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  1. Article ; Online: Psychometric validation of the Danish version of the Major Depression Inventory using data from the Lolland-Falster health study (LOFUS).

    Christensen, Karl Bang / Packness, Aake / Simonsen, Erik / Brodersen, John

    Nordic journal of psychiatry

    2024  , Page(s) 1–10

    Abstract: Purpose: The Major Depression Inventory (MDI) is a widely used self-rating depression scale commonly in primary care in Denmark. It has not been subject to robust psychometric validation in a general population setting. The aim of this study was to ... ...

    Abstract Purpose: The Major Depression Inventory (MDI) is a widely used self-rating depression scale commonly in primary care in Denmark. It has not been subject to robust psychometric validation in a general population setting. The aim of this study was to evaluate the psychometric measurement properties of the MDI when applied in the general population.
    Methods: We evaluated statistical psychometric validity using modern test theory (confirmatory factor analysis, item response theory models and Rasch measurement theory) testing local independence and differential item function across groups defined by gender, age, education, and chronic disease status. Separate analyses across different strata and across different statistical models were employed.
    Results: Regarding structural validity we consistently identified local dependence for the item two pairs (MDI2,MDI3) and (MDI4,MDI5) across strata. This result was confirmed by bifactor CFA models and item screening. We further identified substantial differential item functioning with respect to age group and with respect to chronic disease. We identified quantified the magnitude of this lack of measurement invariance.
    Conclusion: The MDI is psychometrically valid in homogenous sub populations, but the disclosed evidence of local dependence means that published estimates of its reliability cannot be trusted. The lack of measurement invariance means that the instrument cannot be used to compare individuals or groups unless they are similar in terms of age group and chronic disease status.
    Language English
    Publishing date 2024-03-28
    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 10.1080/08039488.2024.2333445
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  2. Book ; Conference proceedings: Proceedings of the Scandinavian Symposium on Borderline Conditions

    Simonsen, Erik

    April 16 - 17, 1993, Copenhagen, Denmark

    (Acta psychiatrica Scandinavica : Supplementum ; 379)

    1994  

    Event/congress Scandinavian Symposium on Borderline Conditions (1993, Kopenhagen)
    Author's details ed.: Erik Simonsen
    Series title Acta psychiatrica Scandinavica : Supplementum ; 379
    Acta psychiatrica Scandinavica
    Acta psychiatrica Scandinavica ; Supplementum
    Collection Acta psychiatrica Scandinavica
    Acta psychiatrica Scandinavica ; Supplementum
    Keywords Borderline Personality Disorder / congresses ; Borderline-Persönlichkeitsstörung
    Subject Borderline-Syndrom ; Borderlinesyndrom
    Language English
    Size 75 S. : graph. Darst.
    Publisher Munksgaard
    Publishing place Copenhagen
    Publishing country Denmark
    Document type Book ; Conference proceedings
    HBZ-ID HT006227700
    ISBN 87-16-15082-1 ; 978-87-16-15082-0
    Database Catalogue ZB MED Medicine, Health

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  3. Article ; Online: Concurrent validity of the anxiety symptom-scale compared to two well-being scales: results from the Lolland-Falster health study.

    Packness, Aake / Sparle Christensen, Kaj / Simonsen, Erik

    Nordic journal of psychiatry

    2023  Volume 77, Issue 6, Page(s) 532–539

    Abstract: 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 ... ...

    Abstract 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 respondents completing all psychometric questions in the Lolland Falster Health Study.
    Method: Receiver operating characteristic analyses comparing Anxiety Symptom-scale WHO-5 and CL.
    Results: 2.5% of respondents had an anxiety disorder (3% female and 2% male) according to the Anxiety Symptom-scale algorithm. The area under the curve (AUC) was 0.87 for CL and 0.90 for WHO-5 (using inverse scores), indicating high concordance with anxiety disorder as identified by the scale. A score solely ≥2 on item 10 is a relevant cut off to low wellbeing. Anxiety disorder covers a broad range on the scale's sum score, with 3 to 4 indicating low well-being in this population sample and a sensitivity of 0.85 - 0.99 against CL and WHO-5.
    Conclusion: The Anxiety Symptom-scale is a sensitive and valid instrument for the identification of patients in low well-being with symptoms of anxiety. A score ≥2 on the functional impact (Item 10) of all symptoms is a relevant indicator of anxiety associated with low well-being in this sample. A higher Anxiety Symptom-scale sum score is coherent with lower well-being, though without specific cut-off points. Further validation of the Anxiety Symptom-scale in a clinical setting is recommended.
    MeSH term(s) Adult ; Humans ; Male ; Female ; Anxiety/diagnosis ; Anxiety Disorders/diagnosis ; ROC Curve ; Psychometrics/methods ; Reproducibility of Results ; Surveys and Questionnaires ; Psychiatric Status Rating Scales
    Language English
    Publishing date 2023-03-13
    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 10.1080/08039488.2023.2174593
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  4. Article ; Online: Prevalence of anxiety disorders and association to socioeconomic position. Results from the Lolland Falster Health Study.

    Packness, Aake / Sparle Christensen, Kaj / Simonsen, Erik

    Nordic journal of psychiatry

    2023  Volume 77, Issue 5, Page(s) 467–474

    Abstract: 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 ... ...

    Abstract 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 Health Study (LOFUS). Analyses of the questionnaire responses to the Anxiety Symptom Scale were done by descriptive statistics and logistic regression analyses adjusted for sex and age.
    Results: 14,834 LOFUS respondents who completed the Anxiety Symptom Scale were included; According to the original algorithm 371 (2.5%) had an anxiety disorder. The adjusted odds ratios (aOR) for anxiety disorder were strongly associated to SEP. We found aOR for anxiety to be: 3.8 (confidence interval (CI 95%) 2.54 - 5.92) for respondents with no postsecondary education compared to those with 3+ years of postsecondary education; 11.9 (CI 8.89 - 16.01) for respondents temporarily out of a job compared to those working; 9.4 (CI 6.06 - 14.51) for those experiencing constant financial strain compared to those not experiencing financial strain. Relaxing the criteria for anxiety to item 10 > 1, the prevalence raised to 3.9%. The association was unchanged related to education; however, the aOR dropped to 9 and 8 respectively, for being temporally out of job, or in financial strain every month- when doing same comparisons.
    Conclusions: The 14-day prevalence of anxiety disorder seems low but strongly associated to SEP especially for individuals temporarily out of a job or experiencing financial strain.
    MeSH term(s) Humans ; Prevalence ; Anxiety Disorders/epidemiology ; Anxiety/epidemiology ; Educational Status
    Language English
    Publishing date 2023-01-20
    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 10.1080/08039488.2022.2154836
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  5. Article ; Online: Psychotic experiences and mental health outcomes in the general population: The Lolland-Falster Health Study.

    Austin, Stephen F / Hastrup, Lene Halling / van Os, Jim / Simonsen, Erik

    Schizophrenia research

    2023  Volume 260, Page(s) 85–91

    MeSH term(s) Humans ; Psychotic Disorders/epidemiology ; Psychotic Disorders/psychology ; Outcome Assessment, Health Care
    Language English
    Publishing date 2023-08-24
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639422-x
    ISSN 1573-2509 ; 0920-9964
    ISSN (online) 1573-2509
    ISSN 0920-9964
    DOI 10.1016/j.schres.2023.08.013
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  6. Article ; Online: Antipsychotic prescribing practices for outpatients with schizophrenia and reasons for non-clozapine treatment - Data from a Danish quality assessment audit.

    Jakobsen, Michelle I / Schaug, Julie P / Nielsen, Jimmi / Simonsen, Erik

    Nordic journal of psychiatry

    2023  Volume 77, Issue 5, Page(s) 481–490

    Abstract: Background: Clozapine is the gold standard for treating treatment-resistant schizophrenia (TRS) although widely underutilised. Both organisational, patient- and clinician related reasons for the underutilisation have been reported, however, the clinical ...

    Abstract Background: Clozapine is the gold standard for treating treatment-resistant schizophrenia (TRS) although widely underutilised. Both organisational, patient- and clinician related reasons for the underutilisation have been reported, however, the clinical impact of either in real-world settings is not fully elucidated.
    Aim: This audit aimed to evaluate the local antipsychotic (AP) prescribing practices for outpatients with schizophrenia and to assess the spectrum and prevalence of journalised reasons for non-clozapine treatment amongst eligible outpatients.
    Methods: Data on demographics, current and former AP treatments, as well as documented reasons for non-clozapine treatment, was extracted through chart audit.
    Results: Of the 668 affiliated outpatients with schizophrenia, 43% were treated with AP polytherapy (APP) and 19.6% with clozapine. The most prevalent reason for clozapine discontinuation was related to side effects whereas the most prevalent reason for refusal or omission of clozapine treatment was related to the associated monitoring regimen.
    Conclusions: This audit showed that APP prescribing is a highly prevalent practice in our services when treating outpatients with schizophrenia and that clozapine is underutilised in a 'last resort' manner. The blood-monitoring regimen associated with clozapine treatment was found to be an important factor in the underutilisation. It seemed, however, that the monitoring constituted a barrier for different reasons, requiring different approaches to remedy. Future studies, directly involving both patients and clinicians in the identification and management of the most clinically relevant barriers and their corresponding facilitators, are warranted.
    MeSH term(s) Humans ; Clozapine/adverse effects ; Antipsychotic Agents/adverse effects ; Schizophrenia/drug therapy ; Schizophrenia/epidemiology ; Outpatients ; Denmark/epidemiology
    Chemical Substances Clozapine (J60AR2IKIC) ; Antipsychotic Agents
    Language English
    Publishing date 2023-01-18
    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 10.1080/08039488.2022.2160878
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  7. Article ; Online: Personality Pathology and Functional Impairment in Patients With Hypochondriasis.

    Bach, Bo / Skjernov, Mathias / Simonsen, Erik

    Journal of the Academy of Consultation-Liaison Psychiatry

    2022  Volume 64, Issue 1, Page(s) 28–34

    Abstract: Background: Research indicates substantial co-occurance of personality pathology and hypochondriasis, which both involve significant psychosocial impairment.: Objective: This study sought to investigate the role of personality pathology for ... ...

    Abstract Background: Research indicates substantial co-occurance of personality pathology and hypochondriasis, which both involve significant psychosocial impairment.
    Objective: This study sought to investigate the role of personality pathology for explaining functional impairment in patients with hypochondriasis, while accounting for the influence of health anxiety severity.
    Methods: Patients diagnosed with hypochondriasis (N = 84; 60% women) were administered interview- and self-report instruments for personality pathology, health anxiety severity, and functional impairment (general, social, and physical): The Structured Clinical Interview for DSM-IV Axis II (SCID-II), the Personality Inventory for DSM-5 (PID-5), the Short Health Anxiety Inventory (SHAI), the 36-item Short Form health survey (SF-36), and the Global Assessment of Functioning (GAF). Hierarchical regression analyses were performed with boot-strapping (1000 samples).
    Results: Findings overall showed that personality pathology incrementally explained functional impairment over the influence of health anxiety severity. More specifically, findings revealed that the incremental effect of PID-5 trait dimensions was substantially larger than the SCID-II personality disorder criterion-count. Functional impairment was specifically associated with SCID-II symptoms of Avoidant Personality disorder and dependent personality disorder as well as PID-5 trait domains of negative affectivity, detachment, and psychoticism.
    Conclusions: The findings highlight the potential significance of personality pathology for understanding and clinical management of functional impairment in patients with hypochondriasis. The personality features that best explained functional impairment were avoidant personality disorder and dependent personality disorder and, in particular, DSM-5 and the International Classification of Diseases, 11th revision personality trait domains of negative affectivity, detachment, and psychoticism.
    MeSH term(s) Humans ; Female ; Male ; Hypochondriasis/diagnosis ; Hypochondriasis/psychology ; Personality Disorders/diagnosis ; Personality Disorders/psychology ; Personality ; Regression Analysis ; Problem Behavior
    Language English
    Publishing date 2022-08-11
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2667-2960
    ISSN (online) 2667-2960
    DOI 10.1016/j.jaclp.2022.08.001
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  8. Article ; Online: Maladaptive personality traits may link childhood trauma history to current internalizing symptoms.

    Bach, Bo / Bo, Sune / Simonsen, Erik

    Scandinavian journal of psychology

    2022  Volume 63, Issue 5, Page(s) 468–475

    Abstract: Research supports a strong relationship between childhood maltreatment and internalizing psychopathology (e.g., anxiety and depression), and features of personality are assumed to explain some of this relationship. In this study, we proposed a model in ... ...

    Abstract Research supports a strong relationship between childhood maltreatment and internalizing psychopathology (e.g., anxiety and depression), and features of personality are assumed to explain some of this relationship. In this study, we proposed a model in which maladaptive traits mediate the effect of childhood trauma history on internalizing symptoms in adult individuals. A mixed sample (N = 462) composed of 142 psychiatric patients and 320 community-dwelling individuals completed the Childhood Trauma Questionnaire (CTQ), the Personality Inventory for DSM-5 (PID-5), and the Symptom Checklist (SCL-27) for internalizing psychopathology. The effect of childhood traumas explained 34% of the variance in internalizing symptoms while controlling for the influence of age and gender. The traits accounted for 78% of this effect, which was predominantly exerted through the domains of Negative Affectivity, Detachment, and Psychoticism, and specifically through the facets of Depressivity, Suspiciousness, Anxiousness, Perceptual Dysregulation, and Distractibility. This finding provides preliminary support for the proposed model indicating that the aforementioned maladaptive trait domains potentially function as mediating links by which childhood traumas are translated into internalizing symptoms in adulthood. However, these findings must be interpreted with caution due to the cross-sectional and retrospective mono-method design of this study. Clinical implications are discussed in relation to transdiagnostic treatment and the potential value of specifying trait domain specifiers in ICD-11 and DSM-5 models of personality disorders.
    MeSH term(s) Adult ; Adverse Childhood Experiences ; Cross-Sectional Studies ; Humans ; Personality ; Personality Inventory ; Retrospective Studies
    Language English
    Publishing date 2022-05-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 219197-0
    ISSN 1467-9450 ; 0036-5564
    ISSN (online) 1467-9450
    ISSN 0036-5564
    DOI 10.1111/sjop.12830
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    Zs.B 957: Show issues Location:
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  9. Article ; Online: Theodore Millon.

    Simonsen, Erik

    Journal of personality disorders

    2014  Volume 28, Issue 2, Page(s) iii–iv

    MeSH term(s) Awards and Prizes ; Faculty/history ; Faculty, Medical/history ; History, 20th Century ; History, 21st Century ; Humans ; Periodicals as Topic/history ; Personality Disorders/history ; Societies, Medical/history ; United States
    Language English
    Publishing date 2014-04
    Publishing country United States
    Document type Biography ; Historical Article ; Journal Article ; Portraits
    ZDB-ID 639252-0
    ISSN 1943-2763 ; 0885-579X
    ISSN (online) 1943-2763
    ISSN 0885-579X
    DOI 10.1521/pedi.2014.28.2.iii
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    Zs.A 2287: Show issues Location:
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  10. Article ; Online: Rasch analysis of the structural validity of the anxiety symptom scale in the lolland-falster health study.

    Christensen, Kaj Sparle / Packness, Aake / Pedersen, Henrik Schou / Simonsen, Erik

    Journal of affective disorders

    2022  Volume 303, Page(s) 58–63

    Abstract: 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!# ...

    Abstract 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 differential item functioning, test for local dependency of items, and calculation of reliability were used to evaluate the psychometric characteristics of the ASS.
    Results: Ordered response categories were achieved for nine of ten items after modifying the original six-point scoring system into a five-point system. After adjustment of the sample size to 500 persons, the ASS fitted the Rasch Model (p = 0.051). Dimensionality testing supported combining the ten items into a total score. No significant differential item functioning was observed for sex, age group, and educational level. Items 1 and 9 and items 4 and 5 demonstrated indication of local dependency. Combining these two item pairs improved the fit of the ASS to the Rasch model.
    Limitations: The total ASS was poorly targeted for the LOFUS population as the majority of persons were located at the lower end of the construct. This poor alignment could explain the low reliability (PSI 0.49). Analyzing a balanced random sample of responders with high and low ASS scores demonstrated a sufficient PSI (0.81).
    Conclusions: Despite problems with the measurement structure, the ASS seems to be a promising instrument for measuring anxiety. However, it may prove more reliable for use in clinical samples of respondents.
    MeSH term(s) Anxiety/diagnosis ; Humans ; Psychometrics ; Reproducibility of Results ; Surveys and Questionnaires
    Language English
    Publishing date 2022-02-06
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 135449-8
    ISSN 1573-2517 ; 0165-0327
    ISSN (online) 1573-2517
    ISSN 0165-0327
    DOI 10.1016/j.jad.2022.02.006
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