DSM-IV field trial: testing a new proposal for somatization disorder.
OBJECTIVE
The purpose of this study was to evaluate for APA a proposed strategy to diagnose somatization disorder for possible inclusion in DSM-IV.


METHODS
Five sites--Washington University, University of Kansas, University of Iowa, University of Arkansas, and Mount Sinai Medical Center in New York--participated in a collaborative field trial. Female subjects (N = 353) were recruited from several different services (psychiatry, internal medicine, and family practice) and were evaluated for the presence or absence of the disorder. This assessment was performed with a new instrument constructed by combining all the criteria for somatization disorder from the proposed criteria for DSM-IV, DSM-III, DSM-III-R, Perley-Guze, and proposed criteria for ICD-10.


RESULTS
A high level of concordance was found between the proposed diagnostic strategy for DSM-IV and the current criteria (DSM-III-R), as well as the earlier criteria (Perley-Guze and DSM-III). The ICD-10 criteria agreed poorly with all other criteria sets. The level of experience of the rater (expert versus novice) with the earlier (Perley-Guze, DSM-III) and current (DSM-III-R) criteria did not influence the identification of cases by use of DSM-IV criteria. No racial effect was introduced by any of the criteria sets.


CONCLUSIONS
The strategy for DSM-IV is an accurate and simpler method of diagnosing somatization disorder that does not require special expertise for proper use.
Yutzy
S H
SH
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110.
Cloninger
C R
CR
Guze
S B
SB
Pribor
E F
EF
Martin
R L
RL
Kathol
R G
RG
Smith
G R
GR
Strain
J J
JJ
D000328:Adult; D015331:Cohort Studies; D004522:Educational Status; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D017533:Marital Status; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D044469:Racial Groups; D015203:Reproducibility of Results; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology; D009626:Terminology as Topic