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September 1969

Factors of Symptom Distress: Doctor Ratings of Anxious Neurotic Outpatients

Author Affiliations

Philadelphia; Baltimore; Washington, DC; Chicago
From the Psychopharmacology Research Branch, NIMH, Chevy Chase, Md (Dr. Lipman); Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia (Dr. Rickels); Department of Psychiatry and Behavioral Sciences, the Johns Hopkins University School of Medicine (Dr. Covi); the Biometric Laboratory, George Washington University (Dr. Derogatis); and the Department of Psychiatry, the University of Chicago School of Medicine, Chicago (Dr. Uhlenhuth). Dr. Derogatis is currently at the Johns Hopkins University School of Medicine.

Arch Gen Psychiatry. 1969;21(3):328-338. doi:10.1001/archpsyc.1969.01740210072009

IN A SERIES of related papers by Mattsson et al,1 Williams et al,2 and Lipman et al,3 a Symptom Distress Check List (SCL), developed by Parloff, Frank, and their coworkers,4,5 containing items covering the spectrum of common psychoneurotic complaints, was factor-analyzed, employing the self-ratings of more then 1,500 anxious-neurotic outpatients. These Factors were tested for their sensitivity in discriminating pharmacologic and nonpharmacologic influences within the context of a double-blind, placebo-controlled trial of meprobamate in which doctor medication attitudes were experimentally manipulated via role-playing techniques.6

Of the five stable and clinically meaningful factors extracted from the patients' selfratings, Somatization and Fear-Anxiety proved most sensitive to main drug effects, whereas the remaining three factors—General Neurotic Feelings, Cognitive-Performance Difficulty, and Depression—were more reliably influenced by the interaction of pharmacologic and nonpharmacologic variable in the treatment context.

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