The DOI matches its Crossref record; 35 of the 38 references it cites were found in a registry or an index.
Screening for somatization and hypochondriasis in primary care and neurological in-patients
Abstract
The aim of this study was to investigate the internal and external validity of the Whiteley Index as a screening instrument for somatization illness. A 14-item version of the Whiteley Index for hypochondriacal traits was given to 99 of 191 consecutive primary care patients, aged 18-65 years, and to 100 consecutive patients, aged 18-60 years, admitted for the first time to a neurological ward. The primary care sample was, in addition, interviewed by means of the SCAN (Schedules for Clinical Assessment in Neuropsychiatry) psychiatric interview. The GPs and the neurologists were asked to rate various characteristics of the patients that might indicate somatization. The internal validity of the Whiteley Index was tested by means of latent structure analysis. On this basis, a reduced seven-item scale (Whiteley-7 scale) and two subscales (i.e., an Illness Conviction and Illness Worrying scale, each with three items) were constructed. All three had a high internal validity fitting into the very restricted Rasch statistical model (p>0.05) and an acceptable transferability between most of the subpopulations investigated. In the primary care population, the Whiteley-7 and the Illness Conviction scales at cut-point 0/1 showed 1.00 and 0.87 sensitivity and 0.65 and 0.87 specificity, respectively, using as "gold standard" the fulfillment of criteria for at least one ICD-10 somatoform disorder, and 0.71 and 0.63 sensitivity and 0.62 and 0.87 specificity, respectively, as gold standard for the fulfillment of criteria for at least one DSM-IV somatoform disorder, excluding the NOS diagnostic group. The Illness Worrying subscale showed less impressive performance in this respect. The agreement between the Whiteley-7 scale including the two subscales and neurologists' rating and the GPs' rating and the somatization subscale on the SCL-90 was modest or worse. It may be concluded that the Whiteley-7 scale and the Illness Conviction subscale had acceptable psychometric profiles, and both seem to be promising screening tools for not only hypochondriasis but also for somatoform disorders in general.
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“The WI-7 is a frequently used outcome measure that has shown good sensitivity and specificity in screening for health anxiety [32].”
From Cost Effectiveness of Internet-Delivered Acceptance and Commitment Therapy for Patients with Severe Health Anxiety: A Randomised Controlled Trial (2022) · cites this paper as [32]
Citations
Cites
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Benke, C., Autenrieth, L. K., Asselmann, E., & Pané-Farré, C. A. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113462 · Cited by 585
Andersen, J. H., Haahr, J. P., & Frost, P. (2007) · Arthritis & Rheumatism · doi:10.1002/art.22513 · Cited by 472
Nikčević, A. V., Marino, C., Kolubinski, D. C., Leach, D., & Spada, M. M. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.10.053 · Cited by 344
Fink, P., & Schröder, A. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2010.02.004 · Cited by 334
“In a two-phase design, consecutive patients attending their primary care physician or a medical or a neurological department were screened for physical symptoms [24], illness worry [25], and anxiety or depression [26]; those with high scores on any of these instruments were selected for the Schedules for Clinical Asse…”
MethodSelf-citationFink, P., Toft, T., Hansen, M. S., Ørnbøl, E., & Olesen, F. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31802e46eb · Cited by 314
“ley-index (24) measuring worrying and conviction of illness.”
BackgroundSelf-citation
Metadata
- Authors
- Fink, P., Ewald, H., Jensen, J., Sørensen, L., Engberg, M., Holm, M., & Munk-Jørgensen, P.
- Affiliations
- Aarhus University Hospital (DK)
- Corresponding author
- Fink, Per
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 1999-03
- Volume
- 46
- Issue
- 3
- Pages
- 261-273
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W146236585
- Cited by
- 314
- References
- 38
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 15 · 2023: 14 · 2022: 18 · 2021: 15 · 2020: 22 · 2019: 22 · 2018: 10 · 2017: 19 · 2016: 11 · 2015: 8 · 2014: 14 · 2013: 13 · 2012: 12
- FWCI
- 3.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Scopus (Elsevier) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- somatization, health anxiety, Whiteley Index, somatoform disorders, screening tool, internal validity, generalizability, neurology inpatients, primary care patients, SCL-90, Rasch model, latent structure analysis, sensitivity and specificity
- MeSH terms
- Adolescent, Adult, Aged, Family Practice, Female, Humans, Male, Mass Screening, Middle Aged, Neurology, Predictive Value of Tests, Primary Health Care, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Sensitivity and Specificity, Somatoform Disorders, Reproducibility of Results
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