Screening for DSM-IV somatoform disorders in chronic pain patients

Abstract

Background: The Screening Instrument for Somatoform Symptoms (SOMS) has been developed for selecting subjects with various somatoform disorders. To date, this instrument has not been used for pain patients. The purpose of this study was, therefore, to apply the SOMS to chronic pain patients, and to compare different SOMS cutoff item scores with regard to their sensitivity, specificity and (positive and negative) predictive value for selecting subjects with DSM-IV somatoform disorders among pain patients.

Methods: In a consecutive sample of 105 chronic pain outpatients, the SOMS was administered in addition to an operationalized psychiatric assessment according to DSM-IV.

Results: Patients with a somatoform disorder reported significantly more SOMS symptoms than patients without somatoform disorders (p < 0.02). As shown, a cutoff score of >/=4 somatoform items appeared useful for determining a somatoform disorder. However, only a limited number of cases could be correctly classified by the SOMS (range 53-66%).

Conclusion: Therefore, the applicability of the SOMS as a screening instrument for somatoform disorders in chronic pain patients awaits further clarification.