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A Symptom Checklist to Screen for Somatoform Disorders in Primary Care

Received May 7, 1997; revised November 10, 1997; accepted November 20, 1997. From the Regenstrief Institute for Health Care (KK), Richard Roudebush Veterans Affairs Medical Center (RS), Indiana University School of Medicine (KK, RS), Indianapolis; New York State Psychiatric Institute and the Department of Psychiatry, Columbia University, New York, New York (RLS); and the Department of Family Practice, University of South Alabama College of Medicine, Mobile, Alabama (Dr. deGruy). The work for this study was done at the authors' institutions. Address reprint requests to Dr. Kroenke, Regenstrief Institute for Health Care, RG–6, 1001 West 10th St., Indianapolis, IN 46202.

Current DSM-IV somatoform diagnoses may inadequately capture many somatizing patients in primary care. By using data from two studies (1,000 and 258 patients, respectively), the authors determined 1) the optimal threshold on a checklist of 15 physical symptoms to screen for a recently proposed somatoform diagnosis, multisomatoform disorder (MSD), and 2) the concordance between MSD and somatization disorder. The optimal threshold for pursuing a diagnosis of MSD was seven or more physical symptoms. The majority (88%) of the patients who met criteria for MSD had either full or abridged somatization disorder. MSD was intermediate between abridged and full somatization disorder in terms of its association with functional impairment, psychiatric comorbidity, family dysfunction, and health care utilization and charges.

Key Words: Primary Care • Somatoform Disorders • Symptom Checklist

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