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Correct
The
patient's PHQ-15 score of 17 puts her in the highest 10% of patients
presenting in outpatient clinics and is a strong marker for somatization
rather than a systemic medical disorder. Cutpoints of 5, 10, and
15 on the PHQ-15 represent mild, medium, and high levels of somatization
respectively.
Somatization
is typically defined as the tendency to experience and seek care
for multiple, medically unexplained, physical symptoms. Although
patients with either a multi-system disease or multiple chronic
medical disorders (e.g. coronary artery disease, emphysema, osteoarthritis
and diabetes mellitus) might experience numerous physical symptoms,
they typically identify the small number of symptoms that are
most bothersome rather than complete the PHQ-15 or any other symptom
rating scale in such a "polysymptomatic" fashion as
demonstrated in Figure 7.1.
At least 10%
of patients presenting for medical care have high somatization
scores, and another 20% have medium levels of somatization. Understanding
the prevalence of medium to high symptom reporting in medical
patients is important when interpreting the potential significance
of disease-related symptoms, treatment side effects, or therapeutic
responses in clinical or research settings. Separating somatizing
tendencies inherent in certain individuals from symptoms due to
extrinsic disorders, medications, or other agents may require
baseline measures like the PHQ-15 as well as longitudinal assessment.
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