躯体症状自评量表的编制与试测研究

Evaluation of Somato Symptom Self-rating Scale

目的编制“躯体症状自评量表(SSS)”筛查躯体形式障碍并量化地判断其严重度。方法103例躯体形式障碍符合中国精神疾病分类方案与诊断标准(CCMD-3)有关躯体形式障碍诊断标准。选择的患者平均年龄39岁,平均病程2.8年。同期在本院职工中选择年龄、性别、教育程度匹配、躯体健康的对照组103例。躯体症状自评量表(SSS)的项目来源:“躯体形式症状筛查量表(SOMS)”的所有项目、WHO编制的“神经精神病学临床评估草案(SCAN)”的部分项目、认知和睡眠的项目分解以及基于文化背景差异的项目添加,SSS共有95项,每个项目分为5个级别,≥3为阳性。结果项目的敏感性:躯体形式障碍组与正常对照组比较没有显著差异的项目共15项,其中12项来自SOMS项目;给出了SSS所有项目的发生频度;“全身乏力或易疲劳、头晕或眩晕、心慌或心悸、健忘、入睡很困难、头痛、后背痛、颈肩痛、口干或咽喉干燥、视力模糊”组成SSS简式,以19/20分为划界分,识别躯体形式障碍的敏感性88%,特异性82%。结论SSS分别由10项、80项和95项组成3种版本,可以分别用于临床初步筛查、严重度判断和国际比较。

Objective To develop a new assessment method of the severity of somatoform disorder, and to evaluate its validity of Somato Symptom Self-rating Scale （SSS）. Methods 103 patients with somatoform disorder according to CCMD-3 diagnostic criteria visiting the department of Neurology in Huashan Hospital were included. Average age was 39 years and average course was 2.8 years. Items of SSS come from Screening for Somatoform Symptoms （SOMS）, Schedules for Clinical Assessment in Neuropsychiatry （SCAN）, dissolution of items cognition and sleep, and add many items based Chinese cultures. Each item of SSS divided into 5 degree and ≥3 scores mean positive. Results （1）sensitivity of items： there were 15 items no significant difference between somatoform disorder group and normal group. （2） Occurrence frequency of all 95 items had heen provided. （3） most common symptoms （excessive tiredness upon mild exertion, Giddiness, Heart palpitations, Amnesia, fall asleep difficulty, headache, Back pain, neck and shoulder pain, dry or throat mouth, and obscure of sight） may be compose of SSS brief version. With a cutoff point of 19/20, the specificity and sensitivity of SSS brief version identify somatoform disorder were 88% and 82%. Conclusions 3 SSS version form include 10, 80 and 95 items, can be used clinical screening, severity judgment and international comparison respectively.