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. 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: yygylh2000@sina.com.
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.
OBJECTIVES: To develop and verify the Psychosomatic Symptom Scale (PSSS) among psychosomaticpatients and the cut-off value of PSSS in distinguishing psychosomaticpatients 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.