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Showing papers by "Janet B. W. Williams published in 2002"


Journal ArticleDOI
TL;DR: The PHQ-15 is a brief, self-administered questionnaire that may be useful in screening for somatization and in monitoring somatic symptom severity in clinical practice and research.
Abstract: OBJECTIVE Somatization is prevalent in primary care and is associated with substantial functional impairment and healthcare utilization. However, instruments for identifying and monitoring somatic symptoms are few in number and not widely used. Therefore, we examined the validity of a brief measure of the severity of somatic symptoms. METHODS The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-15 comprises 15 somatic symptoms from the PHQ, each symptom scored from 0 ("not bothered at all") to 2 ("bothered a lot"). The PHQ-15 was administered to 6000 patients in eight general internal medicine and family practice clinics and seven obstetrics-gynecology clinics. Outcomes included functional status as assessed by the 20-item Short-Form General Health Survey (SF-20), self-reported sick days and clinic visits, and symptom-related difficulty. RESULTS As PHQ-15 somatic symptom severity increased, there was a substantial stepwise decrement in functional status on all six SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. PHQ-15 scores of 5, 10, 15, represented cutoff points for low, medium, and high somatic symptom severity, respectively. Somatic and depressive symptom severity had differential effects on outcomes. Results were similar in the primary care and obstetrics-gynecology samples. CONCLUSIONS The PHQ-15 is a brief, self-administered questionnaire that may be useful in screening for somatization and in monitoring somatic symptom severity in clinical practice and research.

2,451 citations


Journal ArticleDOI
TL;DR: In this article, the validity of the Patient Health Questionnaire for Adolescents (PHQ-A), a self-administered instrument that assesses anxiety, eating, mood, and substance use disorders among adolescent primary care patients, was investigated.

421 citations


Journal ArticleDOI
TL;DR: Prevalence rates of psychological disorders and psychosocial stressors differ greatly between younger and older primary care patients and, somewhat contrary to clinical intuition, are lower among older patients.
Abstract: BACKGROUND: Community studies have documented prevalence rates of psychological disorders among older individuals. Further, a growing number of studies have examined depression in older medical patients. However, little is known about the prevalence of a broad range of psychological disorders and psychosocial stressors among older primary care patients. The purpose of the present study was to characterize psychological disorders and psychosocial stressors in older primary care patients and identify differences with younger patients.METHODS: Descriptive survey; criterion standard. Five hundred thirty-four patients 65 years and older and 2466 patients less than 65 years old recruited from eight primary care sites. The Patient Health Questionnaire (PHQ) was employed to assess major depressive disorder, other depressive disorder, panic disorder, other anxiety disorder, probable alcohol abuse/dependence, somatoform disorder, bulimia nervosa, and binge eating disorder. Common psychosocial stressors were also assessed. Patient-reported health status was measured by the Medical Outcomes Study Short Form 20 (SF-20).RESULTS: Older patients were much less likely than younger patients to have a psychological disorder (5% vs. 17%). Also, older patients had significantly less severe psychological symptom (4.7 vs. 8.0) and psychosocial stressor (2.3 vs. 4.7) scores. Worrying about health (10%), weight (9%), and a recent bad event (8%) were the most common stressors among the older group. Like younger patients, older patients who suffered from psychological symptoms and disorders experienced substantial functional impairment.CONCLUSIONS: Prevalence rates of psychological disorders and psychosocial stressors differ greatly between younger and older primary care patients and, somewhat contrary to clinical intuition, are lower among older patients. (Less)

75 citations