Esther12
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http://www.ncbi.nlm.nih.gov/pubmed/24935983
Maybe a worthwhile reference for someone? I've not read the whole thing.
The way some tried to argue that a high symptom count was good evidence of MUS/hysteria/functional symptoms/whatever always seemed silly to me.
Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients.
Carson AJ1, Stone J2, Hansen CH3, Duncan R4, Cavanagh J5, Matthews K6, Murray G7, Sharpe M8.
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Abstract
OBJECTIVE:
Somatic symptoms unexplained by disease are common in all medical settings. The process of identifying such patients requires a clinical assessment often supported by clinical tests. Such assessments are time-consuming and expensive. Consequently the observation that such patients tend to report a greater number of symptom has led to the use of self-rated somatic symptom counts as a simpler and cheaper diagnostic aid and proxy measure for epidemiological surveys. However, despite their increasing popularity there is little evidence to support their validity.
METHODS:
We tested the score on a commonly used self-rated symptom questionnaire- the Patient Health Questionnaire (PHQ 15) (plus enhanced iterations including an additional 10 items on specific neurological symptoms and an additional 5 items on mental state) for diagnostic sensitivity and specificity against a medical assessment (with 18 months follow-up) in a prospective cohort study of 3781 newly attending patients at neurology clinics in Scotland, UK.
RESULTS:
We found 1144/3781 new outpatients had symptoms that were unexplained by disease. The patients with symptoms unexplained by disease reported higher symptoms count scores (PHQ 15: 5.6 (95% CI 5.4 to 5.8) vs 4.2 (4.1 to 4.4) p<0.0001). However, the PHQ15 performed little better than chance in its ability to identify patients with symptoms unexplained by disease. The findings with the enhanced scales were similar.
CONCLUSIONS:
Self-rated symptom count scores should not be used to identify patients with symptoms unexplained by disease.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Maybe a worthwhile reference for someone? I've not read the whole thing.
The way some tried to argue that a high symptom count was good evidence of MUS/hysteria/functional symptoms/whatever always seemed silly to me.