Utrecht Somatic Screener (USS)


Patients who have a chronic and severe substance use disorder are encompassed in the category of Severe Mental Illness (SMI) patients. These are patients who have to deal with threefold problems, namely addiction problems, psychiatric comorbidity and comorbid somatic problems, resulting in a high degree of dysfunction in several areas of life. The Severe Mental Illness combined with substance-related disorder is often associated with poor somatic health and severe psychosocial problems.

In the case of serious addiction problems, the consequences of somatic illness – such as pain and feeling unwell – are often suppressed by the use of psychoactive substances, benzodiazepines or pain medication, and are therefore masked (Middeldorp, 2008). Patients with long-term addiction problems present their physical complaints to their GP at a relatively late stage. This leads to a delay in diagnosis and treatment, which results in a more serious course of certain disorders.

Nurse practitioners have developed the Utrecht Somatic Screening List (USS) and improved it in successive versions to the USS 2.0. The purpose of the USS is to identify early physical health problems in patients with serious addiction problems, with this nurse-administered instrument. The USS 2.0 is a promising instrument that can be used in addiction care. It has good content validity and is built on existing guidelines. In addition, it has been tested for feasibility in practice.


First, it is important to gain insight into the nature and extent of the somatic problems of the target group of patients with addiction problems as described above. This knowledge can be used to design nursing interventions that are in line with the described health problems that emerge from the screening.

The study is conducted and is based on a multicenter observational, cross-sectional design. The population for this study consists of Severe Mental Illness patients with long-term and severe substance use disorders (SUDs). A stratified sample of 150 patients is drawn in which patients are randomly approached in proportion to the relative size of the subpopulations within the Medical Heroin Unit, the Opiate Maintenance Treatment and FACT Addiction Teams.

Research aim

With the USS project, we will answer the following research questions

  • Which health problems and complaints have been described with the USS 2.0. and which patient variables are associated with these complaints? How do these prevalences compare to prevalences in the general population?
  • Which patient characteristics are related to health status?
  • What is the lifestyle behavior of the target group and which patient characteristics are associated with this?
  • To what extent do patients use health services? What is the degree of self-management and what support is needed?
  • What is the suffering/suffering experienced by patients, and what is the connection between this?