Psychometric validation of the German version of the somatic symptom disorder – B criteria scale (SSD-12) in a primary care population with depression and anxiety: A COSMIN-guided analysis

IF 3.7 2区医学 Q1 PSYCHIATRY

General hospital psychiatry Pub Date : 2025-09-04 DOI:10.1016/j.genhosppsych.2025.09.001

Deborah van Eickels , Klara Henning , Michel Wensing , Hans-Christoph Friederich , Markus W. Haun

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引用次数: 0

Abstract

Objective

Somatic Symptom Disorder (SSD) is common and often underdiagnosed in primary care, especially in patients with depression and anxiety. The SSD-12 is a self-report questionnaire assessing psychological features of SSD. This study aimed to validate the SSD-12 longitudinally in a primary care sample with depressive and/or anxiety symptoms, following COSMIN guidelines.

Methods

We conducted a secondary analysis of the PROVIDE-C trial, including 365 adults with moderate depressive and/or anxiety symptoms. Psychometric evaluation of the SSD-12 used data from three time points (baseline, 6, and 12 months). Factorial validity was assessed via confirmatory factor analysis (CFA) comparing unidimensional and three-factor models. Measurement invariance was examined across gender, age, chronic illness, and study arms using multi-group and longitudinal CFA. Additional analyses included internal consistency (McDonald's Omega), test-retest reliability (ICC), measurement error (SEM, SDC), convergent validity (correlations with PHQ-9, GAD-7, RAS-G, SF-12, EQ-5D), and responsiveness (correlations of SSD-12 change scores with PHQ-ADS change).

Results

CFA supported a three-factor structure (cognitive, affective, behavioral) at all time points. Measurement invariance was confirmed across subgroups and longitudinally. The SSD-12 showed high internal consistency, adequate test-retest reliability, and good responsiveness. Construct validity showed moderate positive correlations with anxiety, and small positive correlations with depression.

Conclusion

The SSD-12 exhibits strong psychometric properties in psychologically burdened primary care patients and is suitable for screening and monitoring somatic symptom burden in both cross-sectional and longitudinal examinations. Further research should refine thresholds for clinically meaningful change and cut-off points across diverse patient groups to enhance clinical interpretability.

Trial registration: ClinicalTrials.gov NCT04316572.

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德国版躯体症状障碍- B标准量表（SSD-12）在抑郁症和焦虑症初级保健人群中的心理测量验证：cosmin指导分析

目的躯体症状障碍（SSD）在初级保健中很常见，但常被误诊，尤其是在抑郁和焦虑患者中。SSD-12是一份评估SSD心理特征的自我报告问卷。本研究旨在遵循COSMIN指南，在具有抑郁和/或焦虑症状的初级保健样本中纵向验证SSD-12。方法：我们对provid - c试验进行了二次分析，包括365名有中度抑郁和/或焦虑症状的成年人。SSD-12的心理测量评估使用三个时间点（基线、6个月和12个月）的数据。通过验证性因子分析（CFA）比较一维和三因素模型来评估因子效度。使用多组和纵向CFA检验了性别、年龄、慢性疾病和研究组之间的测量不变性。其他分析包括内部一致性（麦当劳ω）、重测信度（ICC）、测量误差（SEM、SDC）、收敛效度（与PHQ-9、GAD-7、as - g、SF-12、EQ-5D的相关性）和响应性（SSD-12变化得分与PHQ-ADS变化的相关性）。结果scfa在各时间点均支持认知、情感、行为三因素结构。在亚组和纵向上证实了测量不变性。SSD-12具有较高的内部一致性、足够的重测信度和良好的响应性。建构效度与焦虑呈中度正相关，与抑郁呈轻微正相关。结论SSD-12在心理负担患者中表现出较强的心理测量特性，适用于横断面和纵向检查的躯体症状负担筛查和监测。进一步的研究应细化临床意义变化的阈值和不同患者群体的分界点，以提高临床可解释性。试验注册：ClinicalTrials.gov NCT04316572。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

General hospital psychiatry 医学-精神病学

CiteScore

9.60

自引率

2.90%

发文量

125

审稿时长

20 days

期刊介绍： General Hospital Psychiatry explores the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the journal provides a forum for professionals with clinical, academic, and research interests in psychiatry''s role in the mainstream of medicine.