Assessing medically unexplained symptoms: evaluation of a shortened version of the SOMS for use in primary care

Abstract

Abstract Background To investigate the validity and stability of a Portuguese version for the Screening for Somatoform Symptoms-2 (SOMS-2) in primary care (PC) settings. Methods An adapted version of the SOMS-2 was filled in by persons attending a PC unit. All medically unexplained symptoms were further ascertained in a clinical interview and by contacting the patient's physicians and examining medical records, attaining a final clinical symptom evaluation (FCSE). An interview yielded the diagnosis of Clinical Somatization (CS) and the diagnosis of current depressive and anxiety disorders. Results From the eligible subjects, 167 agreed to participate and 34.1% of them were diagnosed with somatization. The correlation between the number of self-reported and FCSE symptoms was 0.63. After excluding symptoms with low frequency, low discriminative power and not correlated with the overall scale, 29 were retained in the final version. A cut-off of 4 symptoms gave a sensitivity of 86.0% and a specificity of 95.5% on the FCSE and 56.1% and 93.6% at self-report. Stability in the number of symptoms after 6 months was good (k = 0.57). Conclusions The 29 symptoms version of the SOMS-2 with a cut-off of 4 showed a high specificity and sensitivity, being reliable as a referral tool for further specialized diagnosis.