Assessing DSM-5 criteria of somatic symptom disorder in medically hospitalized inpatients: A cross-sectional analysis

In the revised DSM-5, Somatic Symptom Disorder (SSD) no longer requires medically unexplained symptoms and instead focuses on psychobehavioral positive criteria, applicable regardless of the underlying cause. Evidence on the frequency and characteristics of SSD among medically hospitalized inpatients remains scarce. We therefore investigated SSD frequency and age- and gender-associated characteristics in this population.

This cross-sectional analysis used baseline data from SomPsyNet, an intervention targeting SOMatic hospital inpatients to prevent PSYchosocial distress through a care NETwork. SSD was assessed using the Somatic Symptom Scale-8 (SSS-8) and the Somatic Symptom Disorder-B Criteria Scale (SSD-12), applying DSM-5-aligned and established cut-offs. Criteria were operationalized as A) somatic symptom burden (SSS-8 sum score ≥ 9 or per item≥3), B) symptom-related distress (SSD-12 ≥ 23), and C) proxies for symptom persistence. Associations with age were examined using robust regression.

Among 3109 inpatients enrolled between June 2020 and December 2022, 20.6 % (SSS-8 sum score ≥ 9) to 21.9 % (SSS-8 per item≥3) met all three SSD criteria. Among the 25.5 % of patients positive for Criterion B (SSD-12 ≥ 23), Criteria A and C were frequently also met. No female predominance in symptom-related distress was observed. Younger patients reported higher somatic symptom burden and symptom-related distress (SSS-8: B = -0.04, t = -7.51; SSD-12: B = -0.05, t = -5.11).

Symptoms consistent with DSM-5 SSD criteria were common among medically hospitalized inpatients. These findings underscore the frequency of SSD-related distress in this setting, highlight age- and gender-related differences in symptom presentation, and emphasize the need for further research to clarify its clinical implications.