Use of the Psychosocial Index: A Sensitive Tool in Research and Practice

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Background: A number of studies have documented psychosocial problems, psychiatric morbidity and impaired quality of life in primary care patients. Objective: The aim of this trial was to test the usefulness of the joint use of different diagnostic interviews and self-rated questionnaires. Methods: Two hundred consecutive patients in a primary care practice in Italy underwent the Structured Clinical Interview for DSM-5 and the Semi-Structured Interview for the Diagnostic Criteria for Psychosomatic Research (DCPR) in its recently revised form. As self-rated evaluations, the PsychoSocial Index, the Short-Form Health Survey and the Illness Attitude Scales were administered. Results: There were 46 patients (23%) with at least 1 DSM-5 diagnosis. Eighty-eight patients (44%) had at least 1 DCPR diagnosis, mainly maladaptive illness behavior (26.5%), allostatic overload (15.5%) and demoralization (15%). There were 47 (23.5%) patients who had a DCPR diagnosis only; 5 subjects (2.5%) had a DSM diagnosis only. Patients with DCPR syndromes displayed significantly higher self-rated levels of stress, psychological distress and maladaptive illness behavior and significantly lower levels of quality of life and well-being than patients with no diagnoses. Conclusions: In a busy clinical setting, a simple self-rated questionnaire such as the PsychoSocial Index may afford a useful tool to unveil patient current distress. The DCPR can provide clinical information for a substantial number of patients who do not satisfy DSM-5 classification criteria and yet present with psychosocial problems, as measured by self-rated scales. The DCPR may improve the assessment and treatment plan of primary care psychologists or consulting psychiatrists.

Section: Methodsmentioning

confidence: 99%

“…One item, quality of life, has 5 possible choices, from excellent to awful. The PSI has been used in various clinical populations in different countries and showed high sensitivity, discriminating varying degrees of psychosocial impairment in different populations [13]. …”

Section: Methodsmentioning

confidence: 99%

A Trial Integrating Different Methods to Assess Psychosocial Problems in Primary Care

Piolanti

Gostoli

Gervasi

et al. 2019

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“…The psychosomatic evaluation includes important psychosocial variables according to clinimetric principles [67,68,69,70,71,72,73]. The term ‘clinimetrics' was introduced by a supporter of the psychosomatic movement, Alvan R. Feinstein, in 1982, to indicate a domain concerned with indexes, rating scales, and other expressions that are used to describe or measure symptoms, physical signs, and other clinical phenomena [67].…”

Section: Psychosomatic Assessment and Individualized Carementioning

confidence: 99%

Current Psychosomatic Practice

Fava

Cosci²,

Sonino³

2016

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254

317

Psychosomatic research has advanced over the past decades in dealing with complex biopsychosocial phenomena and may provide new effective modalities of patient care. Among psychosocial variables affecting individual vulnerability, course, and outcome of any medical disease, the role of chronic stress (allostatic load/overload) has emerged as a crucial factor. Assessment strategies include the Diagnostic Criteria for Psychosomatic Research. They are presented here in an updated version based on insights derived from studies carried out so far and encompass allostatic overload, type A behavior, alexithymia, the spectrum of maladaptive illness behavior, demoralization, irritable mood, and somatic symptoms secondary to a psychiatric disorder. Macroanalysis is a helpful tool for identifying the relationships between biological and psychosocial variables and the individual targets for medical intervention. The personalized and holistic approach to the patient includes integration of medical and psychological therapies in all phases of illness. In this respect, the development of a new psychotherapeutic modality, Well-Being Therapy, seems to be promising. The growth of subspecialties, such as psychooncology and psychodermatology, drives towards the multidisciplinary organization of health care to overcome artificial boundaries. There have been major transformations in health care needs in the past decades. From psychosomatic medicine, a land of innovative hypotheses and trends, many indications for changes in the current practice of medicine are now at hand. The aim of this critical review is to outline current and potential clinical applications of psychosomatic methods.

“…The rules differ from classical psychometrics, which developed outside the clinical field, mainly in the educational and social areas [10,14,15,16]. Indeed, the application of the classical psychometric model to the clinical challenges has been criticized in light of 2 major inadequacies [17,18].…”

mentioning

confidence: 99%

Clinical Pharmacopsychology: Conceptual Foundations and Emerging Tasks

Fava

Tomba

Bech

2017

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The aim of this critical review was to outline emerging trends and perspectives of clinical pharmacopsychology, an area of clinical psychology that is concerned with the psychological effects of medications. The historical development of clinical pharmacopsychology is outlined, with discussion of its most representative expressions and reference to current challenges of clinical research, with particular reference to clinimetrics. The domains of clinical pharmacopsychology encompass the clinical benefits of psychotropic drugs, the characteristics that predict responsiveness to treatment, the vulnerabilities induced by treatment (side effects, behavioral toxicity, iatrogenic comorbidity), and the interactions between drug treatment and psychological variables. Its aim is to provide a comprehensive assessment of the clinical important changes that are concerned with (a) wanted and expected treatment effects, (b) treatment-induced unwanted side effects, and (c) the patient's own personal experience of a change in terms of well-being and/or quality of life. Clinical pharmacopsychology offers a unifying framework for the understanding of clinical phenomena in medical and psychiatric settings. Research in this area deserves high priority.