Validation of the four‐dimensional symptom questionnaire (4DSQ) and prevalence of psychological symptoms in orthopedic shoulder patients

Abstract

Psychological problems are common in shoulder patients. A validated psychological questionnaire measuring clinically relevant psychological symptoms (including distress, depression, anxiety, and somatization) in shoulder patients is lacking. The FourDimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire to identify distress, depression, anxiety, and somatization which has been validated in primary care populations. The aim of this study was to validate the 4DSQ in orthopedic shoulder patients. We assessed whether the 4DSQ measures these four constructs the same way in an orthopedic population with shoulder problems compared to a general practice population. We also investigated the prevalence of psychological symptoms in shoulder patients. The shoulder group consisted of 200 consecutive patients and the general practice group comprised 368 patients, matched for gender and age. Differential item functioning analysis showed that the 4DSQ measures the different psychological symptoms in orthopedic shoulder patients the same way as in general practice patients. The shoulder patients tended to score higher on the somatization scale, resulting in a new cut-off point for somatization. The prevalence of distress, somatization, anxiety, and depression in the shoulder group was 23%, 14%, 10%, and 8%, respectively. It can be concluded from this study that the 4DSQ in orthopedic shoulder patients measures the same constructs as in general practice patients and can therefore be used in orthopedic practice to measure psychological symptoms in patients with shoulder complaints. ß

Psychological symptoms and the MCID of the DASH score in shoulder surgery

“…The 4DSQ is a psychological questionnaire validated in orthopedic shoulder patients [ 1 ]. The 4DSQ is a 50-item self-report questionnaire that identifies four psychological disorders: distress, depression, anxiety and somatisation [ 20 ].…”

The Influence of Preoperative and Postoperative Psychological Symptoms on Clinical Outcome after Shoulder Surgery: A Prospective Longitudinal Cohort Study

“…The primary determinant was the Four-Dimensional Symptom Questionnaire (4DSQ), a psychological questionnaire validated for orthopaedic shoulder patients [4]. The 4DSQ is a 50-item self-report inventory that is able to identify four common psychological symptoms: distress, depression, anxiety and somatisation [25].…”

“…Shoulder problems are often chronic and may have a substantial impact on physical activity, mental state and quality of life [2,3]. A high prevalence of psychological symptoms in patients with shoulder complaints was reported in several studies [4–6]. Psychological factors in patients with shoulder complaints might play a role in the aetiology, perceived disability and pain, the persistence of symptoms and clinical outcome of treatment.…”

The outcome of hydrodilation in frozen shoulder patients and the relationship with kinesiophobia, depression, and anxiety

“…Psychosocial factors are frequently present in patients with shoulder complaints and might play a role in the disease, the perception of pain and disability, and the functional outcome after surgery [16]. The chronicity of the complaints often negatively impacts the quality of life and physical and mental well‐being.…”