TY - JOUR
AU - A. Schneider
AU - N. Kornder
AU - K. Linde
AU - A. Hapfelmeier
A1 - 
AB - BACKGROUND: To investigate the impact of patient selection in different health sectors on sensitivities and specificities of psychosomatic questionnaires and clinical signs and symptoms (CSS) for predicting daily life impairment (DLI) in individuals after SARS-CoV-2 infection. METHODS: Secondary data analysis of three independent cross-sectional surveys in general population (n = 2828), fourteen primary care practices (n = 204), and rehabilitation hospital (n = 161). DLI and symptoms were captured using questionnaires. PHQ-15 (Patient Health Questionnaire-15) and SSD-12 (Somatic Symptom Disorder-12), PHQ-2 (Patient Health Questionnaire-2), GAD-2 (Generalized Anxiety Disorder-2), and FAS (Fatigue Assessment Scale) were used to assess somatic symptom disorder (SSD), depression, anxiety and fatigue. Diagnostic indices were calculated to predict DLI. RESULTS: The sensitivities of questionnaires and CSS increased, and specificities decreased from general population to practices and hospital. SSD-12 had a higher diagnostic odds ratio (dOR; 95 % confidence interval) (17.4; 12.6-24.0) in population than in practices (8.4; 3.6-19.7) or hospital (8.1; 1.7-31.7). FAS > 22 had higher dOR (15.0; 11.8-19.1) in population than in practices (5.3; 2.8-9.8) or hospital (4.8; 1.4-16.3). The pattern (population / practice / hospital) was similar in depression (9.2; 7.0-12.0 / 8.0; 3.6-18.1 / 12.2; 1.5-96.2) and anxiety (8.0; 6.0-10.8 / 2.4; 1.0-5.6 / 3.0; 0.6-14.1). Areas under the curves of questionnaires were highest in population, followed by hospital, and consistently lower for practices. CONCLUSION: There is a large variation in sensitivities and specificities to predict DLI. The extent to which SSD or psychosomatic comorbidity contributes to DLI varied across the health sectors in which patients are diagnosed and treated.
AD - Institute of General Practice and Health Services Research, Department of Clinical Medicine, School of Medicine and Health, TUM University Hospital Rechts der Isar, Technical University Munich, Munich, Germany. Electronic address: antonius.schneider@tum.de.; Department of Primary Care, University of Marburg, Marburg, Germany.; Institute of General Practice and Health Services Research, Department of Clinical Medicine, School of Medicine and Health, TUM University Hospital Rechts der Isar, Technical University Munich, Munich, Germany.; Institute of General Practice and Health Services Research, Department of Clinical Medicine, School of Medicine and Health, TUM University Hospital Rechts der Isar, Technical University Munich, Munich, Germany; Institute of AI and Informatics in Medicine, School of Medicine and Health, TUM University Hospital Rechts der Isar, Technical University Munich, Munich, Germany.
AN - 41237522
BT - J Psychosom Res
C5 - Measures
DA - Jan
DO - 10.1016/j.jpsychores.2025.112439
DP - NLM
ET - 20251105
JF - J Psychosom Res
LA - eng
N2 - BACKGROUND: To investigate the impact of patient selection in different health sectors on sensitivities and specificities of psychosomatic questionnaires and clinical signs and symptoms (CSS) for predicting daily life impairment (DLI) in individuals after SARS-CoV-2 infection. METHODS: Secondary data analysis of three independent cross-sectional surveys in general population (n = 2828), fourteen primary care practices (n = 204), and rehabilitation hospital (n = 161). DLI and symptoms were captured using questionnaires. PHQ-15 (Patient Health Questionnaire-15) and SSD-12 (Somatic Symptom Disorder-12), PHQ-2 (Patient Health Questionnaire-2), GAD-2 (Generalized Anxiety Disorder-2), and FAS (Fatigue Assessment Scale) were used to assess somatic symptom disorder (SSD), depression, anxiety and fatigue. Diagnostic indices were calculated to predict DLI. RESULTS: The sensitivities of questionnaires and CSS increased, and specificities decreased from general population to practices and hospital. SSD-12 had a higher diagnostic odds ratio (dOR; 95 % confidence interval) (17.4; 12.6-24.0) in population than in practices (8.4; 3.6-19.7) or hospital (8.1; 1.7-31.7). FAS > 22 had higher dOR (15.0; 11.8-19.1) in population than in practices (5.3; 2.8-9.8) or hospital (4.8; 1.4-16.3). The pattern (population / practice / hospital) was similar in depression (9.2; 7.0-12.0 / 8.0; 3.6-18.1 / 12.2; 1.5-96.2) and anxiety (8.0; 6.0-10.8 / 2.4; 1.0-5.6 / 3.0; 0.6-14.1). Areas under the curves of questionnaires were highest in population, followed by hospital, and consistently lower for practices. CONCLUSION: There is a large variation in sensitivities and specificities to predict DLI. The extent to which SSD or psychosomatic comorbidity contributes to DLI varied across the health sectors in which patients are diagnosed and treated.
PY - 2026
SN - 0022-3999
SP - 112439
ST - Sensitivities and specificities of questionnaires and clinical signs and symptoms to predict daily life impairment after SARS-CoV-2 infection varied across different health sectors
T1 - Sensitivities and specificities of questionnaires and clinical signs and symptoms to predict daily life impairment after SARS-CoV-2 infection varied across different health sectors
T2 - J Psychosom Res
TI - Sensitivities and specificities of questionnaires and clinical signs and symptoms to predict daily life impairment after SARS-CoV-2 infection varied across different health sectors
U1 - Measures
U3 - 10.1016/j.jpsychores.2025.112439
VL - 200
VO - 0022-3999
Y1 - 2026
ER -