Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-17T06:54:29.928Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of somatoform disorders: a review of strategies and instruments

Published online by Cambridge University Press:  24 June 2014

Wolfgang Hiller  and
Aleksandar Janca
Wolfgang Hiller*
Affiliation:
Department of Clinical Psychology, University of Mainz, Germany
Aleksandar Janca
Affiliation:
School of Psychiatry and Clinical Neuroscience, University of Western Australia Royal Perth Hospital, Perth, Australia
*
Dr Wolfgang Hiller, University of Mainz, Department of Clinical Psychology, Staudingerweg 9, D-55099 Mainz, Germany. Tel. +49 61313922344; Fax: +49 61313924623; E-mail: hiller@mail.uni-mainz.de
Get access Rights & Permissions [Opens in a new window]

Abstract

We provide an overview of methods and instruments developed for the assessment of somatoform disorders. Four diagnostic purposes have been identified: (i) classification according to a diagnostic system; (ii) screening for probable cases; (iii) dimensional measurement of syndrome severity; and (iv) assessment of associated clinical features. Existing instruments designed for each of these strategies are described, including specifications of their psychometric properties, particular features, advantages and disadvantages. A conclusion of this review is that the currently existing ‘family of assessment instruments’ in the field of somatoform disorders should be used to improve the comparability of scientific findings in different cultures and settings.

Keywords

assessmentinstrumentsdiagnostic methodsclassificationsomatoform disordershypochondriasis
Type
Review Article
Information
Acta Neuropsychiatrica , Volume 15 , Issue 4 , August 2003 , pp. 167 - 179
Copyright
Copyright © 2003 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. Washington DC: APA, 1980. Google ScholarPubMed
American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington DC: APA, 1994. Google ScholarPubMed
World Health Organization (WHO). The ICD-10 Classification of Mental and Behavioural Disorders, Diagnostic Criteria for Research. Geneva: WHO, 1993. Google ScholarPubMed
Pilowsky, I.Abnormal Illness Behaviour. Chichester: Wiley, 1997. Google ScholarPubMed
Rief, W, Hiller, W, Margraf, J.Cognitive aspects of hypochondriasis and the somatization syndrome. J Abnorm Psychol 1998;107: 587–595.CrossRefGoogle ScholarPubMed
Spitzer, RL, Williams, JB W, Gibbon, M, First, M.The structured clinical interview for DSM-III-R (SCID) – I. History, rationale and description. Arch General Psychiatry 1992;49: 624–629. CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JB W.Structured Clinical Interview for DSM-IV Axis I Disorders. Washington DC. American Psychiatric Press 1997. Google Scholar
World Health Organization (WHO). The Composite International Diagnostic Interview (CIDI). Washington, DC: American Psychiatric Press, 1994. Google ScholarPubMed
Robins, LN, Wing, J, Wittchen, H-Uet al. The Composite International Diagnostic Interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch General Psychiatry 1988;45: 1069–1077. CrossRefGoogle ScholarPubMed
Janca, A, Burke, JD Jr,Isaac, Met al. The World Health Organization Somatoform Disorders Schedule. A preliminary report on design and reliability. Eur Psychiatry 1995;10: 373–378. CrossRefGoogle ScholarPubMed
Janca, A, Isaac, M, Costa, E, Silva, JA.World Health Organization International Study of Somatoform Disorders – background and rationale. Eur J Psychiatry 1995;9: 100–110. Google Scholar
Hiller, W, Zaudig, M, Mombour, W, Bronisch, T.Routine psychiatric examinations guided by ICD-10 diagnostic checklists (International Diagnostic Checklists). Eur Arch Psychiatr Neurol Sci 1993;242: 218–223. CrossRefGoogle Scholar
Hiller, W, Zaudig, M, Mombour, W.IDCL. International Diagnostic Checklists for ICD-10 and DSM-IV. Seattle: Hogrefe & Huber, 1996. Google Scholar
Williams, JBW, Gibbon, M, First, Met al. The Structured Clinical Interview for DSM-III-R (SCID) – II. Multisite test-retest reliability. Arch General Psychiatry 1992;49: 630–636. CrossRefGoogle ScholarPubMed
Wittchen, H-U.Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 1994;28: 57–84.CrossRefGoogle ScholarPubMed
Fleiss, JL.Statistical Methods for Rates and Proportions, 2nd edn. New York: Wiley, 1981. Google Scholar
Wittchen, H-U, Zaudig, M, Spengler, Pet al. Wie zuverlässig ist operationalisierte Diagnostik ? – Die Test-Retest-Reliabilität des Strukturierten Klinischen Interviews für DSM-III-R. (How reliable are operationalized diagnoses? – The test-retest reliability of the Structured Clinical Interview for DSM-III-R). Zeitschr Klin Psychol 1991;20: 136–152. Google Scholar
Semler, G, Wittchen, H-U, Joschke, Ket al. Test-retest reliability of a standardized psychiatric interview (DIS/CIDI). Eur Arch Psychiatr Clin Neurosci 1987;236: 214–222. CrossRefGoogle Scholar
Hiller, W, Von Bose, M, Dichtl, G, Agerer, D.Reliability of checklist-guided diagnoses for DSM-III-R affective and anxiety disorders. J Affect Disord 1990;20: 235–247.CrossRefGoogle Scholar
Robins, LN, Helzer, JE, Croughan, J, Ratcliff, KS.National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Arch General Psychiatry 1981;38: 381–389. CrossRefGoogle ScholarPubMed
Burnam, NA, Karno, M, Hough, RL, Escobar, JI, Forsythe, AB.The Spanish Diagnostic Interview Schedule. Reliability and comparison with clinical diagnoses. Arch General Psychiatry 1983;40: 1189–1196. CrossRefGoogle ScholarPubMed
Helzer, JE, Robins, LN, McEvoy, LTet al. A comparison of clinical and Diagnostic Interview Schedule diagnoses. Arch General Psychiatry 1985;42: 657–666. CrossRefGoogle ScholarPubMed
Swartz, M, Hughes, D, George, L, Blazer, D, Landermann, R, Bucholz, K.Developing a screening index for community studies of somatization disorder. J Psychosom Res 1986;20: 335–343. CrossRefGoogle ScholarPubMed
World Health Organization (WHO). Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Washington, DC: American Psychiatric Press, 1994. Google ScholarPubMed
Spitzer, RL, Williams, JBW, Kroenke, Ket al. Utility of a new procedure for diagnosing mental disorders in primary care: the PRIME-MD 1000 Study. J Am Med Assoc 1994;272: 1749–1756. CrossRefGoogle ScholarPubMed
Linzer, M, Spitzer, R, Kroenke, Ket al. Gender, quality of life, and mental disorders in primary care: results from the PRIME-MD 1000 study. Am J Med 1996; 101: 526–533.CrossRefGoogle ScholarPubMed
Rief, W, Hiller, W, Heuser, J.SOMS – Screening für Somatoforme Störungen. Manual Zum Fragebogen (SOMS – the Screening for Somatoform Symptoms – Manual). Berne: Huber Publishers, 1997. Google Scholar
Rief, W, Hiller, W, Geissner, E, Fichter, MM.A two-year follow-up study of patients with somatoform disorders. Psychosomatics 1995;36: 376–386.CrossRefGoogle ScholarPubMed
Othmer, E, Desouza, C.A screening test for somatization disorder (hysteria). Am J Psychiatry 1985;142: 1146–1149.Google Scholar
Smith, GR, Brown, FW.Screening indexes in DSM-III-R somatization disorder. General Hosp Psychiatry 1990;12: 148–152. CrossRefGoogle ScholarPubMed
Bucholz, KK, Dinwiddie, Sh, Reich, T, Shayka, JJ, Cloninger, CR.Comparison of screening proposals for somatization disorder empirical analyses. Compr Psychiatry 1993;34: 59–64.CrossRefGoogle ScholarPubMed
Escobar, JI, Rubio-Stipec, M, Canino, G, Karno, M.Somatic symptom index (SSI): a new and abridged somatization construct. Prevalence and epidemiological correlates in two large community samples. J Nerv Ment Disord 1989;177: 140–146. CrossRefGoogle ScholarPubMed
Escobar, JI, Waitzkin, H, Silver, RC, Gara, M, Holman, A.Abridged somatization: a study in primary care. Psychosom Med 1998;60: 466–472.CrossRefGoogle ScholarPubMed
Janca, A, Isaac, M, Tacchini, G.Somatoform Disorders Symptom Checklist, Version 1.0. (MNH/MND/94.1/2). Geneva: WHO, 1994. Google Scholar
Janca, A, Hiller, W.ICD-10 checklists – a tool for clinicians' use of the ICD-10 classification of mental and behavioral disorders. Compr Psychiatry 1996;37: 180–187.CrossRefGoogle ScholarPubMed
Katon, W, Lin, E, Vonkorff, M, Russo, J, Lipscomb, P, Bush, T.Somatization: a spectrum of severity. Am J Psychiatry 1991;148: 34–40.Google Scholar
Hiller, W, Rief, W, Fichter, MM.Further evidence for a broader concept of somatization disorder using the Somatic Symptom Index. Psychosomatics 1995;36: 285–294.CrossRefGoogle ScholarPubMed
Derogatis, LR.The SCL-90-R Manual. Scoring and Administration Procedures for the SCL-90-R. Baltimore: Johns Hopkins University School of Medicine, 1983. Google Scholar
Barsky, AJ, Wyshak, G, Klerman, GL, Latham, KS.The prevalence of hypochondriasis in medical outpatients. Soc Psychiatry Psychiatr Epidemiol 1990;25: 89–94.Google ScholarPubMed
Kellner, R.A Symptom Questionnaire. J Clin Psychiatry 1987;48: 268–274.Google ScholarPubMed
Mumford, DB, Bavington, JT, Bhatnagar, KS, Hussain, Y, Mirza, S, Naraghi, MM.The Bradford Somatic Inventory Br J Psychiatry 1991;158: 379–386. Google Scholar
Pilowsky, I.Dimensions of hypochondriasis. Br J Psychiatry 1967;113: 89–93.CrossRefGoogle ScholarPubMed
Kellner, R.Illness attitude scales. In: Kellner, R, ed. Somatization and Hypochondriasis. New York: Praeger-Greenwood Publishers, 1986: 319–324. Google ScholarPubMed
Kellner, R.Abridged Manual of the IAS (Illness Attitude Scales) (mimeographed). Albuquerque: University of New Mexico, 1987. Google Scholar
Speckens, AEM, Spinhoven, P, Sloekers, PPA, Bolk, JH, Van Hemert, AM.A validation study of the Whitely Index, the Illness Attitude Scales, and the Somatosensory Amplification Scale in general medical and general practice patients. J Psychosom Res 1996;40: 95–104.CrossRefGoogle ScholarPubMed
Hiller, W, Rief, W, Fichter, MM.Dimensional and categorical approaches to hypochondriasis. Psychol Med 2002;32: 707–718.CrossRefGoogle ScholarPubMed
Hiller, W, Rief, W.Internationale Skalen für Hypochondrie – Whiteley Index und Illness Attitude Scales. Manual zur Anwendung und Auswertung (International Scales for Hypochondriasis – Whiteley Index and Illness Attitude Scales). Administration and Scoring Manual). Bern, Switzerland: Huber Publishers, in press. Google Scholar
Rief, W, Hessel, A, Braehler, E.Somatization symptoms and hypochondriacal features in the general population. Psychosom Med 2001;63: 595–602.CrossRefGoogle ScholarPubMed
Lucock, MP, Morley, S.The Health Anxiety Questionnaire. Br J Health Psychol 1996;1: 137–150. CrossRefGoogle Scholar
Butcher, JN, Dahlstrom, WG, Graham, JR, Tellegen, A, Kaemmer, B.Minnesota Multiphasic Personality Inventory (MMPI-2). Manual for Administration and Scoring. Minneapolis: University of Minnesota Press, 1989. Google Scholar
Butcher, JN, Graham, JR, Williams, CL, Ben-Porath, YS.Development and Use of the MMPI-2 Content Scales. Minneapolis: University of Minnesota Press, 1990. Google Scholar
Rief, W, Hiller, W.A new approach to assess treatment effects in somatoform disorders. Psychosom Res, in press. Google Scholar
Derogatis, LR, Rickels, K, Rock, AF.The SCL-90 and the MMPI: a step in the validation of a new self-report scale. Br J Psychiatry 1976;128: 280–289.CrossRefGoogle ScholarPubMed
Speckens, AEM, Van Hemert, AM, Spinhoven, P, Bolk, JH.The diagnostic and prognostic significance of the. Whitely Index, the Illness Attitude Scales, and the Somatosensory Amplification Scale. Psychol Med 1996;26: 1085–1090.CrossRefGoogle ScholarPubMed
Hadjistavropoulos, HD, Asmundson, GJG.Factor analytic investigation of the Illness Attitudes Scale in a chronic pain sample. Behav Res Ther 1998;36: 1185–1195.CrossRefGoogle Scholar
Fink, P, Ewald, H, Jensen, Jet al. Screening for somatization and hypochondriasis in primary care and neurological in-patients: a seven-item scale for hypochondriasis and somatization. J Psychosom Res 1999;46: 261–273.CrossRefGoogle ScholarPubMed
Wise, TN, Sheridan, MJ.Psychometric properties of the Illness Attitudes Scale in psychiatric patients. Psychol Rep 2001;89: 73–76.CrossRefGoogle ScholarPubMed
Barsky, AJ, Wyshak, G.Hypochondriasis and somatosensory amplification. Br J Psychiatry 1990;157: 404–409.CrossRefGoogle ScholarPubMed
Robbins, JM, Kirmayer, LJ.Transient and persistent hypochondriacal worry in primary care. Psychol Med 1996;26: 575–589.CrossRefGoogle ScholarPubMed
Jyvaejaervi, S, Joukamaa, M, Vaeisaenen, E, Larivaara, P, Kivelae, S, Keinaenen, KS.Somatizing frequent attenders in primary health care. J Psychosom Res 2001;50: 185–192.CrossRefGoogle Scholar
Barsky, AJ.Amplification, somatization, and the somatoform disorders. Psychosomatics 1992;33: 28–34.CrossRefGoogle ScholarPubMed
Barsky, AJ, Wyshak, G, Klerman, GL.The Somatosensory Amplification Scale and its relationship to hypochondriasis. J Psychiatr Res 1990;24: 323–334.CrossRefGoogle ScholarPubMed
Barsky, AJ, Wyshak, G, Klerman, GL.Transient hypochondriasis. Arch General Psychiatry 1990;47: 746–752. CrossRefGoogle ScholarPubMed
Salkovskis, PM, Warwick, HMC.Meaning, misinterpretations, and medicine: a cognitive-behavioral approach to understanding health anxiety and hypochondriasis. In: Starcevic, V, Lipsitt, DR, eds. Hypochondriasis: Modern Perspectives on an Ancient Malady. New York: Oxford University Press, 2001: 202–222. Google Scholar
Barsky, AJ, Coeytaux, RR, Sarnie, MK, Cleary, PD.Hypochondriacal patients'beliefs about good health. Am J Psychiatry 1993;150: 1085–1089.Google Scholar
Robbins, JM, Kirmayer, LJ.Attributions of common somatic symptoms. Psychol Med 1991;21: 1029–1045.CrossRefGoogle ScholarPubMed
Sensky, T, MacLeod, AK, Rigby, MF.Causal attributions about common somatic sensations among frequent general practice attenders. Psychol Med 1996;26: 641–646.CrossRefGoogle ScholarPubMed
Rief, W, Ihle, D, Pilger, F.A new approach to assess illness behaviour. J Psychosom Res 2003;54: 405–414.CrossRefGoogle ScholarPubMed
Pilowsky, I.Dimensions of illness behaviour as measured by the Illness Behaviour Questionnaire. A replication study. J Psychosom Res 1993;37: 53–62.CrossRefGoogle ScholarPubMed
Pilowsky, I, Spence, N.Manual for the Illness Behaviour Questionnaire (IBQ), 3rd edn. Adelaide: University of Adelaide, 1994. Google Scholar
Zonderman, AB, Heft, MW, Costa, PT.Does the Illness Behavior Questionnaire measure abnormal illness behavior? Health Psychol 1985;4: 425–436.CrossRefGoogle ScholarPubMed
Noyes, R, Langbehn, DR, Happel, RL, Sieren, LR, Muller, BA.Health Attitude Survey. A scale for assessing somatizing patients. Psychosomatics 1999;40: 470–478.CrossRefGoogle ScholarPubMed
Martin, RD.The somatoform conundrum: a question of nosological values. General Hosp Psychiatry 1999;21: 177–186. CrossRefGoogle ScholarPubMed
Spitzer, RL, Fleiss, JL.A re-analysis of the reliability of psychiatric diagnosis. Br J Psychiatry 1974;125: 341–374.CrossRefGoogle ScholarPubMed
Rief, W, Heuser, J, Mayrhuber, E, Stelzer, I, Hiller, W, Fichter, MM.The classification of multiple somatoform symptoms. J Nerv Ment Dis 1996;184: 680–687.CrossRefGoogle ScholarPubMed
Rief, W, Hiller, W.Toward empirically based criteria for the classification of somatoform disorders. J Psychosom Res 1999;46: 507–518.CrossRefGoogle ScholarPubMed
Leibbrand, R, Hiller, W, Fichter, MM.Hypochondriasis and somatization: two distinct aspects of somatoform disorders? J Clin Psychol 2000;56: 63–72.3.0.CO;2-O>CrossRefGoogle ScholarPubMed
Barsky, AJ, Barnett, MC, Cleary, PD.Hypochondriasis and panic disorder. Boundary and overlap. Arch General Psychiatry 1994;51: 918–925. CrossRefGoogle ScholarPubMed
Hiller, W, Heuser, J, Fichter, MM.The DSM-IV nosology of chronic pain: a comparison of pain disorder and multiple somatization syndrome. Eur J Pain 2000;4: 45–55.CrossRefGoogle ScholarPubMed
Thompson, WG, Longstreth, GF, Drossman, DAet al. Functional bowel disorders and functional abdominal pain. Gut 1999;(45 Suppl. II): 1143–1147. CrossRefGoogle ScholarPubMed
Salkovskis, P.Psychological treatment of noncardiac chest pain: the cognitive approach. Am J Med 1992;92(Suppl. 5A):114S–121S.CrossRefGoogle ScholarPubMed
Hamilton, M.Developing a rating scale for primary depressive illness. Br J Soc Clin Psychol 1967;6: 278–296.CrossRefGoogle Scholar
Fisch, RZ.Masked depression. its interrelations with somatization, hypochondriasis, and conversion. Int J Psychiatry Med 1987;17: 367–379.CrossRefGoogle ScholarPubMed
Rost, KM, Smith, GR.Improving the effectiveness of routine care for somatization. J Psychosom Res 1997;43: 463–465.CrossRefGoogle ScholarPubMed
Hiller, W, Fichter, MM, Rief, W.A controlled treatment study of somatoform disorders including analysis of health care utilization and cost-effectiveness. J Psychosom Res 2003;54: 369–380.CrossRefGoogle ScholarPubMed
Peveler, R, Kilkenny, L, Kinmonth, A-L.Medically unexplained physical symptoms in primary care: a comparison of self-report screening questionnaires and clinical opinion. J Psychosom Res 1997;42: 245–252.CrossRefGoogle ScholarPubMed