Assessment of SSD in Outpatients by Using SSS-CN

Study Overview
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Brief Summary
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About 70-80% of patients with somatic symptom disorder (SSD) visit the general medical hospital instead of psychiatric or other mental health settings. The current self-reporting questionnaires are neither sufficiently considering companioned anxiety or depression nor validated for monitor the treatment efficacy of such group. The Somatic Symptom Scale-China (SSS-CN) is developed due to the urging clinical demanding in general hospital. The study aims to investigate whether the SSS-CN could serve as a timely and practical instrument to detect SSD and assess the severity of the disorder.

Detailed Description
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One of the most common medical conditions seen in general hospital is somatic symptoms disorder (SSD). As the disorder is characterized by the prominent attention to somatic concerns, patients mainly present initially in medical rather than mental health care settings. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is currently the gold standard for the diagnosis of SSD, but it is clinically hard to follow. Thus, It is more clinically practical to detect a disorder by self-administered questionnaires, that patients can score symptoms according to their own condition and severity in a short time. However, the current self-reporting questionnaires, such as the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder Scale-7 (GAD-7), and the Patient Health Questionnaire-15 (PHQ-15) are neither sufficiently considering companioned anxiety or depression nor validated for monitor the treatment efficacy of SSD patients. The Somatic Symptom Scale-China (SSS-CN) is developed based on DSM-5 to assess SSD, and it is an abbreviated 20-item version of somatic symptoms that can be entirely self-administered by the patient, but its assessment value has not yet been widely tested. The study aims to investigate whether the SSS-CN could serve as a timely and practical instrument to detect SSD and assess the severity of the disorder.

Official Title
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The EARLY Validation and Utility of Somatic Symptom Scale CHINA (SSS-CN) for Assessing Somatic Symptom Disorder in MYOcardial Outpatients of General Hospital

Conditions
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Somatization Disorder

Intervention / Treatment
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* Drug: Deanxit, SSRI or SRNI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age 18-80 years old; patients who have no previous diagnosed somatic disease; patients without systemic disease that can account the physical discomfort; patients who agree to take the checklists and undertake assessment from a physician. Exclusion Criteria: patients who have lost their self-assessed abilities or refuse to participate in; patients who have been previously confirmed serious mental disorders, mental retardation or dementia; patients who are taking anti-anxiety agents or anti-depression agents; patients who are unable to complete at least 1 time follow-up.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with SSD<br>Patients are diagnosed with SSD by physician according to DSM-5,and will be treated with Deanxit, SSRI or SRNI on the basis of severity assessment by physician. | Drug: Deanxit, SSRI or SRNI<br>* After recruiting participants and collecting the baseline data, the SSS-CN, PHQ-15, PHQ-9 and GAD-7 questionnaires will be carried out. An independent diagnosis will be made by primary care physician using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criterion standard. Deanxit, selective serotonin reuptake inhibitors (SSRI) or serotonin-norepinephrine reuptake inhibitors (SNRI) will be selectively prescribed according to the severity category assessed by physician. Two, 6,10 weeks after patients with correspondent medications, a face-to-face interview, telephone interview or mobile-apps survey will be underwent to follow-up using the SSS-CN, PHQ-15, PHQ-9 and GAD-7 checklists.<br>|
| Patients with non-SSD<br>No SSD is diagnosed by physician according to DSM-5 | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The diagnosis accuracy of somatic burden assessment by SSS-CN | The primary objectives of this study are to test the diagnosis accuracy of somatic burden assessment by SSS-CN. Investigators expect that somatic symptom disorder assessed by SSS-CN is as accurate as diagnoses made by the DSM-5 criterion standard | Within 24 hours after collecting the scale. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The assessment of treatment efficacy by SSS-CN | Investigators hypothesize that the SSS-CN is effective in monitoring treatment efficacy of SSD in primary care patients. | Two,6,10 weeks after patients with correspondent medications. | 
| The advantage of SSS-CN | To explore whether SSS-CN is non-inferior compared with PHQ-15. | Baseline and 2,6,10 weeks after patients with correspondent medications. | 
| SSD companioned with anxiety or depression | To evaluate how often does SSD companioned with anxiety or depression, or at which circumstance does SSD companioned with anxiety or depression. | Baseline and 2,6,10 weeks after patients with correspondent medications. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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somatic symptom disorder, the Somatic Symptom Scale-China, mental disorders management