Application and validation of the bodily distress syndrome checklist in a psychosomatic outpatient sample, Wertenbruche-Rocke et al, 2021

Andy

Retired committee member
Objective
The BDS checklist is a self-report measure to assess the most common somatic symptoms in functional somatic syndromes, based on the diagnostic concept of Bodily Distress Syndrome. The aim of the study was to examine the psychometric properties and validity of the BDS checklist in a psychosomatic sample and to investigate whether it is suitable to detect DSM-5 somatic symptom disorders (SSD).

Method
In a cross-sectional study, n = 368 patients from a psychosomatic outpatient clinic completed the BDS checklist and a semi-structured clinical interview on SSD. Item and scale characteristics and measures of reliability and validity were determined.

Results
The BDS checklist showed good item characteristics and reliability (Cronbach α = 0.89). Factor analysis confirmed four symptom clusters (CFI = 0.95, TLI = 0.95, RMSEA = 0.091, 90% CI = 0.085–0.097). The BDS total score showed significant correlations with other measures of somatic symptom burden (r = 0.79, p < .001), health anxiety (r = 0.46, p < .001), depression (r = 0.45, p < .001), and general anxiety (r = 0.41, p < .001). Higher BDS checklist scores were associated with higher physical and mental health impairment and higher health care use. Diagnostic accuracy regarding somatic symptom disorder was moderate (AUC = 0.72, 95% CI: 0.67–0.77).

Conclusion
Findings of our study indicate that the BDS checklist is a reliable and valid measure to assess the most common somatic symptoms in a psychosomatic setting. It is however not sufficient to detect persons at risk for somatic symptom disorder. A combination with further questionnaires could probably improve diagnostic accuracy.
Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0163834320301730
 
The validation process in EBM is a complete joke. Literally: we like what it says therefore it is valid.

Turns out inventing a process to circumvent the scientific method and make it easier to publish nonsense leads to circumventing the unscientific trash being published more easily. By that metric EBM can be considered a success, it made it so easy you can publish anything.

It's like a nostalgic form of pre-science research, like they used to do back in the days before science.
 
Woah. Hamburg. They have a department that they blatantly call psychosomatic medicine. Blows my mind they have actually got any patients who would turn up for an appointment there.
Also in my nearest big town, which my GP tried to trick me into making an appointment at by telling me about a great hospital department which specialised in rare illnesses and might just find out what's going on with me. So I called the number he gave me, and the conversation went something like this:

"Psychosomatic clinic?"
... stunned silence ... "I beg your pardon? Did you say psychosomatic clinic?"
"Yes, do you want an appointment or don't you?"
"No thank you."

I have been in hiding ever since. Hopefully that one call wasn't enough for them to open a file on me.
 
What exactly does it mean that you have validated a disease state that may or may not exist and for which there is no objective diagnostic test?

Usually, from reading decades ago, in psych when you validate you validate for consistency, including internal consistency. In other words, do you get the same results, reliably, over time and for most patients? The reality or unreality of the diagnosis is not in question.

Let me be clear, there are many people with diagnoses who have real issues, even life threatening issues. The questions are about the diagnostic entity and labels, and from there about the treatments.

EBM is becoming the new dogma. In particular its very susceptible to insiders changing the goalposts. Externally its vulnerable to medical professionals, not just doctors, who are busy, under-resourced and often overworked, simply accepting what they read in summaries. They do not have the time, incentives and sometimes even skills to evaluate the evidence. EBM is rapidly becoming the new rubber stamp in medicine.

In particular the psychiatric division of Cochrane, from my understanding, is not holding psychiatric research to a high scientific standard. If you do not even have an objective and reliable diagnostic test, how can you be sure that much of the research is about a real clinical entity? Real people are sick and in distress but this does not mean that diagnoses and treatments are always efficacious. These patients deserve better, much better.

I am not claiming this is about ubiquitous failures in psychiatry, but its definitely a major issue. People - the public, public servants, scientists and medical professionals - need to realize that evidence that is not scientific is intrinsically much less reliable.
 
Also in my nearest big town, which my GP tried to trick me into making an appointment at by telling me about a great hospital department which specialised in rare illnesses and might just find out what's going on with me. So I called the number he gave me, and the conversation went something like this:

"Psychosomatic clinic?"
... stunned silence ... "I beg your pardon? Did you say psychosomatic clinic?"
"Yes, do you want an appointment or don't you?"
"No thank you."

I have been in hiding ever since. Hopefully that one call wasn't enough for them to open a file on me.
Interesting response - do you want an appointment or don’t you - would imply you’re not the only person who had that experience
 
Back
Top Bottom