Depression in adolescents is a serious psychiatric illness. GPs play an important role in identif... more 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. To determine if three verbally asked key questions are valid for identifying depression in adolescents. A cross-sectional, general practice multicentre, validation study was conducted in Oslo, Norway, and Aarhus, Denmark. A total of 294 adolescents answered three verbally asked key questions followed by a Composite International Diagnostic Interview (CIDI) for psychiatric diagnosis. Inclusion criteria were age (14-16 years) and fluency in the Norwegian or Danish language. The primary outcome was ROC curve statistics in terms of sensitivity and specificity, predictive values, and likelihood ratios of the three key questions. Secondary outcomes were Loevinger's H, Cronbach's α, and prevalence of depression. The three key questions met the criteria for construct and criterion validity for detecting depression among the adolescents. ROC curve statistics for the three key questions demonstrated an AUC of 0.79 for the answer 'yes' to either screening question and of 0.73 for the answer 'yes' to the help question. The positive predictive value was 31% and the negative predictive value was 97%. The three key questions are useful for identifying depression in adolescents in primary health care.
The Danish Government Committee on Psychiatry states that recovery-oriented rehabilitation is an ... more 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 potential. A comprehensive national plan of action on how to develop a recovery-oriented rehabilitation to Danish citizens with mental disorders is recommended.
Infectious diseases (London, England), Jan 27, 2015
Sexually transmitted infections (STIs) continue to be highly prevalent in young people. New under... more 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 the impact of concurrent partnerships and short gap length. This study aimed to examine the significance of concurrent partnerships and short gap length between serially monogamous partnerships in Chlamydia trachomatis-infected individuals compared to the general population. A Danish cross-sectional study was conducted among individuals aged 15-29 years with a verified C. trachomatis infection and a sample of the background population. Participants answered a web-based questionnaire on sexual behaviour. Associations were identified in multivariate analyses. In total, 36% of the included young adults reported that they had two or more partn...
Multimorbidity, especially co-morbidity between mental and somatic disorders, represents a growin... more 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 of time to handle more than one problem at a time and a close cooperation of treatment between physician, patient and staff. This article points to patient education and involvement of relatives, the use of problem-solving techniques, collaborative care and use of telemedicine tools as possible solutions.
Functional symptoms and disorders are common in primary care. Bodily distress syndrome (BDS) is a... more 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 present study was to investigate the psychometric properties of the checklist and to test the construct of BDS. The 30-item BDS checklist was completed by 2480 adult primary care patients in a cross-sectional study on contact and disease patterns in Danish general practice. We performed (internal) validation analyses of the collected checklist data. We also performed factor and latent class analyses to identify both BDS symptom groups and BDS patient groups. Internal validation analyses revealed acceptable and usable psychometric properties of the BDS checklist. The factor analyses identified the four distinct determining factors for BDS: car...
According to the World Health Organization, depression ranks as a major contributor to the global... more 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 depression among adolescents. The project is a GP multicentre study conducted in Denmark and Norway. A total of 294 adolescents (14-16 years) responded by answering a paper- or web-based questionnaire and later completed a Composite International Diagnostic Interview, which was used as the gold standard. Depression was defined by ICD-10 criteria. Criterion validity was examined, the likelihood ratios measured and cut-offs for depression were calculated using the Youden index. The prevalence of depression was 11.8% in our sample. The optimal cut-off point was 11 for the WHO-5 test and 9 for the HSCL-6 test. There were no gender differences. For t...
Sexually transmitted infections and unwanted pregnancies occur at high rates among youth. Underst... more 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 recommended by the European Centre for Disease Prevention and Control. A nationwide cross-sectional study was conducted in Denmark among a random sample of 20 000 men and women in 2012. Respondents completed a web-based sexual behaviour questionnaire and data were linked to a nationally held demographic database. Core indicators for sexual behaviour frequency stratified by gender are presented as unweighted and weighted data after consideration of sociodemographic differences between respondents and non-respondents. Response rate was 20.4%. Condoms were used at sexual debut by 69.9% of women and 62.3% of men, while 14.3% of women and 15.1% of men used no con...
The use of psychometric tests is increasing in Danish general practice. The instruments are usual... more 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 of data obtained, indications for use and the GP-perceived benefit of test results. Twenty GPs were invited to test the e-CMDQ during the period from 1 January 2005 to 31 December 2005. They received a fee for using the instrument, equivalent to that received for using other validated psychiatric rating scales. Eleven GPs participated and included a total of 125 (average 11.4, range 2-36) patients during the test period. The average time spent on completing the e-CMDQ was 5.6 minutes. Data were almost complete with 4,499 out of 4,500 possible patient responses. The instrument was mainly used on suspicion of psychiatric morbidity, when prob...
The narrow ICD-10 and DSM-IV definition of hypochondriasis makes it a rarely used diagnosis. Base... more 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 patient must also have at least one of five other symptoms. The prevalence was 9.5 for both genders. There was a good agreement between the diagnoses made during the psychiatric interview and the physicians' assessments.
The British journal of general practice : the journal of the Royal College of General Practitioners, 2003
Somatisation is highly prevalent in primary care (present in 25% of visiting patients) but often ... more Somatisation is highly prevalent in primary care (present in 25% of visiting patients) but often goes unrecognised. Non-recognition may lead to ineffective treatment, risk of iatrogenic harm, and excessive use of healthcare services. To examine the effect of training on diagnosis of somatisation in routine clinical practice by general practitioners (GPs). Cluster randomised controlled trial, with practices as the randomisation unit. Twenty-seven general practices (with a total of 43 GPs) in Vejle County, Denmark. Intervention consisted of a multifaceted training programme (the TERM [The Extended Reattribution and Management] model). Patients were enrolled consecutively over a period of 13 working days. Psychiatric morbidity was assessed by means of a screening questionnaire. GPs categorised their diagnoses in another questionnaire. The primary outcome was GP diagnosis of somatisation and agreement with the screening questionnaire. GPs diagnosed somatisation less frequently than had ...
The British journal of general practice : the journal of the Royal College of General Practitioners, 2003
Research on questionnaires as screening tools for psychiatric disorders has yielded conflicting r... more Research on questionnaires as screening tools for psychiatric disorders has yielded conflicting results. To examine the effect of a routinely administered questionnaire on recognition of common psychiatric disorders in general practice. Randomised controlled trial. Twenty-eight general practices in Aarhus County, Denmark. Thirty-eight general practitioners (GPs) and 1785 consecutive patients, aged 18-65 years old, presenting with a new health problem, participated. Before consultation, patients were screened using a brief screening questionnaire (SQ) including somatisation, anxiety, depression, and alcohol abuse scales. Patients were randomised to one of two groups: 900 questionnaires were disclosed and scored by the GPs, 885 were blinded. A stratified subsample of 701 patients was interviewed after the consultation using a standardised psychiatric research interview (SCAN). Overall the GPs' recognition rates were 14% (95% confidence interval [CI] = -2 to 30) better for depressi...
Depression in adolescents is a serious psychiatric illness. GPs play an important role in identif... more 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. To determine if three verbally asked key questions are valid for identifying depression in adolescents. A cross-sectional, general practice multicentre, validation study was conducted in Oslo, Norway, and Aarhus, Denmark. A total of 294 adolescents answered three verbally asked key questions followed by a Composite International Diagnostic Interview (CIDI) for psychiatric diagnosis. Inclusion criteria were age (14-16 years) and fluency in the Norwegian or Danish language. The primary outcome was ROC curve statistics in terms of sensitivity and specificity, predictive values, and likelihood ratios of the three key questions. Secondary outcomes were Loevinger's H, Cronbach's α, and prevalence of depression. The three key questions met the criteria for construct and criterion validity for detecting depression among the adolescents. ROC curve statistics for the three key questions demonstrated an AUC of 0.79 for the answer 'yes' to either screening question and of 0.73 for the answer 'yes' to the help question. The positive predictive value was 31% and the negative predictive value was 97%. The three key questions are useful for identifying depression in adolescents in primary health care.
The Danish Government Committee on Psychiatry states that recovery-oriented rehabilitation is an ... more 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 potential. A comprehensive national plan of action on how to develop a recovery-oriented rehabilitation to Danish citizens with mental disorders is recommended.
Infectious diseases (London, England), Jan 27, 2015
Sexually transmitted infections (STIs) continue to be highly prevalent in young people. New under... more 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 the impact of concurrent partnerships and short gap length. This study aimed to examine the significance of concurrent partnerships and short gap length between serially monogamous partnerships in Chlamydia trachomatis-infected individuals compared to the general population. A Danish cross-sectional study was conducted among individuals aged 15-29 years with a verified C. trachomatis infection and a sample of the background population. Participants answered a web-based questionnaire on sexual behaviour. Associations were identified in multivariate analyses. In total, 36% of the included young adults reported that they had two or more partn...
Multimorbidity, especially co-morbidity between mental and somatic disorders, represents a growin... more 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 of time to handle more than one problem at a time and a close cooperation of treatment between physician, patient and staff. This article points to patient education and involvement of relatives, the use of problem-solving techniques, collaborative care and use of telemedicine tools as possible solutions.
Functional symptoms and disorders are common in primary care. Bodily distress syndrome (BDS) is a... more 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 present study was to investigate the psychometric properties of the checklist and to test the construct of BDS. The 30-item BDS checklist was completed by 2480 adult primary care patients in a cross-sectional study on contact and disease patterns in Danish general practice. We performed (internal) validation analyses of the collected checklist data. We also performed factor and latent class analyses to identify both BDS symptom groups and BDS patient groups. Internal validation analyses revealed acceptable and usable psychometric properties of the BDS checklist. The factor analyses identified the four distinct determining factors for BDS: car...
According to the World Health Organization, depression ranks as a major contributor to the global... more 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 depression among adolescents. The project is a GP multicentre study conducted in Denmark and Norway. A total of 294 adolescents (14-16 years) responded by answering a paper- or web-based questionnaire and later completed a Composite International Diagnostic Interview, which was used as the gold standard. Depression was defined by ICD-10 criteria. Criterion validity was examined, the likelihood ratios measured and cut-offs for depression were calculated using the Youden index. The prevalence of depression was 11.8% in our sample. The optimal cut-off point was 11 for the WHO-5 test and 9 for the HSCL-6 test. There were no gender differences. For t...
Sexually transmitted infections and unwanted pregnancies occur at high rates among youth. Underst... more 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 recommended by the European Centre for Disease Prevention and Control. A nationwide cross-sectional study was conducted in Denmark among a random sample of 20 000 men and women in 2012. Respondents completed a web-based sexual behaviour questionnaire and data were linked to a nationally held demographic database. Core indicators for sexual behaviour frequency stratified by gender are presented as unweighted and weighted data after consideration of sociodemographic differences between respondents and non-respondents. Response rate was 20.4%. Condoms were used at sexual debut by 69.9% of women and 62.3% of men, while 14.3% of women and 15.1% of men used no con...
The use of psychometric tests is increasing in Danish general practice. The instruments are usual... more 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 of data obtained, indications for use and the GP-perceived benefit of test results. Twenty GPs were invited to test the e-CMDQ during the period from 1 January 2005 to 31 December 2005. They received a fee for using the instrument, equivalent to that received for using other validated psychiatric rating scales. Eleven GPs participated and included a total of 125 (average 11.4, range 2-36) patients during the test period. The average time spent on completing the e-CMDQ was 5.6 minutes. Data were almost complete with 4,499 out of 4,500 possible patient responses. The instrument was mainly used on suspicion of psychiatric morbidity, when prob...
The narrow ICD-10 and DSM-IV definition of hypochondriasis makes it a rarely used diagnosis. Base... more 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 patient must also have at least one of five other symptoms. The prevalence was 9.5 for both genders. There was a good agreement between the diagnoses made during the psychiatric interview and the physicians' assessments.
The British journal of general practice : the journal of the Royal College of General Practitioners, 2003
Somatisation is highly prevalent in primary care (present in 25% of visiting patients) but often ... more Somatisation is highly prevalent in primary care (present in 25% of visiting patients) but often goes unrecognised. Non-recognition may lead to ineffective treatment, risk of iatrogenic harm, and excessive use of healthcare services. To examine the effect of training on diagnosis of somatisation in routine clinical practice by general practitioners (GPs). Cluster randomised controlled trial, with practices as the randomisation unit. Twenty-seven general practices (with a total of 43 GPs) in Vejle County, Denmark. Intervention consisted of a multifaceted training programme (the TERM [The Extended Reattribution and Management] model). Patients were enrolled consecutively over a period of 13 working days. Psychiatric morbidity was assessed by means of a screening questionnaire. GPs categorised their diagnoses in another questionnaire. The primary outcome was GP diagnosis of somatisation and agreement with the screening questionnaire. GPs diagnosed somatisation less frequently than had ...
The British journal of general practice : the journal of the Royal College of General Practitioners, 2003
Research on questionnaires as screening tools for psychiatric disorders has yielded conflicting r... more Research on questionnaires as screening tools for psychiatric disorders has yielded conflicting results. To examine the effect of a routinely administered questionnaire on recognition of common psychiatric disorders in general practice. Randomised controlled trial. Twenty-eight general practices in Aarhus County, Denmark. Thirty-eight general practitioners (GPs) and 1785 consecutive patients, aged 18-65 years old, presenting with a new health problem, participated. Before consultation, patients were screened using a brief screening questionnaire (SQ) including somatisation, anxiety, depression, and alcohol abuse scales. Patients were randomised to one of two groups: 900 questionnaires were disclosed and scored by the GPs, 885 were blinded. A stratified subsample of 701 patients was interviewed after the consultation using a standardised psychiatric research interview (SCAN). Overall the GPs' recognition rates were 14% (95% confidence interval [CI] = -2 to 30) better for depressi...
Uploads
Papers by Kaj Christensen