Diagnostic Criteria for Psychosomatic Research (DCPR) and DSM-5 in primary care

• Published in: Journal of psychosomatic research 2018-06, Vol.109, p.102-103
• Main Authors: Fava, G.A., Piolanti, A., Gervasi, J., Guidi, J., Sonino, N.
• Format: Article
• Language: English
• Subjects: Alexithymia; Anxiety disorders; Classification; Clinical information; Clinical interviews; Comparative analysis; Diagnosis; Diagnostic and Statistical Manual; Emotions; Medical diagnosis; Mental disorders; Mood; Patients; Presenilin 1; Primary care; Psychological aspects; Psychological distress; Psychological well being; Psychosocial factors; Somatic symptoms; Stress
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2018.03.056

Aims: There is increasing interest in methods for identifying psychological distress in primary care. The aim of the study is to compare the classification system of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the revised version of the Diagnostic Criteria for Psychosomatic Research - (DCPR) in the setting of primary care. Methods: Two hundred consecutive patients (mean age: 46.5 (SD=14.5) years; 68 males and 132 females) in a primary care practice in Italy underwent the Structured Clinical Interview for DSM-5 and the Semi-structured Interview for the DCPR. The Psychosocial Index (PSI), a self-rating scale based on clinimetric principles, was also administered. Results: There were 46 patients (23%) with at least one DSM-5 diagnosis. The most frequent findings were somatic symptoms and related disorders (10%), mood (8%) and anxiety (7.5%) disorders. 88 patients (44%) presented with at least one DCPR diagnosis, particularly allostatic overload (15.5%), alexithymia (13.5%) and demoralization (13%). There were 47 patients who had a DCPR-R diagnosis only. Five subjects had a DSM diagnosis without DCPR. Patients with DCPR diagnoses displayed significantly higher levels of stress and psychological distress and significantly lower levels well-being by the PS1. Conclusion: The findings indicate that the DSM-5 somatic symptom and related disorders chapter captures only a narrow part of the information necessary for the identification of psychological factors that influence the course of medical disorders. Use of the DCPR provides clinical information for a substantial number of patients in primary care who do not satisfy DSM-5 classification criteria and yet present with high stress, psychological distress and impaired well-being.