Journal
PSYCHOSOMATIC MEDICINE
Volume 83, Issue 2, Pages 164-170Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PSY.0000000000000903
Keywords
somatic symptom disorder; psychological criteria; symptom-related behavior; general population; reference score; PHQ = Patient Health Questionnaire; SSD = somatic symptom disorder; SSS-8=Somatic Symptom Scale-8; SSD-12=Somatic Symptom Disorder— B Criteria Scale 12
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Funding
- German Research Foundation [TO 908/1-1]
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The research indicates that spending 3 to 4 hours per day dealing with physical complaints may be considered excessive, which can affect self-reported physical and mental health status as well as health care utilization.
Objective The diagnostic criteria of somatic symptom disorder (SSD) emphasize that somatic symptoms receive disease value once they are accompanied by excessive thoughts, feelings, or behaviors. The main objective of this study was to examine what constitutes excessiveness in psychological reactions to somatic complaints and how excessive symptom-related behavior influences self-reported health status and health care utilization. Methods A national, representative general population survey was performed between January and March 2016 in Germany, including 2395 individuals older than 13 years. Self-report questionnaires (Somatic Symptom Scale-8, Somatic Symptom Disorder-B Criteria Scale) were used to operationalize the SSD criteria. Group differences in the daily amount of time dedicated to physical complaints were analyzed between individuals with and without SSD. Stepwise linear regression analyses were performed to predict general mental and physical health status, and health care utilization. Results There was a significant effect of group (SSD yes/no) in daily time spent on symptoms, after controlling for age, sex, depression, and anxiety (F(1,2336) = 447.53, p < .001). The SSD group (n = 213) reported an average of 4 hours, whereas individuals without SSD reported 30 minutes. Results of the regression analyses showed that the combination of somatic symptoms and symptom-related psychological features is predictive of worsened self-reported physical and mental health status, and increased health care utilization. Conclusions A range of 3 to 4 hours per day spent on dealing with physical complaints seems indicative of excessiveness. If, during a clinical consultation, a patient reports such a large amount of time, a more comprehensive clinical examination of SSD should follow.
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