A simple instrument for assessing stress in clinical practice.

Methods to assess the role of stress factors in patients with medical conditions are often rather complex, require specific training, and are difficult to use in clinical practice. We attempted to develop a short index tailored to a busy clinical setting, which would be easy to use while providing adequate individual information. This index (Psychosocial Index) was largely derived from well-established instruments, such as Kellner's Screening List for Psychosocial Problems. In addition, on the basis of the patient's self-report of items, the clinician is asked to rate four dimensions of the patient's life: stress, wellbeing, psychological distress, and illness behaviour. The questionnaires of 34 female patients with functional medical disorders were first rated by an internist and afterwards, blindly, by a psychiatrist. Agreement between the two raters was excellent, as measured by the intraclass correlation coefficient. It is hoped that this Psychosocial Index may provide a new tool for psychosomatic research and practice.