Comparing SSS-CN With PHQ-15 In Evaluating Patients With Suspected Psychological Disorders In The Department Of Cardiovascular Medicine

Aims:Somatic Symptom Scale-China(SSS-CN)is a scale inquiring somatic and psychological symptoms and has been applied to assess the presence and severity of somatization symptom disorders(SSD)in Chinese patients.However,there was no study comparing SSS-CN with Patient Health Questionnaire-15(PHQ-15),a recognized mature scale evaluating SSD worldwide.Methods:One thousand three hundred and twenty-four suspected patients in the department of cardiovascular medicine had been screened by three-question method,and initially considered highly likely to have psychological disorders.Then they completed the evaluation of four scales,including SSS-CN,PHQ-15,Patient Health Questionnaire-9(PHQ-9)and General Anxiety Disorder-7(GAD-7).The results of the PHQ-15 diagnosis were used as the gold standard for statistical analysis of the sensitivity and specificity of the SSS-CN in diagnosing SSD.Reliability analysis was performed with the Kappa statistic to determine consistency between SSS-CN and PHQ-15.The relationship between two qualitative variables was analyzed by Spearman correlation analysis.Results:1.The proportions of SSD evaluated by SSS-CN and PHQ-15 were83.2% and 87.0%,respectively.2.SSS-CN score was significantly correlated with PHQ-15 one(r =0.709,P < 0.001).The sensitivity of SSS-CN in diagnosing SSD was90.71% and the specificity was 66.86%.There was a moderate agreement between SSS-CN and PHQ-15 in assessing SSD,with Kappa value0.512.3.Anxiety and/or depression were detected in about 70% of patients with SSD.There was significant correlation between the score of each SSD scale and that of GAD-7 or PHQ-9(SSS-CN: r = 0.614 or 0.674;PHQ-15: r = 0.444 or 0.582,all P < 0.001).The patients with moderate or severe SSD evaluated by each SSD scale had significantly higher scores and positive rates of GAD-7 or PHQ-9 than those with mild SSD(P <0.05).4.Notably,the proportion of anxiety or depression was significantly higher in patients with moderate or severe SSD evaluated by the SSS-CN than in those with moderate or severe SSD evaluated by the PHQ-15(P <0.05).There was no significant difference in the proportion of anxiety or depression in patients with mild SSD evaluated by the two scales.Conclusions:SSS-CN has high sensitivity and acceptable specificity for the diagnosis of SSD and there was moderate agreement between the SSS-CN and the PHQ-15 in assessing SSD in patients with suspected psychological disorders in cardiovascular medicine.There was significant correlation between the score of each SSD scale and that of GAD-7 or PHQ-9.SSS-CN scores were more strongly correlated with GAD-7 or PHQ-9 scores than PHQ-15 scores;the proportion of anxiety and/or depression was higher in patients with moderate or severe SSD assessed by the SSS-CN.The results suggest that SSS-CN is one of the ideal scale to fast screen the patients with suspected psychological disorders in the department of cardiovascular medicine.5 graphs,2 table and 43 references...