Preliminary psychometric evaluation of the Somatoform Dissociation Questionnaire (SDQ-20) in a Hungarian psychiatric sample

Background Somatoform dissociation is the somatic manifestation of dissociation. It refers to physical symptoms that resemble somatic diseases or the effect of substance use but cannot be explained by any organic disorder. Identifying the dissociative nature of a somatic symptom and its frequently hidden history of trauma can be challenging. Since no psychometric instrument is currently available in Hungary to screen for this phenomenon, the adaptation and preliminary psychometric analysis of a reliable measurement is essential. Objective The present study aimed to examine and adapt the psychometric properties of the Hungarian version of the Somatoform Dissociation Questionnaire (SDQ-20) while also investigating the prevalence of somatoform dissociation among psychiatric patients and its association with childhood trauma. Method A cross-sectional study was conducted with 112 heterogeneous adult psychiatric patients aged 18 – 65 years ( M = 38.36; SD = 13.51) at the Department of Psychiatry and Psychotherapy of the University of Debrecen Clinical Centre. Participants were selected via convenience sampling and completed a battery of questionnaire that included the Hungarian adaptation of the SDQ-20, the Dissociative Experiences Scale (DES), the Adverse Childhood Experiences (ACE) Questionnaire and the Patient Health Questionnaire-15 (PHQ-15) Somatic Symptom Severity Scale. Results The Hungarian version of the SDQ-20 showed excellent internal consistency (Cronbach’s α = 0.831; McDonald's ω = 0.84). A significant, positive correlation was observed between SDQ-20 and DES ( ρ = 0.521; p < 0.001). Furthermore, childhood traumatization showed a stronger association with the SDQ-20 ( ρ = 0.356; p < 0.001) than with the PHQ-15 ( ρ = 0.213; p < 0.05). The study established the cut-off score of our sample at 29.5, revealing that 24.1% of the participants exhibited a somatoform dissociative tendency. Adverse childhood experiences were highly frequent, with 41.1% of the total sample and 63.0% of those with somatoform dissociation reporting four or more ACEs. Binary logistic regression significantly associated physical abuse with higher odds of reporting both psychoform and somatoform dissociation. Conclusion Given the preliminary evidence regarding the psychometric properties of the Hungarian version, the SDQ-20 can be considered a reliable tool for screening somatoform dissociative symptoms in psychiatric settings. Our findings suggest the importance of screening for somatoform dissociation and considering its association with adverse childhood experiences among psychiatric patients to facilitate the identification of patients who would benefit from trauma-focused interventions. Further studies using larger samples, structured clinical interviews, test-retest designs, and independent clinical criteria are needed to establish structural validity, diagnostic thresholds, and clinical utility.