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Functional somatic syndromes: sensitivities and specificities of self-reports of physician diagnosis.
Psychosom Med. 2012 Nov-Dec; 74(9):891-5.PM

Abstract

OBJECTIVE

Functional somatic syndromes have no laboratory or pathologic abnormalities and so are diagnosed by symptom-based case definitions. However, many studies, including recent ones, have used self-reports of physician diagnosis rather than the case definitions. Our objective was to determine the sensitivities and specificities of self-report of physician diagnosis for chronic fatigue syndrome (CFS), fibromyalgia (FM), irritable bowel syndrome (IBS), panic disorder, and migraine.

METHODS

Each of 312 female patients with incident interstitial cystitis/bladder pain syndrome and matched population-based controls were queried on self-report of physician diagnosis and separately on established case definitions for each of these syndromes.

RESULTS

Using the symptom-based case definitions as standards, we found that self-report of physician diagnosis did not identify 90% of the controls who had CFS, 77% who had FM, 69% who had IBS, 43% who had panic disorder, and 23% who had migraine. In addition, it missed most individuals with multiple syndromes. Findings in one cohort (controls) were confirmed in another (patients with interstitial cystitis/bladder pain syndrome).

CONCLUSIONS

Self-report of physician diagnosis did not identify most of the three most venerable functional somatic syndromes, IBS, FM, and, especially, CFS; nor did it identify substantial minorities of individuals with panic disorder and migraine. Self-report of physician diagnosis was particularly poor in recognizing persons with multiple syndromes. The insensitivity of this diagnostic test has effects on not only prevalence and incidence estimates but also correlates, comorbidities, and case recruitment. To reveal individuals with these syndromes, singly or together, queries of symptoms, not diagnoses, are necessary.

Authors+Show Affiliations

Department of Medicine and of Epidemiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA. jwarren@medicine.umaryland.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23071343

Citation

Warren, John W., and Daniel J. Clauw. "Functional Somatic Syndromes: Sensitivities and Specificities of Self-reports of Physician Diagnosis." Psychosomatic Medicine, vol. 74, no. 9, 2012, pp. 891-5.
Warren JW, Clauw DJ. Functional somatic syndromes: sensitivities and specificities of self-reports of physician diagnosis. Psychosom Med. 2012;74(9):891-5.
Warren, J. W., & Clauw, D. J. (2012). Functional somatic syndromes: sensitivities and specificities of self-reports of physician diagnosis. Psychosomatic Medicine, 74(9), 891-5. https://doi.org/10.1097/PSY.0b013e31827264aa
Warren JW, Clauw DJ. Functional Somatic Syndromes: Sensitivities and Specificities of Self-reports of Physician Diagnosis. Psychosom Med. 2012 Nov-Dec;74(9):891-5. PubMed PMID: 23071343.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional somatic syndromes: sensitivities and specificities of self-reports of physician diagnosis. AU - Warren,John W, AU - Clauw,Daniel J, Y1 - 2012/10/15/ PY - 2012/10/17/entrez PY - 2012/10/17/pubmed PY - 2013/3/19/medline SP - 891 EP - 5 JF - Psychosomatic medicine JO - Psychosom Med VL - 74 IS - 9 N2 - OBJECTIVE: Functional somatic syndromes have no laboratory or pathologic abnormalities and so are diagnosed by symptom-based case definitions. However, many studies, including recent ones, have used self-reports of physician diagnosis rather than the case definitions. Our objective was to determine the sensitivities and specificities of self-report of physician diagnosis for chronic fatigue syndrome (CFS), fibromyalgia (FM), irritable bowel syndrome (IBS), panic disorder, and migraine. METHODS: Each of 312 female patients with incident interstitial cystitis/bladder pain syndrome and matched population-based controls were queried on self-report of physician diagnosis and separately on established case definitions for each of these syndromes. RESULTS: Using the symptom-based case definitions as standards, we found that self-report of physician diagnosis did not identify 90% of the controls who had CFS, 77% who had FM, 69% who had IBS, 43% who had panic disorder, and 23% who had migraine. In addition, it missed most individuals with multiple syndromes. Findings in one cohort (controls) were confirmed in another (patients with interstitial cystitis/bladder pain syndrome). CONCLUSIONS: Self-report of physician diagnosis did not identify most of the three most venerable functional somatic syndromes, IBS, FM, and, especially, CFS; nor did it identify substantial minorities of individuals with panic disorder and migraine. Self-report of physician diagnosis was particularly poor in recognizing persons with multiple syndromes. The insensitivity of this diagnostic test has effects on not only prevalence and incidence estimates but also correlates, comorbidities, and case recruitment. To reveal individuals with these syndromes, singly or together, queries of symptoms, not diagnoses, are necessary. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/23071343/Functional_somatic_syndromes:_sensitivities_and_specificities_of_self_reports_of_physician_diagnosis_ DB - PRIME DP - Unbound Medicine ER -