Integrating DCPR-R and DSM-5 into clinical psychosomatic practice in Taiwan: Their relationship with psychopathologies and quality of life.

IF 16.3 1区医学 Q1 PSYCHIATRY

Psychotherapy and Psychosomatics Pub Date : 2025-03-21 DOI:10.1159/000545409

Wei-Lieh Huang, Yi-Ting Chiu, Chi-Shin Wu, Bernd Löwe, Shih-Cheng Liao

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引用次数: 0

Abstract

Introduction: This study aimed to assess the benefit of integrating the Diagnostic Criteria for Psychosomatic Research-Revised (DCPR-R) into the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). Specifically, it examined whether this integration enhances the understanding of psychopathologies and quality of life (QOL) in psychosomatic medicine.

Methods: In this cross-sectional study conducted in Taiwan, 277 patients from psychosomatic clinics and 225 community participants were included. Standardized interview tools based on DCPR-R and DSM-5 were used to assess the presence of various diagnoses. Participants also completed several scales related to persistent somatic symptoms, negative emotions, and QOL. Latent class analysis was used to explore the clustering of diagnoses, and multiple linear regression analysis was employed to investigate the relationship between diagnoses, psychopathologies, and QOL under conditions of possible comorbidity.

Results: Three classes were identified via latent class analysis: somatic symptoms, demoralization and stress, and insomnia. In the multivariate analysis considering multiple diagnoses simultaneously, the number of diagnoses significantly associated with psychopathologies and QOL was greatly reduced compared to the univariate analysis. Persistent somatization was more strongly associated with somatic distress than somatic symptom disorder. Several DCPR-R constructs showed significant associations with illness-related anxiety. The DCPR-R diagnoses with broader influences on QOL were demoralization, demoralization with hopelessness, and irritable mood.

Conclusions: The results suggest the potential clinical significance of integrating DCPR-R and DSM-5 in Eastern societies. The DCPR-R diagnoses with significant findings mentioned above may contribute to the personalized treatment plans for patients in psychosomatic medicine.

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导言：本研究旨在评估将《心身医学研究诊断标准-修订版》（DCPR-R）纳入《精神疾病诊断与统计手册第五版》（DSM-5）的益处。具体而言，该研究探讨了这一整合是否增强了心身医学对精神病理学和生活质量（QOL）的理解：这项横断面研究在台湾进行，共纳入了 277 名来自心身医学诊所的患者和 225 名社区参与者。研究使用基于 DCPR-R 和 DSM-5 的标准化访谈工具来评估是否存在各种诊断。参与者还完成了与持续性躯体症状、负面情绪和 QOL 相关的几个量表。潜类分析用于探索诊断的聚类，多元线性回归分析用于研究在可能合并症的条件下诊断、精神病理学和 QOL 之间的关系：结果：通过潜类分析确定了三个类别：躯体症状、意志消沉和压力以及失眠。在同时考虑多种诊断的多变量分析中，与单变量分析相比，与精神病理学和 QOL 显著相关的诊断数量大大减少。与躯体症状障碍相比，持续躯体化与躯体痛苦的相关性更强。DCPR-R 的几个结构与疾病相关焦虑有显著关联。对 QOL 影响较大的 DCPR-R 诊断是意志消沉、意志消沉伴无望和易怒情绪：结论：研究结果表明，在东方社会整合 DCPR-R 和 DSM-5 具有潜在的临床意义。上述具有重要发现的 DCPR-R 诊断可能有助于心身医学为患者制定个性化治疗方案。

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来源期刊

Psychotherapy and Psychosomatics 医学-精神病学

CiteScore

29.40

自引率

6.10%

发文量

期刊介绍： Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.