4dkl: EncoMPASS Translation: RMSD: 0. TM-Score: 1. Coverage: 1. Number of Repeats: 2. Levels: 1. Unrefined RMSD: Unrefined TM Score: The Distress scale contains 16 items and has a score range of 0–32, the Depression scale contains 6 Terluin B. De Vierdimensionale Klachtenlijst ( 4DKL). ‘no’ = score 0. ‘sometimes’ = score 1. ‘regularly’ or more often = score 2. Distress Depression Anxiety Somatisation. Interpretation: moderately elevated: > > 2.

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Studies I and J were funded by B. Distress, Depression and Anxiety. Receiver operating characteristic ROC curves of the 4DSQ scales with respect to detecting a psychosocial diagnosis in general practice patients. A socio-epidemiological study for the preventive mental health care] Nijmegen, Katholieke Universiteit Nijmegen; Replicated factor structure of the Beck Depression Inventory. Table 5 Logistic regression analysis with psychosocial diagnosis as dependent variable and the 4DSQ scores as independent variables; scoreljst A.

The Four-Dimensional Symptom Questionnaire 4DSQ appears to be a valid self-report questionnaire to measure distress, depression, anxiety and somatization in primary care. The second questionnaire was returned by patients after a mean interval between the questionnaires of Scoring via het web Testmij Online of met het Windows computerprogramma Datec Score Manager met automatische persoonlijke rapportage.

In order to test whether or not each 4DSQ scale had at least some unique variance that was not shared with the other scales, we regressed each of the scales onto the other scales, and calculated the standardised Beta coefficients and the explained proportion of variance R 2. Note the very low mean scores for Depression and Anxiety in the studies A and B. Elevated scores on Depression or Anxiety were virtually always accompanied by elevated Distress scores, whereas the reverse was not true.

Functional somatic symptoms and syndromes. These findings support the use of the 4DSQ Distress scale as a screener for psychological problems of any kind in primary care. Klik hier voor een voorbeeld rapport. We hypothesised that distress was more strongly associated with stress and social functioning than depression, anxiety and somatization. MLMH acquired the data of study F and assisted in the analyses of these data. Conceptually, as mentioned above, distress represents the most general expression of any psychological problem.

Differences in 4DSQ scores in patients with a somatic diagnosis between patients with definite, possible and no somatization according to the GP; study A.


The scatterplots suggest that Distress “underlied” Depression, Anxiety, and to a lesser extent Somatization. The Depression score was the best discriminator between patients with and without a major depression, the AUC of the Depression score 0. Modifications to this model such as omitting an item with a relatively low factor loading item 3 or allowing five Distress items to cross-load on the Depression factor items 29, 31, 32, 36 and 37 did not improve the model fit.

Scorflijst unselected samples the applicability of the 4DSQ Depression and Anxiety scales appeared to be limited because of relatively low prevalence rates of depressive and anxiety disorders, wcorelijst the Distress and Somatization scales exhibited significant variability.

Terluin B, Verbraak M.

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Man Ther ; Additional file 3 Respondent burden. Three patients did not fill in the questionnaires. Coverage of the symptom questionnaires measuring distress, depression, anxiety and somatization by the 4DSQ scales; standardised Beta-coefficients and explained shared variance R 2 results from linear regression analysis.

Click here for file 7. Table 17 Relationships of stress-related measures, personality and social functioning with the 4DSQ scales; standardised Beta-coefficients and explained variance R 2 results from multiple regression analysis. Criterion validity was assessed by comparing the 4DSQ scores with clinical diagnoses, the GPs’ diagnosis of any psychosocial problem for Distress, standardised psychiatric diagnoses for Depression and Anxiety, and GPs’ suspicion of somatization for Somatization.

Table 15 Correlations between the 4DSQ scales and other symptom questionnaires measuring distress, depression, anxiety and somatization; Pearson correlation coefficients r. Yet, we have chosen this approach because it is an elegant way of studying the relative effects of stress and personality on the different 4DSQ dimensions. A low Distress score is highly predictive of the Depression and Anxiety scores which must be lowbut a high Distress score is minimally predictive of the Depression and Anxiety scores which can be anywhere between low and high.

4DKL Vragenlijst – Datec Psychologische Tests

Br J Gen Pract. Assuming a relatively low reliability of our “criterion” for somatization, and considering that validity can never surpass reliability, an AUC-value of 0. Logistic regression analysis with GP’s suspicion of somatization in patients with a somatic diagnosis as dependent variable and the 4DSQ scores as independent variables, according to the level of GP’s suspicion; study A.


We used data from studies C, D, F and H to compare the 4DSQ scales with other questionnaires measuring distress, depression, anxiety or somatization.

Social functioning measures were recorded in studies A, F and G.

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To a large extent this peculiar relationship between the 4DSQ dimensions is responsible for the high correlations between Distress, on the one hand, and Depression, Anxiety and Somatization on the other hand.

This article has been cited by other articles in PMC.

In svorelijst D 55 GP patients with psychological symptoms were interviewed twice by their GP with an interval of 1—2 days. Forty-six GPs identified adult patients, aged 18 years and older, who scored 5 or more on the Short and Simple Screening Interview [ 55 ]. The patients from study E had the highest mean Anxiety and Somatization scores.

Paper assessing the reliability, precision and smallest detectable change of the 4DSQ scales, using the data of studies C through J. Paper assessing the time needed to fill in the 4DSQ, using the data of study J. Job Content Questionnaire MQ: Comparing the mean scores across samples provided already an aspect of construct validity.

Given the unknown reliability of the criterion, any relationship with the 4DSQ Somatization score can be interpreted as supporting validity of the 4DSQ Somatization scale.

Reliability and validity of the assessment of depression in general practice: Abstract Background The Four-Dimensional Symptom Questionnaire 4DSQ is a self-report questionnaire that has been developed in primary care to distinguish non-specific general distress from depression, anxiety and somatization.

The 4DSQ is free for non-commercial use in health care and research and it is available as a Dutch and an English version [ scorleijst ]. BMC Fam Pract ; Additional file to reference 1 Responsiveness.

On further consideration, the anxiety concept measured by the STAI State scale seems to be quite different from the anxiety concept measured by the other anxiety scales, in that it seems to be related to “normal” nervousness and lack of wellbeing i. General Health Questionnaire GP: Somatisation as a risk factor for incident depression and anxiety.