Page 82 - JCBP-2-1

Journal of Clinical and
Basic Psychosomatics Screening for SSD-B criteria in China

impacted symptom-related cognitive behavior, collectively (P < 0.001). The cutoff value for WI-8 was 18.5, with
explaining 71% of the variation in symptom-related sensitivity and specificity values of 80.8% and 85.4%,
cognitive behavior (Table 7). respectively. In the case of utilizing time for the predictive
diagnosis of SSD-12, the highest diagnostic accuracy for
In the comparative study, the Pearson correlation
analysis demonstrated a strong positive correlation SSD–B criteria was achieved with a cutoff value of 1.25 h
or higher, yielding an AUC of 0.839 (P < 0.001), and
between symptom-related cognitive behavior and health- sensitivity and specificity values were 68.3% and 84.5%,
related anxiety (r = 0.797, P < 0.01). However, weak positive respectively. Upon combining WI-8 with time in the
correlations were observed with the duration of worrying predictive diagnosis of SSD-12, a binary logistic regression
about physical discomfort per day (r = 0.427, P < 0.01) and analysis was performed, resulting in the linear model as
the number and severity of physical symptoms (r = 0.466, follows:
P < 0.01) (Table 8). Furthermore, using the total score of
SSD-12 as the dependent variable, the correlation analysis Logit(P) = -5.740 + 0.215 × Time + 0.262 × WI-8 (I)
identified that only the time spent worrying about physical
discomfort per day and health-related anxiety significantly This combined approach improved the AUC to 0.921
impacted symptom-related cognitive behavior. These (P < 0.001), with sensitivity and specificity values of 88.6%
factors collectively accounted for 66% of the variation in and 80.7%, respectively (Table 10 and Figure 1).
symptom related-cognitive behavior (Table 9). In the comparative study, the utilization of WI-8 in
the predictive diagnosis of SSD-12 resulted in an AUC of
3.5. Receiver operating characteristic
0.925 (P < 0.001), with a WI-8 cutoff value of 10.5. The
A ROC analysis was employed to examine the predictive corresponding sensitivity and specificity were 90% and
ability of time spent on symptoms and the WI-8 scale 84%, respectively. When time was used in the predictive
in determining SSD-12. The results from the previous diagnosis of SSD-12, the highest diagnostic accuracy for
multicenter study indicated that when WI-8 was used in SSD–B criteria was achieved with a cutoff value of 1.9 h or
the predictive diagnosis of SSD-12, the AUC was 0.907 higher, yielding an AUC of 0.801 (P < 0.001) and sensitivity

Table 7. Multiple linear regression analysis of the influencing Table 9. Multiple linear regression analysis of the influencing
factors of SSD–B criteria in the previous multicenter study factors of SSD–B criteria in the comparative study
Variables SE Standardized β t P Variables SE Standardized β t P
PHQ-15 0.056 0.103 4.200 <0.01 WI-8 0.096 0.736 11.912 <0.01
WI-8 0.041 0.660 23.765 <0.01 Time (h/d) 0.180 0.191 3.092 <0.01
Time (h/d) 0.077 0.203 8.463 <0.01 Notes: SE: standard error; Whiteley Index-8 (WI-8) is used to quantify
Notes: SE: Standard error; Patient Health Questionnaire-15 (PHQ-15) disease beliefs and health-related concerns; Time refers to the amount
is used to quantify the number of physical symptoms and the degree of time patient spent on physical symptoms per day (h/d: hours
of distress; Whiteley Index-8 (WI-8) is used to quantify disease beliefs per day).
and health-related concerns; Time refers to the amount of time patient
spent on physical symptoms per day (h/d: hours per day). Table 10. Predicting SSD‑12 using Time, WI‑8, and WI‑8
and Time in the previous multicenter study
Table 8. Correlation analysis between SSD–B criteria and
other factors in the comparative study Items WI‑8 Time WI‑8 and Time
ROC (AUC) 0.907 0.839 0.921
Variables SSD‑12 PHQ‑15 WI‑8 Time (h/d)
Cutoff value 18.5 1.25 0.284
SSD-12 1 0.466 0.797 0.427
Youden index 0.662 0.528 0.693
PHQ-15 - 1 0.567 0.253
Sensitivity 0.808 0.683 0.886
WI-8 - - 1 0.321
Specificity 0.854 0.845 0.807
Time (h/d) - - - 1
95% confidence interval 0.885 – 0.929 0.809 – 0.869 0.901 – 0.940
Notes: Somatic Symptom Disorder–B Criteria Scale (SSD-12) is used
to quantify symptom-related psychological behaviors; Patient Health P-value <0.001 <0.001 <0.001
Questionnaire-15 (PHQ-15) is used to quantify the number of physical Notes: WI-8 and Time: −5.740+0.215×Time+0.262×WI-8; Whiteley
symptoms and the degree of distress; Whiteley Index-8 (WI-8) is used Index-8 (WI-8) is used to quantify disease beliefs and health-related
to quantify disease beliefs and health-related concerns; Time refers to concerns; Time refers to the amount of time patient spent on physical
the amount of time patient spent on physical symptoms per day symptoms per day; AUC: Area under the ROC curve; ROC: Receiver
(h/d: hours per day); “-” represents no relevant data. operating curve.

Volume 2 Issue 1 (2024) 6 https://doi.org/10.36922/jcbp.1813