Page 84 - JCBP-2-1

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

The physical component of SSD can escalate the diagnostic accuracy and ultimately enhancing the overall
severity and complexity of depression and anxiety management of SSD.
disorders, resulting in heightened psychological distress However, the research is subject to limitations inherent
and functional impairment [14,33] . A comparative study on in cross-sectional studies with large sample sizes. One
health anxiety between SSD and illness anxiety disorder notable limitation is the absence of SCID-5-RV gold
(IAD) revealed that individuals with SSD experience standard diagnostic interviews with patients to confirm
more pronounced functional impairment are more SSD diagnosis. In addition, the selection of departments
prone to panic and generalized anxiety disorder, and seek where SSD patients visit more frequently may introduce
medical consultation more frequently than IAD patients. biases in the results, potentially leading to an offset in the
In other words, SSD is associated with heightened health findings. The current study mainly focused on exploring
anxiety due to disease [14,34] . In our studies, the results have the use of time spent worrying about physical discomfort
indicated that WI-8 is an effective predictor of symptom- and the WI-8 scale as standards for measuring SSD
related cognitive behavior. In the previous multicenter psychological behavior. Consequently, no further analysis
study, WI-8 (r = 0.823, P < 0.01), time spent worrying was conducted on anxiety and depression. The specificity of
about physical symptoms (r = 0.570, P < 0.01), and the joint predictive diagnosis results from the ROC analysis
PHQ-15 (r = 0.519, P < 0.01) were all significant predictors did not exhibit improvement. This finding suggests that
in a multiple regression analysis. The findings indicate that outpatient patients can undergo more effective screening
anxiety related to one’s health, the duration of attention for SSD, reducing the likelihood of overlooking suspicious
to symptoms, and the number and severity of physical cases. However, caution should be exercised regarding the
symptoms all exert a decisive impact on SSD–B criteria. potential situation of “over-diagnosis.” In future research
However, in the comparative study, PHQ-15 was not endeavors, researchers are encouraged to employ the
included in the equation. This omission may be related to gold standard for diagnosis and broaden the scope of
the fact that patients with severe physical symptoms tend targeted departments. This approach aims to attain a more
to prefer non-psychiatric clinics. accurate and comprehensive understanding of temporal
In addition, to further predict the diagnosis of SSD–B quantification values or other meaningful indicators that
criteria using the WI-8 scale and time spent worrying about can effectively screen SSD–B criteria.
physical symptoms, we separately calculated their ROC
curves. Both of our studies indicated a higher AUC and 5. Conclusion
a greater predictive accuracy for the WI-8 scale compared This study presents a simple, cost-effective, rapid, and
to time alone. In the previous multicenter study, when direct method for clinical doctors to assess the SSD–B
the WI-8 scale and time were combined for predictive criteria, which can be easily used even by non-psychiatric
diagnosis, the prediction accuracy reached its peak specialists. The combination of WI-8 and time spent
(AUC =0.921), with an improved sensitivity of 88.6%. This worrying about physical symptoms demonstrates
enhancement facilitates more effective screening of SSD–B noteworthy screening and predictive diagnostic values
criteria. As demonstrated in our earlier research , the for SSD-12. In clinical consultations, if patients report
[25]
WI-8 has a determined cutoff value of 19, and the current spending more than 1.25 h/day attending to their physical
study established a time cutoff value of 1.25 h (sensitivity: symptoms or if their WI-8 scale score equals or exceeds 19,
68.3%, specificity: 84.5%). Combining these two measures and they have experienced at least one somatic symptom
can be utilized for screening of SSD–B criteria. Our persistently for more than 6 months, suspicions of SSD
comparative study closely aligns with the results of should be raised, warranting further evaluations.
previous multicenter studies, highlighting the stability
of time and the WI-8 as joint predictors. This research Acknowledgments
holds favorable representativeness and generalization We thank all the participants.
in the three aspects: (i) it provides valuable insights into
predicting and understanding SSD criteria, specifically Funding
focusing on the Chinese context; (ii) by addressing the
unique cultural and societal aspects relevant to China, This study was financially supported by National Natural
this research adds significant depth to the understanding Science Foundation of China Youth Fund (82001313).
of SSD and paves the way for targeted interventions and Conflict of interest
support for individuals experiencing somatic symptoms in
this region; (iii) it offers a promising avenue for improving The authors declare they have no competing interests.

Volume 2 Issue 1 (2024) 8 https://doi.org/10.36922/jcbp.1813