The Patient Health Questionnaire 12 Somatic Symptom scale as a predictor of symptom severity and consulting behaviour in patients with irritable bowel syndrome and symptomatic diverticular disease

Abstract

SUMMARY BackgroundAnxiety, depression and nongastrointestinal symptoms are often prominent in irritable bowel syndrome (IBS), but their relative value in patient management has not been quantitatively assessed. We modified the Patient Health Questionnaire 15 (PHQ-15) by excluding three gastrointestinal items to create the PHQ-12 Somatic Symptom (PHQ-12 SS) scale.

Enhancing Diagnostic Performance of Symptom-Based Criteria for Irritable Bowel Syndrome by Additional History and Limited Diagnostic Evaluation

“…17 Rates of somatoform-type behavior, in particular, have been shown to be significantly higher in patients with IBS, 31 and to differentiate IBS from health with greater accuracy, compared with markers of anxiety and depression. 32 The results of our study support this finding, with a greater accuracy when a combination of the Rome III criteria and high level of somatization was used, as compared with a combination of the Rome III criteria and HADS scores. Incorporating the presence of co-existent functional GI disorders into our modifications to the Rome III criteria may also have improved their performance.…”

Is It Diverticular Disease or Is It Irritable Bowel Syndrome?

“…The frequency of pain in SYMP-DD was 5 (2–13) days per month, lasting 3 (0.1–12) h [2]. Pain is slightly less frequent than in IBS where pain was reported 3 (1–7) days per week [6] and lasted 1–12 h [7]. A key difference between SYMP-DD and IBS is the localisation of the pain.…”

“…Assessing somatisation can be done very quickly using the PHQ12 and is useful in managing IBS patients, since it correlates reasonably with symptom severity as assessed by the IBS symptom severity score [20], r = 0.9, p < 0.001 [6]. It is important to recognise the presence of somatisation since it predicts consulting behaviour and response to treatment in functional GI diseases.…”

“…These are summed to give a measure of severity of somatic symptoms burden which is divided into mild (5–9), moderate (10–14) and severe (>15) with normal subjects scoring less than 5. We have modified this scale by excluding the 3 gastrointestinal symptoms giving a PHQ-12 somatic symptom score (PHQ-12SS) where the cut-off is 4–7 (mild), 8–11 (moderate) and >12 (severe) with normal being <4 [6]. When this was applied to a large group of healthy volunteers and IBS patients, more than two thirds of IBS patients of both diarrhoea, constipation and post-infective subtypes reported abnormal levels.…”

Colon Hypersensitivity to Distension, Rather Than Excessive Gas Production, Produces Carbohydrate-Related Symptoms in Individuals With Irritable Bowel Syndrome

“…The treatments administered were 500mL drinks consisting of 40 grams of carbohydrate At enrolment all participants completed two questionnaires: the Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire (PHQ)-15 from which we calculated the PHQ-12 by excluding the 3 GI-related questions 24 . Participants then attended 3 treatment days separated by at least one week to minimise any carryover effect.…”