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Somatization and Symptoms Evaluation
Author Bios
Introduction
Defining Somatization
Detecting Symptoms
Dimensions of Symptoms
Measuring Symptoms
Currently selected section: Psychiatric Comorbidity
Interpreting Symptom Measures
Functional Syndromes and Symptoms
Etiology of Symptoms
Levels of Etiological Certainty
Strengthening Etiological Classification
Confounding Etiological Factors
Symptoms and Patient Expectations
Interpreting Patient Responses
Measuring Multiple Symptoms
Global Rating of Change
Measuring Somatization
Measuring Other Domains
Conclusions


Chapter 16: Somatization and Symptoms Evaluation: Psychiatric Comorbidity
        

Problem 6.2

The patient also completes the nine-item Patient Health Questionnaire, known as the PHQ-9, and her responses are illustrated in Figure 6.2 below.

Figure 6.2: Patient's Responses on the PHQ-9
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Symptom Not at all Several days More than half the days Nearly every day
1. Little interest or pleasure in doing things
X
2. Feeling down, depressed, or hopeless
X
3. Trouble falling or staying asleep, or sleeping too much
X
4. Feeling tired or having little energy
X
5. Poor appetite or overeating
X
6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down
X
7. Trouble concentrating on things, such as reading the newspaper or watching television
X
8. Moving or speaking so slowly that other people could have noticed? Or the opposite - being so fidgety or restless that you have been moving .around a lot more than usual
X
9. Thoughts that you would be better off dead or of hurting yourself in some way
X
( For office coding: Total Score 15 = 3 + 6 + 6 )
If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
Not difficult at all Somewhat difficult Very difficult Extremely difficult
m. Nausea, gas, or indigestion
X
From the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PRIME-MD PHQ). The PHQ was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues. PRIME-MD® is a trademark of Pfizer Inc. Copyright© 1999 Pfizer Inc. All rights reserved. Reproduced

Question 6.2

The most likely diagnosis in this patient based upon her PHQ-9 and PHQ-15 responses is:
Selection ASomatization disorder
Selection B Major depressive disorder
Selection C Generalized anxiety disorder
Selection D Borderline personality disorder

 

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