Multisomatoform disorder: agreement between patient and physician report of criterion symptom explanation

CNS Spectr. 2006 May;11(5):383-8. doi: 10.1017/s1092852900014516.

Abstract

Objective: To determine the level of agreement between patients and expert physicians in whether criterion multisomatoform (MSD) symptoms are explained.

Methods: We systematically collected reports from 280 primary care patients about whether they had suffered from any of 15 criterion MSD symptoms in the past month and whether they had received a medical explanation from a physician for positive criterion symptoms. The research team compared MSD symptom diagnoses derived from patient report with MSD symptom diagnoses derived from an expert physician report.

Results: MSD symptom diagnoses derived from patient report had 98.7% sensitivity, 97.9% specificity, 89.3% positive predictive value, and 99.7% negative predictive value compared with MSD symptom diagnoses derived from an expert physician report. Analysis demonstrated that 15.0% of patients met symptom criteria for MSD, according to patient and physician report; 83.0% failed to meet symptom criteria for MSD, according to patient and physician report; 1.8% of patients met symptom criteria for MSD, according to patient report but not physician report, while 0.2% met symptom criteria for MSD according to physician report but not by patient report.

Conclusion: Patients demonstrated high agreement with a physician expert in somatization about whether criterion MSD symptoms are explained, suggesting revised screeners may accurately identify somatizing patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Patients*
  • Physicians*
  • Primary Health Care
  • Somatoform Disorders / diagnosis
  • Somatoform Disorders / epidemiology*
  • Somatoform Disorders / psychology*
  • Surveys and Questionnaires