentioning

confidence: 99%

Psychobiological Mechanisms in Somatic Symptom Disorder and Depressive Disorders: An Ecological Momentary Assessment Approach

et al. 2021

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Objective: Persistent somatic symptoms cause strong impairment in persons with somatic symptom disorder (SSD) and depressive disorders (DDs). Specific negative psychological factors (NPFs), such as catastrophizing, negative affectivity, and behavioral avoidance, are assumed to contribute to this impairment and may maintain symptoms via dysregulations of biological stress systems. We examined the associations between NPF and somatic symptoms in the daily life of women with SSD or DD and investigated the mediating role of psychobiological stress responses. Methods: Twenty-nine women with SSD and 29 women with DD participated in an ecological momentary assessment study. For 14 days, intensity of and impairment by somatic symptoms, NPF, and stress-related biological measures (cortisol, alpha-amylase) were assessed five times per day using an electronic device and saliva samples. Multilevel models were conducted. Results: The greater the number of NPF, the higher the concurrent and time-lagged intensity of and impairment by somatic symptoms in both groups (12.0%-38.6% of variance explained; χ 2 (12) p < .001 for all models). NPFs were associated with higher cortisol levels in women with DD and with lower levels in women with SSD (interaction NPF by group: B = −0.04, p = .042 for concurrent; B = −0.06, p = .019 for time-lagged). In women with SSD, lower cortisol levels were associated with higher intensity at the next measurement time point (group by cortisol: B = −1.71, p = .020). No mediation effects were found. Conclusions: NPFs may be considered as transdiagnostic factors in the development and treatment of impairing somatic symptoms. Our findings will allow the development of new treatment strategies that use ecological momentary intervention approaches focusing on NPF.

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Section: Methodsmentioning

confidence: 99%

Psychobiological Mechanisms in Somatic Symptom Disorder and Depressive Disorders: An Ecological Momentary Assessment Approach

et al. 2021

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“…Although there has been considerable debate over changing diagnostic criteria and nomenclature, terms including functional somatic syndromes, somatic symptom disorder, and somatoform disorders have all been utilized to describe the experience of physical symptoms that cannot be explained by any identifiable medical condition. 37 Although these MUS syndromes are given different names in different medical specialties, their associated symptoms are remarkably similar. 38 Symptoms common in other MUS syndromes were also prevalent in the current BII cohort, including fatigue, pain, and cognitive issues.…”

Section: Discussionmentioning

confidence: 99%

Longevity of Post-Explantation Systemic Symptom Improvement and Potential Etiologies: Findings From the ASERF Systemic Symptoms in Women–Biospecimen Analysis Study: Part 4

Glicksman

McGuire

Kadin

et al. 2023

Aesthetic Surgery Journal

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Background Breast Implant Illness (BII) describes a variety of symptoms reported by patients with breast implants. Biospecimens data revealed minimal statistical differences between BII and Non-BII cohorts. Baseline analysis of PROMIS data demonstrated significant differences between the BII Cohort and the two control cohorts. Objectives This study was designed to determine if subjects in the BII Cohort obtained any symptom improvement after explantation, whether symptom improvement was related to the type of capsulectomy, and which symptoms improved. Methods A prospective blinded study enrolled 150 consecutive subjects divided equally into three cohorts. Baseline demographic data and a systemic symptoms survey, including PROMIS validated questionnaires, was obtained at baseline, 3-6 weeks, 6 months, and one year. Results 150 patients were enrolled between 2019-2021. Follow-up at one year is 94% of BII Cohort and 77% of Non-BII and Mastopexy Cohorts. At one year, 88% of patients showed at least partial symptom improvement with a reduction of 2-20 symptoms. The PROMIS score in the BII Cohort decreased at one year for anxiety, sleep disturbances, and fatigue. Systemic symptom improvement was noted out to one year in the BII Cohort regardless of the type of capsulectomy performed. Conclusions Parts 1-3 in this series concluded there were no consistent differences in biospecimen results between the cohorts. Unlike the data observed in the biospecimen analysis, BII subjects had heightened symptoms and poorer PROMIS scores at baseline compared to the control cohorts. The reduction of negative expectations and a potential nocebo effect could contribute to this improvement.

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“…It is applicable in general hospital settings, assessing somatic symptoms, negative emotions and adverse events. (2) The Neuro-11 exhibits strong content reliability and validity, accurately capturing the intended constructs. The three-dimensional structure demonstrates robust construct validity.…”

Section: Introductionmentioning

confidence: 99%

Neuro-11: a new questionnaire for the assessment of somatic symptom disorder in general hospitals

Zeng,

Yu,

et al. 2023

Gen Psych

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BackgroundSomatic symptom disorder (SSD) commonly presents in general hospital settings, posing challenges for healthcare professionals lacking specialised psychiatric training. The Neuro-11 Neurosis Scale (Neuro-11) offers promise in screening and evaluating psychosomatic symptoms, comprising 11 concise items across three dimensions: somatic symptoms, negative emotions and adverse events. Prior research has validated the scale’s reliability, validity and theoretical framework in somatoform disorders, indicating its potential as a valuable tool for SSD screening in general hospitals.AimsThis study aimed to establish the reliability, validity and threshold of the Neuro-11 by comparing it with standard questionnaires commonly used in general hospitals for assessing SSD. Through this comparative analysis, we aimed to validate the effectiveness and precision of the Neuro-11, enhancing its utility in clinical settings.MethodsBetween November 2020 and December 2021, data were collected from 731 patients receiving outpatient and inpatient care at Shenzhen People’s Hospital in China for various physical discomforts. The patients completed multiple questionnaires, including the Neuro-11, Short Form 36 Health Survey, Patient Health Questionnaire 15 items, Hamilton Anxiety Scale and Hamilton Depression Scale. Psychiatry-trained clinicians conducted structured interviews and clinical examinations to establish a gold standard diagnosis of SSD.ResultsThe Neuro-11 demonstrated strong content reliability and structural consistency, correlating significantly with internationally recognised and widely used questionnaires. Despite its brevity, the Neuro-11 exhibited significant correlations with other questionnaires. A test-retest analysis yielded a correlation coefficient of 1.00, Spearman-Brown coefficient of 0.64 and Cronbach’s α coefficient of 0.72, indicating robust content reliability and internal consistency. Confirmatory factor analysis confirmed the validity of the three-dimensional structure (p<0.001, comparative fit index=0.94, Tucker-Lewis index=0.92, root mean square error of approximation=0.06, standardised root mean square residual=0.04). The threshold of the Neuro-11 is set at 10 points based on the maximum Youden’s index from the receiver operating characteristic curve analysis. In terms of diagnostic efficacy, the Neuro-11 has an area under the curve of 0.67.Conclusions(1) The Neuro-11 demonstrates robust associations with standard questionnaires, supporting its validity. It is applicable in general hospital settings, assessing somatic symptoms, negative emotions and adverse events. (2) The Neuro-11 exhibits strong content reliability and validity, accurately capturing the intended constructs. The three-dimensional structure demonstrates robust construct validity. (3) The threshold of the Neuro-11 is set at 10 points.

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Somatic Symptom Disorder, Medically Unexplained Symptoms, Somatoform Disorders, Functional Neurological Disorder: How DSM-5 Got It Wrong

Cited by 14 publications

References 23 publications

Psychobiological Mechanisms in Somatic Symptom Disorder and Depressive Disorders: An Ecological Momentary Assessment Approach

Psychobiological Mechanisms in Somatic Symptom Disorder and Depressive Disorders: An Ecological Momentary Assessment Approach

Longevity of Post-Explantation Systemic Symptom Improvement and Potential Etiologies: Findings From the ASERF Systemic Symptoms in Women–Biospecimen Analysis Study: Part 4

Neuro-11: a new questionnaire for the assessment of somatic symptom disorder in general hospitals

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