Screening for somatization disorder in patients with chronic fatigue

The current definition of Somatization Disorder requires the assessment of each of 35 symptoms, 13 of which have to be scored as meeting special criteria (e.g., not due to medical reasons) in order to make the diagnosis. The detailed questioning and probing about each symptom can be quite elaborate--hence the interest in developing briefer screening indexes. This study evaluated two sets of screening indexes for Somatization Disorder (those of Othmer and DeSouza and Swartz and colleagues) that had been previously developed in psychiatric and community samples. One hundred medical outpatients with chronic fatigue constituted the study sample. The patients underwent thorough medical evaluations and were administered the Diagnostic Interview Schedule (DIS) to make the psychiatric diagnoses. Of the two screening sets, the one developed in a psychiatric outpatient sample (Othmer and DeSouza's) had the best sensitivity. Although a screening index derived from the DIS interviews of this group of patients also had excellent sensitivity, we support the use of Othmer and DeSouza's index in medical outpatients with a chief complaint of chronic fatigue.