Differences among diagnostic groups of psychosomatic patients in the symptom checklist-90-R (SCL-90-R): Consequences for the use of the SCL-90-R in the assessment of changes over time

680 unselected outpatients of our Psychosomatic Clinic were divided into si x diagnostic groups and examined by the SCL-90-R. By ANOVA we found differe nces of means between the diagnostic groups for the global severity score ( GSI) and for the subscale scores. We describe the model of Jacobson et al. [1,2] for the determination of cut-off-points and reliable change indices f or the assessment of changes over time, e.g. after psychotherapy. Our resul ts lead to the conclusion that, although an overall reliable change index f or the GSI can be applied to all psychosomatic patients, cut-off-points sho uld be different following the diagnostic groups. Furthermore, information from the SCL-90-R-subscales as well as other specific symptom scales should be used for the interpretation of significant changes of the GSI.