[The primary screening of patients with autonomic disorders in outpatient clinics in Russia (START1) using the Russian version of The Four-Dimensional Symptom Questionnaire (4DSQ)].
OBJECTIVE
To develop an effective diagnostic algorithm for detection of a mental component in the state of patients diagnosed with autonomic nervous system disorder.


METHODS
In the frames of START1 epidemiological study, we examined 6633 patients with autonomic nervous system disorders (ICD-10 G.90.8 and G90.9) and somatoform disorders (F45) including 18,8% patients who got a referral to a psychiatrist. A linguistically validated Russian version of The Dutch Four-Dimensional Symptoms Questionnaire (4DSQ) was tested in domain subpopulations.


RESULTS
In subpopulations of anxiety and depression, more than 26% of the patients got a referral to a psychiatrist that indirectly supported the assumption on the conformity of 4DSQ to the purposes of primary screening of four-dimensional disorders in the general population of patients with autonomic nervous system disorders.


CONCLUSIONS
The linguistically validated Russian version of 4DSQ enabled to formalize the description of clinical profile of these patients. Cluster analysis of the results allowed to single out two superdomains by the pairwise combination somatization with distress (SDis) and anxiety with depression (ADep). The detection of superdomain SDis appears to be a population specific characteristic of autonomic nervous system disorders in the Russian Federation.
GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva.
N N
NN
Iakhno
GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva.
A B
AB
Smulevich
Department of General Practice, EMGO-Institute, VU University Medical Centre, Amsterdam, The Netherlands.
B
B
Terluin
GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva.
D V
DV
Reĭkhart
OAO 'Valenta Farm', Moskva.
E K
EK
Zakharova
GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva.
A V
AV
Andriushchenko
GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva.
V A
VA
Parfenov
GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva.
M V
MV
Zamergrad
OAO 'Valenta Farm', Moskva.
V S
VS
Arnautov
D000465:Algorithms; D000554:Ambulatory Care Facilities; D001008:Anxiety Disorders / Q000175:diagnosis; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009426:Netherlands; D012426:Russia; D013001:Somatoform Disorders / Q000175:diagnosis; D013315:Stress, Psychological / Q000175:diagnosis; D011795:Surveys and Questionnaires