Development of the psychosomatic symptom scale (PSSS) and assessment of its reliability and validity in general hospital patients in China

Lei Li; Tianci Peng; Rui Liu; Ronghuan Jiang; Dongfeng Liang; Xiangping Li; Aihua Ni; Huan Ma; Xianwen Wei; Hanxiang Liu; Jing Zhang; Hengfen Li; Jianyue Pang; Yunxin Ji; Li Zhang; Yin Cao; Yun Chen; Bo Zhou; Jinny Wang; Xueqin Mao; Lejin Yang; Jianqun Fang; Honglan Shi; Aiqin Wu; Yonggui Yuan

doi:10.1016/j.genhosppsych.2020.01.008

Development of the psychosomatic symptom scale (PSSS) and assessment of its reliability and validity in general hospital patients in China

Gen Hosp Psychiatry. 2020 May-Jun:64:1-8. doi: 10.1016/j.genhosppsych.2020.01.008. Epub 2020 Feb 1.

Authors

Lei Li¹, Tianci Peng², Rui Liu³, Ronghuan Jiang⁴, Dongfeng Liang⁵, Xiangping Li⁶, Aihua Ni⁷, Huan Ma⁷, Xianwen Wei⁸, Hanxiang Liu⁸, Jing Zhang⁹, Hengfen Li¹⁰, Jianyue Pang¹⁰, Yunxin Ji¹¹, Li Zhang¹¹, Yin Cao¹², Yun Chen¹², Bo Zhou¹³, Jinny Wang¹³, Xueqin Mao¹⁴, Lejin Yang¹⁴, Jianqun Fang¹⁵, Honglan Shi¹⁵, Aiqin Wu¹⁶, Yonggui Yuan¹⁷

Affiliations

¹ Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China; Department of Clinical Psychology, The Forth People's Hospital of Lianyungang, Lianyungang, China.
² School of Information Science and Engineering, Southeast University, Nanjing, China.
³ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China; School of Information Science and Engineering, Southeast University, Nanjing, China.
⁴ Department of Psychological Medicine, Chinese PLA General Hospital, Beijing, China.
⁵ Department of Rheumatism, Chinese PLA General Hospital, Beijing, China.
⁶ Department of Cardiovascular Medicine, the Second Xiangya Hospital, Central South University, Changsha, China.
⁷ Department of Clinical Psychology, Hebei Provincial People's Hospital, Shijiazhuang, China.
⁸ Department of Neurology, Puer People's Hospital, Puer, China.
⁹ Department of Cardiovascular Medicine, The First Hospital of Qinhuangdao, Qinhuangdao, China.
¹⁰ Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
¹¹ Department of Psychosomatics, Ningbo First Hospital, Ningbo, China.
¹² Department of Neurology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, China.
¹³ The Center of Psychosomatic Medicine, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, China.
¹⁴ Department of Psychology, Qilu Hospital, Shandong University, Jinan, China.
¹⁵ Mental Health Center, The General Hospital of Ningxia Medical University, Yinchuan, China.
¹⁶ Department of Clinical Psychology, The First Affiliated Hospital of Soochow University, SuZhou, China.
¹⁷ Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China. Electronic address: [email protected].

PMID: 32070913
DOI: 10.1016/j.genhosppsych.2020.01.008

Abstract

Objectives: To develop and verify the Psychosomatic Symptom Scale (PSSS) among psychosomatic patients and the cut-off value of PSSS in distinguishing psychosomatic patients from health controls.

Methods: The PSSS was drafted by an expert workgroup. 996 patients and 366 controls from 14 general hospitals in China were recruited to complete PSSS, Patient Health Questionnaire-15 (PHQ-15) and Symptom Checklist-90 (SCL-90). Student's t-test, Kruskal-Wallis test, Cronbach's α, Spearman's correlation, and confirmatory factor analysis (CFA) were used to verify the PSSS. Receiver operating characteristic (ROC) analyses were used to determine the cut-off value.

Results: Cronbach α of PSSS was 0.907. The PSSS was significantly correlated with SCL-90 somatization subscale (r = 0.682, P < 0.001) and PHQ-15 (r = 0.724, P < 0.001). CFA supported the theoretical two-factor structure of the PSSS, with comparative fit index (CFI) = 0.979, Tucker-Lewis index (TLI) = 0.977, root mean square error of approximation (RMSEA) = 0.039 (90% CI: 0.035-0.042), and standardized root mean residual (SRMR) = 0.054. As the sum score of PSSS was significantly higher in female, cut-off values were determined as 11 in females and 10 in males respectively.

Conclusions: The PSSS is a reliable and valid instrument for measuring psychosomatic symptoms.

Keywords: Cut-off score; PSSS; Psychometrics; Psychosomatic symptom; Self-rated scale.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
China
Female
Hospitals, General*
Humans
Inpatients
Male
Middle Aged
Neuropsychological Tests / standards*
Outpatients
Psychometrics / instrumentation
Psychometrics / methods
Psychometrics / standards*
Psychophysiologic Disorders / diagnosis*
Reproducibility of Results
Sex Factors

Associated data

ChiCTR/ChiCTR-EOC-17010312