Validation of the Four-Dimensional Symptom Questionnaire (4DSQ)
Author Information
Author(s): Terluin Berend, van Marwijk Harm WJ, Adèr Herman J, de Vet Henrica CW, Penninx Brenda WJH, Hermens Marleen LM, van Boeijen Christine A, van Balkom Anton JLM, van der Klink Jac JL, Stalman Wim AB
Primary Institution: VU University Medical Centre
Hypothesis
The 4DSQ is a valid tool for assessing distress, depression, anxiety, and somatization in primary care patients.
Conclusion
The 4DSQ is a valid self-report questionnaire for measuring distress, depression, anxiety, and somatization in primary care patients.
Supporting Evidence
- The Distress scale was associated with any psychosocial diagnosis (AUC 0.79).
- The Depression scale was associated with major depression (AUC = 0.83).
- The Anxiety scale was associated with anxiety disorder (AUC = 0.66).
- The Somatization scale was associated with GPs' suspicion of somatization (AUC = 0.65).
- The 4DSQ scales showed considerable inter-correlations (r = 0.35-0.71).
- CFA confirmed the 4-factor structure with a CFI of 0.92.
- Measures of stress were mainly associated with Distress.
- Distress was associated with psychosocial dysfunctioning, including sick leave.
Takeaway
The 4DSQ helps doctors understand how patients feel by asking about their distress, depression, anxiety, and physical symptoms.
Methodology
Data from 10 different primary care studies were analyzed using ROC and logistic regression analyses to assess criterion and construct validity.
Potential Biases
Potential biases due to the subjective nature of GP diagnoses and the reliance on self-reported data.
Limitations
Data were primarily collected for other purposes and were cross-sectional, limiting causal inferences.
Participant Demographics
The study included a diverse sample of primary care patients, with a mean age of 38.5 years and a majority being women (68%).
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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