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Factors of Symptom Distress:  Doctor Ratings of Anxious Neurotic Outpatients

Ronald S. Lipman, PhD; Chevy Chase, Md; Karl Rickles, MD; Lino Covi, MD; Leonard R. Derogatis, PhD; E. H. Uhlenhuth, MD
Arch Gen Psychiatry. 1969;21(3):328-338. doi:10.1001/archpsyc.1969.01740210072009.
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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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