Assessing medically unexplained symptoms: evaluation of a shortened version of the SOMS for use in primary care

BMC Psychiatry. 2010 May 17:10:34. doi: 10.1186/1471-244X-10-34.

Abstract

Background: To investigate the validity and stability of a Portuguese version for the Screening for Somatoform Symptoms-2 (SOMS-2) in primary care (PC) settings.

Methods: An adapted version of the SOMS-2 was filled in by persons attending a PC unit. All medically unexplained symptoms were further ascertained in a clinical interview and by contacting the patient's physicians and examining medical records, attaining a final clinical symptom evaluation (FCSE). An interview yielded the diagnosis of Clinical Somatization (CS) and the diagnosis of current depressive and anxiety disorders.

Results: From the eligible subjects, 167 agreed to participate and 34.1% of them were diagnosed with somatization. The correlation between the number of self-reported and FCSE symptoms was 0.63. After excluding symptoms with low frequency, low discriminative power and not correlated with the overall scale, 29 were retained in the final version. A cut-off of 4 symptoms gave a sensitivity of 86.0% and a specificity of 95.5% on the FCSE and 56.1% and 93.6% at self-report. Stability in the number of symptoms after 6 months was good (k = 0.57).

Conclusions: The 29 symptoms version of the SOMS-2 with a cut-off of 4 showed a high specificity and sensitivity, being reliable as a referral tool for further specialized diagnosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Comorbidity
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Health Status
  • Humans
  • International Classification of Diseases
  • Personality Inventory / statistics & numerical data*
  • Portugal / epidemiology
  • Primary Health Care / methods*
  • Psychiatric Status Rating Scales
  • Psychometrics
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Sex Factors
  • Somatoform Disorders / diagnosis*
  • Somatoform Disorders / epidemiology
  • Somatoform Disorders / psychology
  • Surveys and Questionnaires*
  • Translating