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  1. Article ; Online: Scalability of the positive and negative syndrome scale: The role of diagnostic heterogeneity and inter-rater reliability.

    Østergaard, Søren Dinesen / Kølbaek, Pernille / Correll, Christoph U

    Acta psychiatrica Scandinavica

    2022  Volume 146, Issue 4, Page(s) 384–385

    MeSH term(s) Humans ; Reproducibility of Results
    Language English
    Publishing date 2022-08-09
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 103-x
    ISSN 1600-0447 ; 0001-690X
    ISSN (online) 1600-0447
    ISSN 0001-690X
    DOI 10.1111/acps.13486
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  2. Article ; Online: Treatment of schizophrenia evaluated via the pharmacopsychometric triangle-An integrative approach with emphasis on well-being and functioning.

    Kølbæk, Pernille / Mors, Ole / Correll, Christoph U / Østergaard, Søren D

    Schizophrenia (Heidelberg, Germany)

    2023  Volume 9, Issue 1, Page(s) 88

    Abstract: Quantification of treatment response is crucial to optimize outcomes for patients with schizophrenia. In this study, we evaluated the relationship between quantitative measures of clinician-rated symptom severity and self-rated side effects, well-being, ... ...

    Abstract Quantification of treatment response is crucial to optimize outcomes for patients with schizophrenia. In this study, we evaluated the relationship between quantitative measures of clinician-rated symptom severity and self-rated side effects, well-being, and functioning among inpatients with schizophrenia using the six-item version of the Positive and Negative Syndrome Scale (PANSS-6), the Glasgow Antipsychotic Side-effect Scale (GASS), the WHO-Five Well-being Index (WHO-5), and the Sheehan Disability Scale (SDS). All measurements were conducted as close to admission and discharge as possible. Well-being and functioning were found to be most strongly associated with the additive effect of symptoms and side effects, while changes in side effects, well-being, and functioning appeared to be relatively independent from changes in symptom severity. The use of both symptom and side effect measures should inform clinical decision-making in the treatment of schizophrenia, as it has the potential to optimize functioning and well-being.
    Language English
    Publishing date 2023-12-16
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 3133210-9
    ISSN 2754-6993 ; 2754-6993
    ISSN (online) 2754-6993
    ISSN 2754-6993
    DOI 10.1038/s41537-023-00420-6
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  3. Article ; Online: Structural validity of the 5-item World Health Organization Well-being Index (WHO-5) in patients with schizophrenia spectrum disorders.

    Nielsen, Cecilie Marie / Lauridsen, Henrik Hein / Østergaard, Søren Dinesen / Kølbæk, Pernille

    Journal of psychiatric research

    2023  Volume 170, Page(s) 387–393

    Abstract: Background: When monitoring the severity and impact of schizophrenia spectrum disorders, a measure of subjective well-being should ideally accompany measures of symptom severity and medication side effects. The self-reported 5-item World Health ... ...

    Abstract Background: When monitoring the severity and impact of schizophrenia spectrum disorders, a measure of subjective well-being should ideally accompany measures of symptom severity and medication side effects. The self-reported 5-item World Health Organization Well-being Index (WHO-5) is a brief, generic, and widely used measure of subjective well-being. However, the structural validity of the WHO-5, namely, whether the individual item scores can be combined to produce a meaningful total score, has not been examined among patients with schizophrenia spectrum disorders.
    Method: Utilizing data from 399 Danish patients with schizophrenia spectrum disorders attending the Psychiatric Services of the Central Denmark Region, we employed Rasch analysis to examine the structural validity (i.e., unidimensionality, overall fit to the Rasch model, and differential item functioning) of the WHO-5.
    Results: The WHO-5 was found to be unidimensional with no differential item functioning for age, sex, or inpatient/outpatient status. However, in the initial analysis, some misfit to the Rasch model, partially caused by the disordering of response categories, was evident. In adjusted analyses in which the item response categories 2 (Less than half of the time) and 3 (More than half of the time) were merged, overall fit to the model was improved.
    Conclusions: When two item response categories were merged, the Danish version of the WHO-5 was found to be structurally valid for patients with schizophrenia spectrum disorders. This suggests that the WHO-5 holds promise as a measure of subjective well-being in this patient population.
    MeSH term(s) Humans ; Schizophrenia ; Psychometrics/methods ; Quality of Life/psychology ; Reproducibility of Results ; Self Report ; Surveys and Questionnaires
    Language English
    Publishing date 2023-12-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 3148-3
    ISSN 1879-1379 ; 0022-3956
    ISSN (online) 1879-1379
    ISSN 0022-3956
    DOI 10.1016/j.jpsychires.2023.12.028
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  4. Article ; Online: Are informants required to obtain valid ratings on the Positive and Negative Syndrome Scale (PANSS)?

    Nielsen, Cecilie Marie / Kølbæk, Pernille / Dines, David / Opler, Mark / Correll, Christoph U / Østergaard, Søren Dinesen

    Schizophrenia (Heidelberg, Germany)

    2023  Volume 9, Issue 1, Page(s) 54

    Abstract: Ratings on the Positive and Negative Syndrome Scale (PANSS) are ideally based on both a patient interview and an informant questionnaire. In research and clinical settings, however, the informant questionnaire is often omitted. This study investigated ... ...

    Abstract Ratings on the Positive and Negative Syndrome Scale (PANSS) are ideally based on both a patient interview and an informant questionnaire. In research and clinical settings, however, the informant questionnaire is often omitted. This study investigated the consequences of omitting informant information by comparing PANSS ratings of patients with schizophrenia (n = 49 patients, 77 ratings) conducted with and without informant information, respectively. Additionally, changes in symptom severity over time based on ratings with and without informant information were also compared for the full PANSS and the six-item version of the PANSS (PANSS-6). PANSS ratings including informant information were higher than those without, both at the total score and individual item level. Additionally, the full PANSS appeared less "responsive" to baseline-to-endpoint changes for ratings without informant information compared to ratings including informant information, while no differences were found for the PANSS-6.
    Language English
    Publishing date 2023-08-31
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 3133210-9
    ISSN 2754-6993 ; 2754-6993
    ISSN (online) 2754-6993
    ISSN 2754-6993
    DOI 10.1038/s41537-023-00378-5
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  5. Article ; Online: Clinical validation of the self-reported 6-item Hamilton Depression Rating Scale (HAM-D6-SR) among inpatients.

    Kølbæk, Pernille / Nielsen, Cathrine Wildenschild / Buus, Chanette Winther / Friis, Signe Riemer / Nilsson, Ellinor / Jensen, Botilla Dalsgaard / Bueno, Andreas Videbæk / Østergaard, Søren Dinesen

    Journal of affective disorders

    2024  Volume 354, Page(s) 765–772

    Abstract: Background: Brief and valid patient-rated symptom scales represent a valuable addition to clinician-rated scales for assessing depression. Studies on the psychometric properties of the self-rated 6-item Hamilton Depression Rating Scale (HAM-D6-SR) have ... ...

    Abstract Background: Brief and valid patient-rated symptom scales represent a valuable addition to clinician-rated scales for assessing depression. Studies on the psychometric properties of the self-rated 6-item Hamilton Depression Rating Scale (HAM-D6-SR) have shown promising results for outpatients with depression. The aim of the present study was to evaluate the psychometric properties of the HAM-D6-SR among inpatients using the clinician-rated 17-item Hamilton Rating Scale for Depression (HAMD17) as the gold standard.
    Methods: Inpatients with unipolar or bipolar depression completed the HAM-D6-SR and were subsequently rated on the HAM-D17 by trained raters, who were blind to the HAM-D6-SR ratings. The pairs of HAM-D6-SR and HAM-D17 ratings were completed twice during admission to evaluate responsiveness over time. Agreement between the HAM-D6-SR and the clinician-rated HAM-D17-derived HAM-D6 was evaluated using the intraclass correlation coefficient (ICC). Responsiveness was evaluated by means of the Spearman's rank correlation coefficient (rho).
    Results: A total of 102 participants completed the HAM-D6-SR at least once (median age: 41 years; 66 % females). The ICC for the HAM-D6-SR and the HAM-D17-derived HAM-D6 was 0.60 (95%CI = 0.30-0.76), with the ICC at the item level ranging from 0.13 (Psychomotor retardation) to 0.75 (Depressed mood). The correlation between the changes in the baseline-endpoint total scores on the HAM-D6-SR and HAM-D17-derived HAM-D6 was rho = 0.59 (p < 0.001).
    Limitations: Test-retest reliability and structural validity were not evaluated.
    Conclusions: The HAM-D6-SR holds promise as a valid self-report of core depressive symptoms among inpatients and may aid treatment decisions. However, the validity of self-reported psychomotor retardation was poor.
    MeSH term(s) Female ; Humans ; Adult ; Male ; Depression/diagnosis ; Self Report ; Reproducibility of Results ; Inpatients ; Psychiatric Status Rating Scales ; Psychometrics
    Language English
    Publishing date 2024-03-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 135449-8
    ISSN 1573-2517 ; 0165-0327
    ISSN (online) 1573-2517
    ISSN 0165-0327
    DOI 10.1016/j.jad.2024.03.014
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  6. Article ; Online: Forty Percent Reduction in Referrals to Psychiatric Services during the COVID-19 Pandemic.

    Kølbæk, Pernille / Nørremark, Bettina / Østergaard, Søren Dinesen

    Psychotherapy and psychosomatics

    2020  Volume 90, Issue 1, Page(s) 67–68

    MeSH term(s) COVID-19 ; Humans ; Pandemics ; Referral and Consultation ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-26
    Publishing country Switzerland
    Document type Letter ; Comment
    ZDB-ID 209490-3
    ISSN 1423-0348 ; 0033-3190
    ISSN (online) 1423-0348
    ISSN 0033-3190
    DOI 10.1159/000509575
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  7. Article: Antipsychotic-placebo separation on the PANSS-6 subscale as compared to the PANSS-30: a pooled participant-level analysis.

    Hieronymus, Fredrik / Kølbæk, Pernille / Correll, Christoph U / Østergaard, Søren D

    NPJ schizophrenia

    2021  Volume 7, Issue 1, Page(s) 41

    Abstract: In order for measurement-based care to be implemented, there is a need for brief rating instruments that can be administered in a short amount of time, but that are still sufficiently informative. Here, we assessed the drug-placebo sensitivity of the six- ...

    Abstract In order for measurement-based care to be implemented, there is a need for brief rating instruments that can be administered in a short amount of time, but that are still sufficiently informative. Here, we assessed the drug-placebo sensitivity of the six-item subscale (PANSS-6) of the 30-item Positive and Negative Syndrome Scale (PANSS-30) using a large collection of patient-level data (n = 6685) from randomized controlled trials of risperidone and paliperidone. When analyzing the data by study, we found no material difference in mean effect sizes (ES) between the two measures (PANSS-30 ES = 0.45, PANSS-6 ES = 0.44; p = 0.642). Stratifying the pooled population according to several putative effect moderators (e.g., age, formulation, dose, or diagnosis) generally yielded no meaningful ES differences between the two measures. Similarly, early improvement (≥20% improvement at week 1) on the PANSS-6 predicted subsequent response (≥40% improvement at endpoint) as well as the analog prediction using PANSS-30. Finally, cross-sectional symptom remission assessed via the PANSS-6 showed very good agreement (sensitivity = 100%, specificity = 98%) with cross-sectional symptom remission defined by the Remission in Schizophrenia Working Group.
    Language English
    Publishing date 2021-08-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2813844-2
    ISSN 2334-265X
    ISSN 2334-265X
    DOI 10.1038/s41537-021-00168-x
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  8. Article ; Online: Mental health of patients with mental illness during the COVID-19 pandemic lockdown: a questionnaire-based survey weighted for attrition.

    Kølbæk, Pernille / Jefsen, Oskar Hougaard / Speed, Maria / Østergaard, Søren Dinesen

    Nordic journal of psychiatry

    2021  Volume 76, Issue 5, Page(s) 338–347

    Abstract: Background: Individuals with pre-existing mental illness may be particularly vulnerable to the negative impact that the coronavirus disease 2019 (COVID-19) pandemic seems to have on mental health. Accordingly, the objective of the present study was to ... ...

    Abstract Background: Individuals with pre-existing mental illness may be particularly vulnerable to the negative impact that the coronavirus disease 2019 (COVID-19) pandemic seems to have on mental health. Accordingly, the objective of the present study was to assess whether patients with mental illness experienced deterioration in mental health during the COVID-19 lockdown of Denmark in the Spring of 2020.
    Methods: We conducted a cross-sectional, questionnaire-based survey coupled with sociodemographic and clinical data from the medical records of all invitees. The latter enabled analysis of attrition and weighting of results. The online questionnaire included the 18-item Brief Symptom Inventory (BSI-18), the five-item World Health Organization Well-Being Index (WHO-5), and 14 questions evaluating worsening or improvement in symptoms during lockdown using the pre-pandemic period as reference.
    Results: A total of 992 randomly drawn patients with mental illness from the psychiatric services of the Central Denmark Region responded to the questionnaire (response rate = 21.6%). The weighted mean WHO-5 and BSI-18 scores were 38 and 28, respectively. A total of 52% of the respondents reported that their mental health had deteriorated during the lockdown, while 33% reported no change, and 16% reported improvement. The most commonly reported reasons for deterioration were loneliness, disruption of routines, concerns regarding the coronavirus, less contact with family/friends, boredom, and reduced access to psychiatric care.
    Conclusion: More than half of the patients reported worsening of their mental health during the pandemic lockdown. There should be an increased emphasis on ensuring both social and clinical support for individuals with mental illness during pandemics.
    MeSH term(s) COVID-19/epidemiology ; COVID-19/prevention & control ; Communicable Disease Control ; Cross-Sectional Studies ; Humans ; Mental Disorders/epidemiology ; Mental Health ; Pandemics ; SARS-CoV-2 ; Surveys and Questionnaires
    Language English
    Publishing date 2021-09-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 1104974-1
    ISSN 1502-4725 ; 0803-9488 ; 0029-1455
    ISSN (online) 1502-4725
    ISSN 0803-9488 ; 0029-1455
    DOI 10.1080/08039488.2021.1970222
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  9. Article ; Online: Symptom severity and well-being of patients with mental illness during the COVID-19 pandemic: a two-wave survey.

    Kølbæk, Pernille / Gil, Yael / Schmidt, Frida Cecilie Lassen / Speed, Maria / Østergaard, Søren Dinesen

    Nordic journal of psychiatry

    2022  Volume 77, Issue 3, Page(s) 293–303

    Abstract: Purpose of the article: To examine changes in symptom severity and well-being during the coronavirus disease 2019 (COVID-19) pandemic among individuals with pre-existing mental illness.: Materials and methods: In February 2021, we conducted a follow- ... ...

    Abstract Purpose of the article: To examine changes in symptom severity and well-being during the coronavirus disease 2019 (COVID-19) pandemic among individuals with pre-existing mental illness.
    Materials and methods: In February 2021, we conducted a follow-up questionnaire-based survey among adults with mental illness, who responded to a similar survey on mental health in June 2020. The participants completed the 18-item Brief Symptom Inventory (BSI-18), the five-item World Health Organization Well-Being Index (WHO-5), and 14 questions evaluating worsening or improvement in mental health using the pre-pandemic period as reference. The survey data were merged with sociodemographic and clinical data from the medical records of all invitees to the first survey, enabling analysis of attrition and weighting of the results.
    Results: A total of 613 of 992 (62%) invitees participated in the follow-up wave of the survey. The weighted mean WHO-5 and BSI-18 scores were 38 and 27, respectively, and did not differ statistically significantly from the first wave. Multivariate logistic regression showed that having a vocational education (skilled worker/craftsman) was positively associated with reporting deterioration in psychological well-being (OR: 2.95, 95%CI: 1.14-7.81), while being unemployed was negatively associated with reporting deterioration in psychological well-being (OR: 0.20, 95%CI: 0.07-0.56) from the first to the second survey wave. The most common reason for self-reported deterioration in mental health was loneliness (70%).
    Conclusions: Approximately one year into the COVID-19 pandemic, the level of symptoms remained high, whereas the level of psychological well-being remained low among patients with mental illness.
    MeSH term(s) Adult ; Humans ; COVID-19/epidemiology ; Pandemics ; SARS-CoV-2 ; Depression/diagnosis ; Mental Disorders/epidemiology ; Surveys and Questionnaires
    Language English
    Publishing date 2022-07-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 1104974-1
    ISSN 1502-4725 ; 0803-9488 ; 0029-1455
    ISSN (online) 1502-4725
    ISSN 0803-9488 ; 0029-1455
    DOI 10.1080/08039488.2022.2099581
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