Assessment of functional somatic disorders in epidemiological research: Self-report questionnaires vs diagnostic interviews,2021, Petersen, Fink et al

[Andy]

Highlights

• Prevalence of diagnoses were lower in the diagnostic interview than in self-reported questionnaires.
• Discrepancies constituted the clinical evaluation of symptom attribution and impairment.

• Symptom questionnaires are an important screening tool.

• Diagnostic interviews are superior in establishing clinically significant diagnoses.
Abstract

Objective
Self-reported symptom questionnaires are often used for identifying individuals with functional somatic disorders (FSD) in epidemiological research. Studies on their validity in establishing clinically valid cases are, however, lacking. We aimed to compare and dissect the processes of identifying participants with FSD with symptom questionnaires and FSD diagnoses established by diagnostic interviews.

Methods
Individuals from the adult Danish population (n = 1590) filled in symptom questionnaires and participated in a diagnostic research interview, performed over telephone by trained family physicians. The two methods were described and compared in different steps: 1) Agreement on presence of symptoms, 2) agreement after FSD symptom pattern criteria had been applied, and 3) agreement on final FSD diagnoses.

Results
Agreement on symptom presence was high (>82%). Using FSD symptom pattern criteria, the two methods agreed in 30–62% of cases within each category. Discrepancies were mainly due to participants fulfilling symptom patterns in the interview but not in the questionnaires. Agreement between final FSD questionnaire cases and final FSD interview diagnoses was moderate (>68%) with lower FSD prevalence in the interview (26.2% vs 44.5%). Discrepancies were largely explained by the interviewers assessing the symptom patterns to be caused by an alternative physical or mental condition.

Conclusion
Prevalence of final FSD diagnoses were markedly lower in the diagnostic interview compared to self-reported questionnaires cases; mainly because of the clinical evaluation of symptom attribution and impairment. Symptom questionnaires may be valuable as screening tools and as trans-diagnostic comparison while diagnostic interviews are necessary in establishing clinically significant FSD diagnoses.

Open access, https://www.sciencedirect.com/science/article/pii/S0022399921001367

 

[Sean]

functional somatic disorders (FSD)

Psychosomatics is just one damn acronym after another.

 

[Amw66]

Is this not just a spin on how rubbish questionnaires are ( without overtly admitting it)

 

[rvallee]

Self-reported symptom questionnaires are often used for identifying individuals with functional somatic disorders (FSD) in epidemiological research

Translation: I'm doing that therefore it's valid.

It's hard not to conclude that nobody reads psychosomatic papers, including peer reviewers and the editors. They just skim it and only bother with typos and other trivial stuff. The common usage of "some people are saying" and pointing at their own work for evidence that their work is worth doing is such a major red flag and yet nobody objects.

What's most frustrating about the crisis of replicability is the pretense that it has affected psychological research at all. Nope, the actual crisis, of validity, is going at full steam.

This is argle-bargle:

Discrepancies were mainly due to participants fulfilling symptom patterns in the interview but not in the questionnaires

Fulfilling:

making someone satisfied or happy because of fully developing their character or abilities

Haha yeah no bias here this is real professional science.

And I guess mainly is another word whose meaning is too ambiguous for some people:

Discrepancies were largely explained by the interviewers assessing the symptom patterns to be caused by an alternative physical or mental condition

So the issue is physicians falsely attributing symptoms to another cause, or sometimes actually catching what was missed before. Which is correct, the problem is clearly one of identification. Medicine is unable to properly do this, this is exactly as expected as physicians are not wizards with magical diagnosing powers. And because medical science is far from complete.

It's genuinely fascinating that the last acceptable mainstream pseudoscience is probably the one that is believed the firmest. Maybe because it's the last one and it feels special to have magic interfere with reality. It's also catastrophic and immoral but then again so are all the other pseudosciences.

And yeah is FSD another one in the stable of acronyms? Has anyone bothered doing a count? I'm sure we're well above 30 by now, probably pushing 50.

 

[Peter T]

Is this a case of SAPS - silly acronym proliferation syndrome?

 

[Woolie]

Discrepancies were largely explained by the interviewers assessing the symptom patterns to be caused by an alternative physical or mental condition.

Soooooo... if we just ask patients to report their symptoms in a questionnaire, without bothering to consider what caused them, we gets lot of cases of FSD. If we actually talk to them, and take the time to consider whether the symptoms are really medically unexplained, we don't get as many.

Conclusion: researchers wanting to make their careers on FSD should avoid interviews and use questionnaires...