Page 83 - JCBP-2-1

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

A B

Figure 1. Receiver operating curve of the ability is to predict somatic symptom disorders (SSD)-12 based on the time spent on symptoms and the WI-8
scale. (A) Receiver operating cure of time and WI-8 in predicting SSD-12 in the previous multicenter study. (B) Receiver operating cure of time and WI-8
in predicting SSD-12 in the comparative study.

and specificity values of 80% and 58%, respectively. Upon Table 11. Prediction of SSD‑12 with time, WI‑8, and WI‑8
combining WI-8 d with time in the predictive diagnosis and time in the comparative study
of SSD-12, a binary logistic regression analysis was
performed, yielding the linear model as follows: Items WI‑8 Time WI‑8 and Time
ROC (AUC) 0.925 0.801 0.935
Logit(P) = −4.705+0.128×Time+0.375×WI-8 (II) Cutoff value 10.5 1.9 0.429
Youden index 0.74 0.46 0.78
This combined approach improved the AUC to 0.935
(P < 0.001), with sensitivity and specificity values of 92% Sensitivity 0.9 0.88 0.92
and 86%, respectively (Table 11 and Figure 1). Specificity 0.84 0.58 0.86
95% confidence interval 0.875–0.976 0.715–0.887 0.888–0.981
3.6. Reliability
P-value <0.001 <0.001 <0.001
Internal consistency was assessed using Cronbach’s alpha Notes: WI-8 and Time: −4.705+0.128×Time+0.375×WI-8; Whiteley
for the total scale score. In the previous multicenter Index-8 (WI-8) is used to quantify disease beliefs and health-related
study, Cronbach’s alpha for the SSD-12 was 0.953, and concerns; Time refers to the amount of time patient spent on physical
it decreased to 0.949 after the removal of the 12 item. symptoms per day; AUC: Area under the ROC curve; ROC: Receiver
th
For both PHQ-15 and WI-8, the values were 0.808 and operating curve.
0.937, respectively, indicating acceptable reliability. In the
comparative study, Cronbach’s alpha for the SSD-12 was in Germany (n = 2,395), which measured the time spent
0.947, and it decreased to 0.943 after the removal of the by SSD patients worrying about physical symptoms (SSD
[24]
12 item. For the PHQ-15 and WI-8, the values were 0.822 group = 4 h, non-SSD group = 0.5 h) . It is noteworthy
th
and 0.916, respectively, indicating acceptable reliability. that the German study used a combination of scales for
diagnosing SSD, dividing participants into SSD and non-
4. Discussion SSD groups . In our comparative study, the high-score
[32]
group (n = 50) spent 5.3 h/day on physical symptoms,
This study conducted two rounds of information collection
and investigation among outpatient patients with physical while patients in the low-score group only spent 2.3 h/day.
complaints in nine tertiary comprehensive hospitals in The longer duration of both groups compared to the
China. The aim was to explore the predictive value of the previous multicenter study may be related to the fact that
time spent focusing on physical symptoms and the WI-8 the patients were from a post-pandemic psychosomatic
scale for screening SSD, as measured by the SSD-12. For department, and the sample size was smaller than that of
analysis, we categorized our participants into low- and high- the previous multicenter study. However, findings from
score SSD groups and compared the statistical differences both domestic and international research consistently
between them. The results of the previous multicenter study demonstrate significant differences in time between the
revealed that patients in the high-score group (n =272) two groups, indicating that SSD patients or patients with
spent 4.5 h/day on physical symptoms, while those in the high psychological scores (SSD-12 scores) do spend more
low-score group only spent 0.9 h/day. This finding aligns time worrying and paying attention to physical symptoms
with a representative national general population survey every day.

Volume 2 Issue 1 (2024) 7 https://doi.org/10.36922/jcbp.1813