Am J Psychiatry 1995; 152:97-101
Copyright © 1995 by American Psychiatric Association
DSM-IV field trial: testing a new proposal for somatization disorder
SH Yutzy, CR Cloninger, SB Guze, EF Pribor, RL Martin, RG Kathol, GR Smith and JJ Strain
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110.
OBJECTIVE: The purpose of this study was to evaluate for APA a proposed
strategy to diagnose somatization disorder for possible inclusion in
DSM-IV. METHOD: Five sites--Washington University, University of Kansas,
University of Iowa, University of Arkansas, and Mount Sinai Medical Center
in New York--participated in a collaborative field trial. Female subjects
(N = 353) were recruited from several different services (psychiatry,
internal medicine, and family practice) and were evaluated for the presence
or absence of the disorder. This assessment was performed with a new
instrument constructed by combining all the criteria for somatization
disorder from the proposed criteria for DSM- IV, DSM-III, DSM-III-R,
Perley-Guze, and proposed criteria for ICD-10. RESULTS: A high level of
concordance was found between the proposed diagnostic strategy for DSM-IV
and the current criteria (DSM-III-R), as well as the earlier criteria
(Perley-Guze and DSM-III). The ICD-10 criteria agreed poorly with all other
criteria sets. The level of experience of the rater (expert versus novice)
with the earlier (Perley- Guze, DSM-III) and current (DSM-III-R) criteria
did not influence the identification of cases by use of DSM-IV criteria. No
racial effect was introduced by any of the criteria sets. CONCLUSIONS: The
strategy for DSM-IV is an accurate and simpler method of diagnosing
somatization disorder that does not require special expertise for proper
use.
