title: Assessing psychological factors affecting medical conditions: comparison between different proposals.
abstract: OBJECTIVE
  We compared the provisional Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for Somatic Symptom Disorders (SSD) and an alternative classification based on the Diagnostic Criteria for Psychosomatic Research (DCPR) as to prevalence and associations with dimensional measures of psychological distress and functioning in a population of medical patients.
  
  
  METHODS
  Seventy consecutive outpatients with congestive heart failure were administered an ad hoc structured clinical interview for the identification of DSM-5 SSD, the section concerning hypochondriasis of the Structured Clinical Interview for DSM-IV, the Structured Interview for DCPR and Paykel's Clinical Interview for Depression. Subjects also completed the Symptom Questionnaire and the Psychosocial Index. Global assessment of functioning was performed with the DSM-IV Axis V.
  
  
  RESULTS
  A diagnosis within DSM-5 SSD was found in 13 patients (18.5%): 61.5% of them were diagnosed with the Psychological Factors Affecting Medical Condition category. Twenty-nine patients (41.4%) were classified according to the DCPR-based proposal: illness denial, demoralization and irritable mood were the most frequent specifiers. The DCPR-based classification showed a greater number of significant associations with dimensional measures of psychological distress, global functioning and stress.
  
  
  CONCLUSIONS
  Compared to DSM-5 SSD, the DCPR-based proposal was more sensitive in detecting psychological factors relevant to illness course and provided a better characterization of such factors. The DCPR-based proposal was also superior in identifying patients with increased psychological distress and poor psychosocial functioning.
authors.affiliation: Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Italy. jenny.guidi2@unibo.it
authors.forename: Jenny
authors.initials: J
authors.lastname: Guidi
authors.forename: Chiara
authors.initials: C
authors.lastname: Rafanelli
authors.forename: Renzo
authors.initials: R
authors.lastname: Roncuzzi
authors.forename: Laura
authors.initials: L
authors.lastname: Sirri
authors.forename: Giovanni A
authors.initials: GA
authors.lastname: Fava
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013001:Somatoform Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires