Comparison of screening proposals for somatization disorder empirical analyses

We report a comparison of three sets of screening criteria, plus a post hoc modification of one, for the diagnosis of somatization disorder. Included in the comparison are the DSM-III-R seven-symptom screen, 11 symptoms identified by Swartz et al., and the hierarchical screen using symptom clusters that has been proposed for DSM-IV, along with a modification to the latter. Data sets used in this test were from the St Louis Epidemiologic Catchment Area (ECA) study and a family study of alcoholism. Findings of sensitivity, specificity, and positive predictive value indicate advantages and disadvantages of each screening set. No one set was clearly superior; selection of screening criteria should be dependent on the intended application.