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Validation of the 4DSQ Somatization Subscale in the Occupational Health Care Setting as a Screener

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Abstract

Purpose Somatoform disorders (physical symptoms without medical explanation that cause dysfunction) are prevalent in the occupational health (OH) care setting and are associated with functional impairment and absenteeism. Availability of psychometric instruments aimed at assessing somatoform disorders is limited. In the OH setting, so far only the Patient-Health-Questionnaire 15 has been validated as screener for somatoform disorder, and has been shown to have moderate validity. The Four-Dimensional Symptom Questionnaire (4DSQ) is frequently used in the OH setting but the Somatization subscale is not validated yet. The aim of this study is to validate the 4DSQ Somatization subscale as screener for DSM-IV somatoform disorder in the OH setting by using the MINI interview as gold standard. Methods Employees absent from work due to physical symptoms, for a period longer than 6 weeks and shorter than 2 years, were asked to participate in this study. They filled out the 4DSQ and underwent a MINI interview by telephone for DSM-IV classification. Specificity and sensitivity scores were calculated for all possible cut-off scores and a receiver operator curve was computed for the Somatization subscale. 95 % confidence intervals (95 % CIs) were calculated for sensitivity and specificity. Results The Somatization subscale of the 4DSQ has an optimal cut point of 9, with specificity and sensitivity equal to 64.3 % [95 % CI (53.6; 73.7 %)] and 60.9 % [95 % CI (40.8; 77.8 %)], respectively. Receiver operator curves showed an area under the curve equal to 0.61 [SE = 0.07; 95 % CI (0.48; 0.75)] for the Somatization subscale of the 4DSQ. Conclusion The 4DSQ Somatization subscale is a questionnaire of moderate sensitivity and specificity.

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Acknowledgements

The authors of this article would like to thank Melanie de Ruiter for doing the MINI interviews on this project, and Jasper Nuijen for his assistance in data management.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Tranzo Department, Tilburg School of Behavioral and Social Sciences, Tilburg University, Tilburg, The Netherlands

    Lars de Vroege & Christina M. van der Feltz-Cornelis

  2. Clinical Centre for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands

    Lars de Vroege & Christina M. van der Feltz-Cornelis

  3. Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands

    Wilco H. M. Emons & Klaas Sijtsma

  4. Department of Health Sciences, University Medical Center of Groningen, Groningen, The Netherlands

    Rob Hoedeman

  5. Department of Science, ArboNed Occupational Health Services, Utrecht, The Netherlands

    Rob Hoedeman

  6. Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands

    Christina M. van der Feltz-Cornelis

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  1. Lars de Vroege
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  2. Wilco H. M. Emons
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  3. Klaas Sijtsma
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  4. Rob Hoedeman
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  5. Christina M. van der Feltz-Cornelis
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Correspondence to Lars de Vroege.

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de Vroege, L., Emons, W.H.M., Sijtsma, K. et al. Validation of the 4DSQ Somatization Subscale in the Occupational Health Care Setting as a Screener. J Occup Rehabil 25, 105–115 (2015). https://doi.org/10.1007/s10926-014-9529-2

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  • DOI: https://doi.org/10.1007/s10926-014-9529-2

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