Kaj Sparle Christensen

• PhD
• Professor at Aarhus University

Introduction: The Anxiety Symptom Scale (ASS) is a ten-item psychometric test, which is frequently used for screening purposes in Danish general practice. The ASS includes nine items on symptoms of anxiety disorders and one item on functional impairment caused by these symptoms. Previous research indicates that reducing the number of response cate...

Objective This study examines the validity of the ASRS-5 as a new screening tool for ADHD and evaluates its proposed screening cut-off in a general population context. Method A nationally representative sample of 2,002 individuals aged 18 to 80 years was surveyed using the ASRS-5, with complete data obtained from 714 participants. Psychometric ana...

Introduction The Mental Pain Questionnaire (MPQ) was developed using a clinimetric approach to bring together the key features of mental pain into a single, brief, transdiagnostic scale. The present study aims at extending the validation of the MPQ to people from three different clinical settings. Methods A multicentre, cross‐sectional study on ad...

Background and Objective Psychotropic drug use is common in older adults, with off‐label use reported despite limited understanding of the safety outcomes compared to on‐label use. Incomplete recordings of treatment indications in the Danish National Prescription Register (DNPR) raise concerns about potential off‐label medication use, particularly...

Objective This study aimed to describe depression treatment patterns, identify unique trajectory groups using a group‐based trajectory approach, and explore associated social determinants in older adults undergoing first‐time depression treatment during a 3‐year follow‐up. Methods This Danish register‐based cohort study included all adults aged ≥...

Background Caring for a family member can be demanding, particularly when caregivers experience profound distress. Supportive interventions may help prevent mental and physical illness in the caregiver. General practice plays a key role by regularly engaging with patients and caregivers, thereby being able to identify their support needs, offer tal...

Background Type two diabetes (T2D) is linked to impaired mental health. International guidelines emphasise the importance of including psychological aspects in diabetes care. Yet, no systematic approach has been implemented to assess mental health in patients with T2D in general practice. Aim To evaluate the mental health of patients with T2D in g...

Background Mental health issues are common among patients with chronic physical conditions, affecting approximately one in five patients. Poor mental health is associated with worse disease outcomes and increased mortality. Problem-solving therapy (PST) may be a suitable treatment for targeting poor mental health in these patients. This study proto...

Objective: The Patient Health Questionnaire-9 (PHQ-9) is a widely used self-reported measure of depression, which was found to display only acceptable psychometric properties. Insufficient attention has been devoted to its clinimetric validity and its clinical utility is still debated, particularly when used for assessing depression severity. This...

Background: Prior studies comparing the mental healthcare utilisation (MHU) of Danish formerly deployed military personnel (FDP) with the general population have not included data on psychotherapy through the Defence or talking therapy with the general practitioner. This study included these and several other data sources in a comprehensive compari...

Background The Major Depression Inventory (MDI) is a patient‐reported outcome measure used by general practitioners to assist with diagnosing and evaluation of the severity of a patient's depression. However, recent studies have questioned the structural validity of the MDI. Objectives We proposed a modified version (mMDI) of the MDI with fewer re...

Background and objective: Mental health issues are common among patients with chronic physical conditions. This study aims to evaluate the feasibility of the Healthy Mind intervention, a general practice-based programme that provides problem-solving therapy (PST) to patients with poor mental well-being and type 2 diabetes (T2D) and/or ischaemic he...

The Health Literacy for School-Aged Children (HLSAC) is a brief, generic instrument measuring health literacy among school-aged children. Given its brevity and broad conceptualization of health literacy, the HLSAC is a potentially valuable measuring instrument among adults as well. This validation study aimed to adapt the HLSAC questionnaire to an...

Objective: The authors investigated the clinical outcomes of commonly used antidepressants among older adults who initiated first-time antidepressants for depression by analyzing the 1-year risk of selected clinically relevant outcomes. Methods: This cohort study used nationwide Danish registry data and included all older adults who redeemed a f...

Background: The Depression, Anxiety and Stress Scale-21 (DASS-21) is a widely used patient-reported outcome measure. While psychometric properties of the DASS-21 have been studied, insufficient attention has been devoted to the assessment of its clinimetric properties. This study verified the clinimetric properties of the Italian version of the DAS...

e13110 Background: Danish cancer survivors receive hospital-based, specialized follow-up care with one central aim to detect cancer recurrence (CR) at an early stage. Nevertheless, CR is frequently detected outside of scheduled follow-up visits as 40-60% of CR patients encounter and present symptoms. The family physician (FP) is presumed to facilit...

Background: The choice of antidepressants for initial pharmacological treatment of depression in older adults and associated patients' characteristics are understudied. We aimed to describe the first selected antidepressant (first-choice) for depression in older adults (≥65 years) and whether patients' sociodemographic and clinical characteristics...

Objective Most mental disorders are diagnosed and treated in general practice. Psychometric tests may help the general practitioner diagnose and treat mental disorders like dementia, anxiety, and depression. However, little is known about the use of psychometric tests in general practice and their impact on further treatment. We aimed to assess the...

Objective: To examine the concurrent validity of the Anxiety Symptom-scale against two well-being scales, the Cantril Ladder (CL) and World Health Organization Well-Being Index (WHO-5), to test the algorithm defining anxiety against these scales, and identify cut-off points for the Anxiety Symptom-scale sum score. Subjects: 14,405 adult responde...

Objectives: Mental disorders have caused increasing sickness absence and related benefit claims in the OECD countries. This study investigates the association between antidepressant treatment initiation and public sick leave compensation (PLSC) in the following year in Denmark. Methods: The study was designed as a register-based prospective coho...

Purpose: The purpose of this study is to describe the prevalence of anxiety disorders in a general population and the association to socioeconomic position (SEP), which has not been described in a Danish context before. Material and methods: We present data on anxiety symptoms from respondents in the rural-provincial Lolland-Falster population H...

Many studies have been conducted on psychological distress but the question of how to conceptualize and assess this phenomenon still remains a controversial issue. Clinimetrics, the science of clinical measurements, may pave the ground for a substantial revision of the clinical conceptualization and assessment of this construct. A Rasch analysis wa...

Objectives: Off-label prescriptions of antidepressants may be of special concern in older-adults. We aimed to study the potential off-label use of antidepressants among adults ≥65 years by describing the patterns, trends, and factors associated with missing and unspecified treatment indications. Methods: We used registry data to describe indicat...

Background: The time interval from first symptom and sign until a cancer diagnosis significantly affects the prognosis. Therefore, recognising and acting on signs of cancer, such as anaemia, is essential. Evidence is sparse on the overall risk of cancer and the risk of specific cancer types in persons with new-onset anaemia detected in an unselect...

Background The assessment of psychological well-being and euthymia represents an emerging issue in clinical psychology and psychiatry. Rating scales and indices such as the 5-item version of the World Health Organization Well-Being Index (WHO-5) and the Euthymia Scale (ES) were developed but insufficient attention has been devoted to the evaluation...

Background We aimed to assess the psychometric properties of the ten-item Anxiety Symptom Scale (ASS) using Rasch analysis. Data from the Lolland-Falster Health Study (LOFUS) were used including ASS data for 16,137 persons aged 18-90 years. Methods Fit to the Rasch model, ordering of response categories, dimensionality testing, test for differenti...

Objective: This is the first study applying Clinimetric Patient-Reported Outcome Measures (CLIPROM) criteria to evaluate the construct validity, sensitivity, and clinical utility of the SCL-90-R in patients with Parkinson’s disease (PD). Methods: A Rasch analysis was conducted using a sample of 488 PD outpatients. Results: Testing for dimensionalit...

Background Anaemia is associated with adverse outcomes, including increased morbidity and all-cause mortality. Diagnostic workup of patients with anaemia is essential to detect underlying disease, especially undiagnosed malignancy. Objective To describe the cancer-relevant diagnostic workup in patients with new-onset anaemia detected in general pr...

Background Anaemia can be a pointer of underlying severe disease, including undiagnosed malignancy. Subsequent blood tests are essential to classify the anaemia into subtypes and to facilitate targeted diagnostic investigation to ensure timely diagnosis of underlying disease. Objective We aimed to describe and classify anaemia based on laboratory...

Background Euthymia has been described as a transdiagnostic construct characterized by the absence of mood disturbances and the presence of an integration of psychic forces, such as coping strategy and well-being. A multidimensional measure, the Euthymia Scale (ES), has been proposed to assess it. We investigated construct and concurrent validity o...

Smoking abstinence expectancies are beliefs about negative and positive short-term psychological and physiological consequences of not smoking. The Smoking Abstinence Expectancies Questionnaire (SAEQ) is a widely used Patient-Reported Outcome Measure (PROM) to assess smoking abstinence expectancies. It has four subscales: negative mood, somatic sym...

Patient-reported outcome measures (PROMs) are self-rated scales and indices developed to improve the detection of the patients’ subjective experience. Given that a considerable number of PROMs are available, it is important to evaluate their validity and usefulness in a specific research or clinical setting. Published guidelines, based on psychomet...

Background Methods to enhance the accuracy of the depression diagnosis continues to be of relevance to clinicians. The primary aim of this study was to compare the diagnostic precision of two different diagnostic strategies using the Mini International Neuropsychiatric Interview (MINI) as a reference standard. A secondary aim was to evaluate accord...

A number of rating scales evaluating symptoms of nicotine withdrawal have been developed over the years but insufficient attention has been devoted to the assessment of their clinimetric properties. Clinimetrics, the science of clinical measurements, is an innovative approach, particularly useful for assessing the validity of rating scales. This is...

Background: A number of patient-reported outcomes (PROs) have been developed but insufficient attention has been devoted to the assessment of their clinimetric properties. Clinimetrics, the science of clinical measurements, has been considered an emerging approach for evaluating reliability and validity of PROs. This is the first study using clinim...

Aims To assess the association between different stages of maternal depression and injury risk in offspring aged 0–10 years. Methods Population‐based cohort study of all live‐born children in Denmark from 1 January 1997 until 31 December 2013 (n = 1,064,387). Main outcome measure was emergency department contacts with a main diagnosis of injury co...

Background Meta-analyses suggest that collaborative care (CC) improves symptoms of depression and anxiety. In CC, a care manager collaborates with a general practitioner (GP) to provide evidence-based care. Most CC research is from the US, focusing on depression. As research results may not transfer to other settings, we developed and tested a Dani...

Introduction Poor mental health is an important public health concern, but mental health problems are often under- recognised. Providing feedback to general practitioners (GPs) on their patients’ mental health status may improve the identification of cases in need of mental healthcare. Objectives To investigate the extent of initiation of mental h...

Objective: This study aimed to assess the measurement properties of the Major Depression Inventory (MDI) in a clinical sample of primary care patients. Design: General practitioners (GPs) handed out the MDI to patients aged 18–65 years on clinical suspicion of depression. Setting: Thirty-seven general practices in the Central Denmark Region partici...

Objective: This study aims to assess the measurement properties of the Major Depression Inventory (MDI) in a clinical sample of primary care patients. Design: General practitioners (GPs) handed out the MDI to patients aged 18–65 years on clinical suspicion of depression. Setting: Thirty-seven general practices in the Central Denmark Region particip...

Background Mental health (MH) problems have considerable personal and societal implications. Systematic MH screening may raise general practitioners’ (GP) awareness of the current need of treatment in their listed patients. The focus of MH screening has so far been on increasing diagnostic rates and treatment of mental disorders, whereas cessation...

Background Depression constitutes a significant part of the global burden of diseases. General practice plays a central role in diagnosing and monitoring depression. A telemedicine solution comprising a web-based psychometric tool may reduce number of visits to general practice and increase patient empowerment. However, the current use of telemedic...

Mental distress is an independent risk factor for illness related impairment. Awareness of mental health (MH) allows prevention, but early detection is not routinely performed in primary care. This cohort study incorporated MH assessment in a health promoting programme. We described the level of poor MH among health check participants, explored the...

Background Depression is a common illness with great human costs and a significant burden on the public economy. Previous studies have indicated that collaborative care (CC) has a positive effect on symptoms when provided to people with depression, but CC has not yet been applied in a Danish context. We therefore developed a model for CC (the Colla...

Background The Major Depression Inventory (MDI) is widely used in Danish general practice as a screening tool to assess depression in symptomatic patients. Nevertheless, no validation studies of the MDI have been performed. The aim of this study was to validate the web-based version of the MDI against a fully structured telephone interview in a pop...

GP use of psychometric tests in Denmark Abbreviation: GP, general practitioner.

Major Depression Inventory, all 10 items used in our study. Note: Reproduced from Bech P. Clinical psychometrics. Oxford: John Wiley and Sons; 2012. Copyright © 2012, John Wiley & Sons, Ltd.1

Objective: The Patient Health Questionnaire (PHQ-9) is widely used for screening of depression in acutely injured trauma survivors. Rasch analysis has been used to evaluate its measurement characteristics. This paper aims: 1) to assess the psychometric properties of the nine PHQ-9 items and 2) to determine the structural validity of using the tota...

Objective We aimed to assess the measurement properties of the ten-item Major Depression Inventory when used on clinical suspicion in general practice by performing a Rasch analysis. Methods General practitioners asked consecutive persons to respond to the web-based Major Depression Inventory on clinical suspicion of depression. We included 22 pra...

Background The outcome of communication training is widely measured by self-efficacy ratings, and different questionnaires have been used. Nevertheless, none of these questionnaires have been formally validated through systematic measurement of assessment properties. Consequently, we decided to further develop a self-efficacy questionnaire which ha...

Multimorbidity is common and is associated with poor mental health and high mortality. Nevertheless, no studies have evaluated whether mental health may affect the survival of people with multimorbidity. We investigated the association between perceived stress and mortality in people with multimorbidity by following a population-based cohort of 118...

Background: Depression in adolescents is a serious psychiatric illness. GPs play an important role in identifying adolescents with depression and those at risk of developing depression. Few validated tools are suitable for identifying adolescent depression in general practice. Aim: To determine if three verbally asked key questions are valid for...

Background There is a lack of validated instruments for detection of depression in ethnic minority adolescent patients in primary care. This study aimed to compare a subgroup of the bilingual, ethnic minority adolescents with the rest of the population using Hscl-10, Hscl-6, WHO-5 and 3-Key Questions for detection of depression in primary care. Me...

Medically unexplained symptoms (MUS) are frequent in soldiers after deployment (Greenberg & Jones 2009). Individuals with severe MUS have low quality of life. Individuals with post-traumatic stress disorder (PTSD) symptoms also report more MUS than those without (Gaupta 2013). Research on MUS and PTSD symptoms is sparse. We aimed to examine the pre...

Sexually transmitted infections (STIs) continue to be highly prevalent in young people. New understanding of sexual risk behaviour is essential for future preventive initiatives. Studies based on self-reported STI history indicate that gap length between sexual partnerships is an important determinant in STI transmission, but little is known about...

According to the World Health Organization, depression ranks as a major contributor to the global burden of disease. A large proportion of adult depressions had their first appearance in adolescence. Brief and reliable rating scales are needed for early detection. The aim of this study is to validate the WHO-5 and the HSCL-6 for detection of depres...

Functional symptoms and disorders are common in primary care. Bodily distress syndrome (BDS) is a newly proposed clinical diagnosis for functional disorders. The BDS diagnosis is based on empirical research, and the symptoms stated in the BDS criteria have been translated into a self-report questionnaire called the BDS checklist. The aim of the pre...

Objectives Sexually transmitted infections and unwanted pregnancies occur at high rates among youth. Understanding sexual behaviour is essential for planning and implementing future effective preventive interventions. The present study examines the sexual behaviour in the general Danish population aged 15–29 years using the core indicators recommen...

The Danish Government Committee on Psychiatry states that recovery-oriented rehabilitation is an important framework and direction in psychiatry. Recovery-oriented rehabilitation means that the intervention is based on best practice. It is also based on four values: self-determination, person involvement, self-determination/choice and growth potent...

Multimorbidity, especially co-morbidity between mental and somatic disorders, represents a growing challenge in general practice. The solution is hardly evermore sophisticated guidelines. The practitioner must improve on basing the clinical assessment of the patient on specific functional ability and need of rehabilitation. This requires allocation...

Background: The Danish General Suburban Population Study (GESUS), the objective of which is to facilitate epidemiological and genetic research, has included the Major Depression Inventory (MDI) and the WHO-Five Well-Being Index (WHO-5) among the medical health questionnaires. We were thus in a position to compare the 2-week prevalence of ICD-10 dep...

To examine the association between mental health status after first-time myocardial infarction (MI) and new cardiovascular events or death, taking into account depression and anxiety as well as clinical, sociodemographic and behavioural risk factors. Population-based cohort study based on questionnaires and nationwide registries. Mental health stat...

Background Chlamydia trachomatis (C. trachomatis) is the most common sexually transmitted bacterial infection among young individuals, and Chlamydia transmission is closely related to sexual behaviour. Previous studies have found overlap between sexual partnerships to be a possible predictor of C. trachomatis, but the importance of this finding has...

Objective: To estimate the frequency of psychological and social classification codes employed by general practitioners (GPs) and to explore the extent to which GPs ascribed health problems to biomedical, psychological, or social factors. Design: A cross-sectional survey based on questionnaire data from GPs. Setting. Danish primary care. Subjec...

Lad mig indlede med at citere Storm P: »Alle taler om vejret, men ingen gør noget ved det«. Ligesådan med stress. Det er oppe i tiden. Der går ikke en dag, uden at man kan laese om nye råd til forebyggelse og behandling af stress. Og der er al mulig grund til at interessere sig for emnet. Stress disponerer nemlig for bl.a. depression, hjerte-kar-sy...

OBJECTIVE. Central health organizations suggest routine screening for depression in high-risk categories of primary care patients. This study compares the effectiveness of high-risk screening versus case-finding in identifying depression in primary care. DESIGN. Using an observational design, participating GPs included patients from 13 predefined r...

VIDENSKAB Den praktiserende laege står over for to store udfor-dringer i forhold til den deprimerede gravide: Den ene er den rettidige diagnose, og den anden er valget af den bedst mulige behandling. Epidemiologiske un-dersøgelser tyder på, at ca. 10% af alle gravide ram-mes af depression, og at stadig flere saettes i behand-ling med antidepressiv...

According to the World Health Organization, depression ranks as a major contributor to the global burden of disease. A large proportion of adult depressions had their first appearance in adolescence. Because primary health care professionals lack valid instruments for early identification of depression, we sought to validate HSCL-10. The design of...

Suggested diagnostic criteria for Hypochondriasis. (0.03 MB DOC)

Hypochondriasis is prevalent in primary care, but the diagnosis is hampered by its stigmatizing label and lack of valid diagnostic criteria. Recently, new empirically established criteria for Health anxiety were introduced. Little is known about Health anxiety's impact on longitudinal outcome, and this study aimed to examine impact on self-rated he...

The use of psychometric tests is increasing in Danish general practice. The instruments are usually paper-based, but a few electronic instruments are now available, including the electronic Common Mental Disorder Questionnaire (e-CMDQ). The aim of the present study is to evaluate the applicability of the e-CMDQ in daily clinical work, the validity...

ADHD is a well established condition in childhood, but much less attention has been given to this diagnosis among adults. It is estimated that 2-4% of the adult population has this condition. Adults with ADHD present symptoms that differ somewhat from those presenting in childhood and they are typically characterized by problems with planning of wo...

Little is known about whether illness perceptions affect health outcomes in primary care patients. The aim of this study was to examine if patients' illness perceptions were associated with their self-rated health in a 2-year follow-up period. One thousand seven hundred eighty-five primary care patients presenting a new or recurrent health problem...

The objective of the study is to improve general practitioners' diagnoses of adolescent depression. Major depression is ranked fourth in the worldwide disability impact. Validation of 1) three key questions, 2) SCL-dep6, 3) SCL-10, 4) 9 other SCL questions and 5) WHO-5 in a clinical study among adolescents. The Composite International Diagnostic In...

To identify predictors of patient satisfaction among a range of patient and practitioner variables. In particular, to focus on patients' illness perceptions and the impact of a randomized controlled trial on the training of physicians in general communication skills and how to treat patients presenting with poorly defined illness. A randomized cont...

To investigate if primary care patients' perceptions of a current health problem were associated with use of health care. One thousand seven hundred eighty-five patients presenting a new health problem to 1 of 38 physicians from 28 general practices in Aarhus County, Denmark. Patients completed a questionnaire on their illness perceptions and emoti...

Prevalence and co-occurrence of mental disorders is high among patients consulting their family general practitioner (GP) for a new health problem, but data on diagnostics and socio-demographics are sketchy. A cross-sectional two-phase epidemiological study. A total of 1785 consecutive patients with new complaints, aged 18-65 years, consulting 28 f...

The narrow ICD-10 and DSM-IV definition of hypochondriasis makes it a rarely used diagnosis. Based on a latent class analysis of the symptoms exhibited by 701 patients (ages 18-65) in general practice, a new and more valid hypochondriasis diagnosis was defined in this study. The main symptom is "obsessive rumination about illnesses", and the patien...

Outcomes of studies on mental health screening in primary care are conflicting. A feasible and effective case-finding approach could benefit both GPs and their patients. (1) to examine the effect of using a composite screening questionnaire (SQ) on GPs' recognition and provision of care, and (2) to outline useful strategies for case-finding. 38 GPs...

The aim of the study was to validate a new case-finding instrument for common mental disorders (CMDQ). A cross-sectional, stratified, two-phase study was carried out in 28 general practices in Aarhus County, Denmark. 1785 consecutive patients, 18-65 years old, consulting 38 GPs with a new health problem participated. Patients were screened before c...

The narrow ICD-10 and DSM-IV definition of hypochondriasis makes it rarely used yet does not prevent extensive diagnosis overlap. This study identified a distinct hypochondriasis symptom cluster and defined diagnostic criteria. Consecutive patients (N=1,785) consulting primary care physicians for new illness were screened for somatization, anxiety,...