Differences in psychometric characteristics of outpatients with somatic symptom disorder from general hospital biomedical (neurology/gastroenterology), traditional Chinese medicine, and psychosomatic settings

Dandan Ma; Wei Lu; Kurt Fritzsche; Anne Christin Toussaint; Tao Li; Lan Zhang; Yaoyin Zhang; Hua Chen; Heng Wu; Xiquan Ma; Wentian Li; Jie Ren; Rainer Leonhart; Jinya Cao; Jing Wei

doi:10.3389/fpsyt.2023.1205824

Differences in psychometric characteristics of outpatients with somatic symptom disorder from general hospital biomedical (neurology/gastroenterology), traditional Chinese medicine, and psychosomatic settings

Front Psychiatry. 2023 Jul 19:14:1205824. doi: 10.3389/fpsyt.2023.1205824. eCollection 2023.

Authors

Dandan Ma¹, Wei Lu², Kurt Fritzsche³, Anne Christin Toussaint⁴, Tao Li¹, Lan Zhang⁵, Yaoyin Zhang⁶, Hua Chen⁷, Heng Wu⁸, Xiquan Ma⁹, Wentian Li¹⁰, Jie Ren¹¹, Rainer Leonhart¹², Jinya Cao¹, Jing Wei¹

Affiliations

¹ Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² Department of Psychosomatic Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital University, Beijing, China.
³ Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Medical Centre - University of Freiburg, Freiburg, Germany.
⁴ Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
⁵ Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China.
⁶ Department of Psychosomatic Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
⁷ Department of Psychological Medicine, Zhong Shan Hospital, Fudan University, Shanghai, China.
⁸ Department of Psychosomatic Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
⁹ Department of Psychosomatic Medicine, Dongfang Hospital, School of Medicine, Tongji University, Shanghai, China.
¹⁰ Department of Clinic Psychology, Wuhan Mental Health Centre, Wuhan, China.
¹¹ Department of Rehabilitation, General Hospital of Jincheng Anthracite Coal Mining Group Co. Ltd., Jincheng, China.
¹² Institute of Psychology, University of Freiburg, Freiburg, Germany.

Abstract

Objective: The aim of this study is to investigate the psychometric characteristics of outpatients diagnosed with somatic symptom disorder (SSD) in biomedical, Traditional Chinese Medicine (TCM) and psychosomatic settings.

Materials and methods: A total of 697 participants who completed SCID-5 and questionnaires were presented in our former study, as 3 of them had missed questionnaire data, a total of 694 participants are presented in this study. A secondary analysis of the psychometric characteristics of Somatic Symptom Disorder-B Criteria Scale (SSD-12), Somatic Symptom Severity Scale of the Patient-Health Questionnaire (PHQ-15), Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) is done to compare differences among outpatients from the three settings of medical specialties.

Results: Based on the DSM-5 criteria, 90 out of 224 (40.2%) participants enrolled in biomedical departments (represented by neurology and gastroenterology departments), 44/231 (19.0%) in TCM departments, and 101/239 (42.3%) in the psychosomatic medicine departments were diagnosed with SSD. The scores of PHQ-15 in the biomedical, TCM and psychosomatic settings were 11.08 (± 4.54), 11.02 (± 5.27) and 13.26 (± 6.20); PHQ-9 were 10.43 (± 6.42), 11.20 (± 5.46) and 13.42 (± 7.32); GAD-7 were 8.52 (± 6.22), 9.57 (± 5.06) and 10.83 (± 6.24); SSD-12 were 22.26 (± 11.53), 22.98 (± 10.96) and 25.03 (± 11.54) respectively. The scores of PHQ-15, PHQ-9 and GAD-7 in SSD patients were significantly higher in psychosomatic departments than that in biomedical settings (p < 0.05). The cutoff point for SSD-12 was ≥16 in total patients; 16, 16, 17 in biomedical, TCM and psychosomatic settings, respectively. The cutoff point for PHQ-15 was found to be ≥8 in total patients; 8, 9, 11 in biomedical, TCM and psychosomatic settings, respectively.

Conclusion: SSD patients from psychosomatic departments had higher level of somatic symptom severity, depression and anxiety than from TCM and biomedical settings. In our specific sample, a cutoff point of ≥16 for SSD-12 could be recommended in all three settings. But the cutoff point of PHQ-15 differs much between different settings, which was ≥8, 9, and 11 in biomedical, TCM, and psychosomatic settings, respectively.

Keywords: biomedical; psychometric; psychosomatic; somatic symptom disorder; traditional Chinese medicine.