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Somatization and Symptoms Evaluation
Author Bios
Introduction
Defining Somatization
Detecting Symptoms
Currently selected section: Dimensions of Symptoms
Measuring Symptoms
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: Dimensions of Symptoms

        

 

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This rating scale is measuring only one dimension of the patient's symptoms -- severity. Unidimensional visual analogue or Likert-type scales are popular methods for obtaining a quick "biopsy" of symptom severity both in clinical as well as research settings. For example, pain assessment has been recommended as a fifth "vital sign" by the Joint Commission for the Accreditation of Hospitals, which has suggested a 10-point scale for quantifying pain. However, there are several other dimensions to pain.

A second dimension is temporal: how often do the patient's symptoms occur and, if they come in episodes (rather than being continuous), how long do episodes last. For example, a patient with migraine headaches may have spells that are just as severe in intensity when they occur, but prophylactic medication may reduce the number or duration of episodes.

A third dimension is degree of impairment or disability. An individual may continue to have migraine headaches at a similar intensity, frequency and duration but with accommodation, pain coping strategies, or specific treatments, be able to work or continue other activities during the headache episodes where originally he or she was bedridden or at least partially incapacitated. In fact, some researchers have found pain disability is a more powerful correlate of symptom burden than pain severity.


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