sj-docx-4-sjp-10.1177_14034948211056752 – Supplemental material for Social position and functional somatic disorders: The DanFunD study

Supplemental material, sj-docx-4-sjp-10.1177_14034948211056752 for Social position and functional somatic disorders: The DanFunD study by Signe U. Schovsbo, Thomas M. Dantoft, Betina H. Thuesen, Katja B. Leth-Møller, Lene F. Eplov, Marie W. Petersen, Torben Jørgensen and Merete Osler in Scandinavian Journal of Public Healt

Social position and functional somatic disorders: The DanFunD study

Background and aim:It is generally accepted that functional somatic disorders (FSDs) are a product of biological, psychological, and social factors. Social position might be part of this complex, but the literature on this issue is currently heterogeneous and inconsistent. The aim of the present study was – in a population-based cohort – to test the hypothesis that lower social position would be associated with higher a risk of FSD.Method:The association between social position and FSD was examined in a cross-sectional study with various measures of social position (education as measured by vocational training; employment; cohabitation; subjective social status) and delimitations of FSD (irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, bodily distress syndrome, and symptom profiles). The associations were analyzed using logistic regressions to calculate odds ratios and 95% confidence intervals. Each social measure was analyzed independently and was adjusted for age and sex.Results:Lower levels of vocational training, being unemployed, and living alone were associated with higher risk of FSD, regardless of the FSD delimitation. There was also a significant negative association between subjective evaluated social status and FSD. The associations remained after multiple adjustments, and seemed to be strongest for the more severe FSD-types.Conclusions:Lower social position is associated with higher risk of FSD, especially the more severe FSD delimitations, which might constitute an especially vulnerable group. However, the mechanisms behind the relations remain unknown

sj-docx-5-sjp-10.1177_14034948211056752 – Supplemental material for Social position and functional somatic disorders: The DanFunD study

Supplemental material, sj-docx-5-sjp-10.1177_14034948211056752 for Social position and functional somatic disorders: The DanFunD study by Signe U. Schovsbo, Thomas M. Dantoft, Betina H. Thuesen, Katja B. Leth-Møller, Lene F. Eplov, Marie W. Petersen, Torben Jørgensen and Merete Osler in Scandinavian Journal of Public Healt

sj-docx-2-sjp-10.1177_14034948211056752 – Supplemental material for Social position and functional somatic disorders: The DanFunD study

Supplemental material, sj-docx-2-sjp-10.1177_14034948211056752 for Social position and functional somatic disorders: The DanFunD study by Signe U. Schovsbo, Thomas M. Dantoft, Betina H. Thuesen, Katja B. Leth-Møller, Lene F. Eplov, Marie W. Petersen, Torben Jørgensen and Merete Osler in Scandinavian Journal of Public Healt

sj-docx-6-sjp-10.1177_14034948211056752 – Supplemental material for Social position and functional somatic disorders: The DanFunD study

Supplemental material, sj-docx-6-sjp-10.1177_14034948211056752 for Social position and functional somatic disorders: The DanFunD study by Signe U. Schovsbo, Thomas M. Dantoft, Betina H. Thuesen, Katja B. Leth-Møller, Lene F. Eplov, Marie W. Petersen, Torben Jørgensen and Merete Osler in Scandinavian Journal of Public Healt

sj-docx-3-sjp-10.1177_14034948211056752 – Supplemental material for Social position and functional somatic disorders: The DanFunD study

Supplemental material, sj-docx-3-sjp-10.1177_14034948211056752 for Social position and functional somatic disorders: The DanFunD study by Signe U. Schovsbo, Thomas M. Dantoft, Betina H. Thuesen, Katja B. Leth-Møller, Lene F. Eplov, Marie W. Petersen, Torben Jørgensen and Merete Osler in Scandinavian Journal of Public Healt

sj-docx-1-sjp-10.1177_14034948211056752 – Supplemental material for Social position and functional somatic disorders: The DanFunD study

Supplemental material, sj-docx-1-sjp-10.1177_14034948211056752 for Social position and functional somatic disorders: The DanFunD study by Signe U. Schovsbo, Thomas M. Dantoft, Betina H. Thuesen, Katja B. Leth-Møller, Lene F. Eplov, Marie W. Petersen, Torben Jørgensen and Merete Osler in Scandinavian Journal of Public Healt

Occurrence and accuracy of a register-based diagnosis of pediatric bipolar disorder: A nationwide cohort study

Objective:To investigate the accuracy of a diagnosis of pediatric bipolar disorder in the Danish National Register compared to the patient charts. Second, we reported on the occurrence of a diagnosis of pediatric bipolar disorder during the study period.Methods:All persons appearing in the Danish nationwide registers between 1995 and 2014 with an incident ICD-10 diagnosis of single hypomanic/manic episode or a diagnosis of bipolar disorder (summarized as bipolar disorder [BD]) before turning 18 years were identified (n = 521) and a random sample (n = 131) hereof was selected for chart review. Each chart was reviewed by two independent Schedules for Clinical Assessment in Neuropsychiatry (SCAN) certified raters to assess whether symptoms documented in the chart were consistent with a formal diagnosis of BD according to the ICD-10 criteria or not.Results:The formal diagnostic criteria for BD according to the ICD-10 were fulfilled in 48 charts (45.3%, 95% CI: [36.1%, 54.8%]) out of 106 reviewable charts, age at index = 16.4 ± 1.6 (range = 9.1–18.3) years. Cohen’s Kappa ranged from 94.4% to 100%. The estimate of a lifetime prevalence up till the current age for bipolar disorder for those of aged 5–18 years, was 0.019% in 2014.Conclusion:Less than half of the register-based pediatric BD diagnoses were confirmed by chart review, which was lower than expected. The occurrence of a register diagnosis of pediatric BD was relatively low

Occurrence and accuracy of a register-based diagnosis of pediatric bipolar disorder: A nationwide cohort study

Objective:To investigate the accuracy of a diagnosis of pediatric bipolar disorder in the Danish National Register compared to the patient charts. Second, we reported on the occurrence of a diagnosis of pediatric bipolar disorder during the study period.Methods:All persons appearing in the Danish nationwide registers between 1995 and 2014 with an incident ICD-10 diagnosis of single hypomanic/manic episode or a diagnosis of bipolar disorder (summarized as bipolar disorder [BD]) before turning 18 years were identified (n = 521) and a random sample (n = 131) hereof was selected for chart review. Each chart was reviewed by two independent Schedules for Clinical Assessment in Neuropsychiatry (SCAN) certified raters to assess whether symptoms documented in the chart were consistent with a formal diagnosis of BD according to the ICD-10 criteria or not.Results:The formal diagnostic criteria for BD according to the ICD-10 were fulfilled in 48 charts (45.3%, 95% CI: [36.1%, 54.8%]) out of 106 reviewable charts, age at index = 16.4 ± 1.6 (range = 9.1–18.3) years. Cohen’s Kappa ranged from 94.4% to 100%. The estimate of a lifetime prevalence up till the current age for bipolar disorder for those of aged 5–18 years, was 0.019% in 2014.Conclusion:Less than half of the register-based pediatric BD diagnoses were confirmed by chart review, which was lower than expected. The occurrence of a register diagnosis of pediatric BD was relatively low

Treatment of difficult-to-treat depression – clinical guideline for selected interventions

Difficult-to-treat-depression (DTD) is a clinical challenge. The interventions that are well-established for DTD are not suitable or effective for all the patients. Therefore, more treatment options are highly warranted. We formulated an evidence-based guideline concerning six interventions not well-established for DTD in Denmark. Selected review questions were formulated according to the PICO principle with specific definitions of the patient population (P), the intervention (I), the comparison (C), and the outcomes of interest (O), and systematic literature searches were performed stepwise for each review question to identify relevant systematic reviews/meta-analyses, and randomized controlled trials. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to assess the methodological quality of the included studies. Clinical recommendations were formulated based on the evidence, the risk-benefit ratio, and perceived patient preferences. We found sufficient evidence for a weak recommendation of repetitive transcranial magnetic stimulation (rTMS) and cognitive behavioural analysis system of psychotherapy (CBASP). The use of bright light therapy in DTD was not sufficiently supported by the evidence, but should be considered as good clinical practice. The interventions should be considered in addition to ongoing antidepressant treatment. We did not find sufficient evidence to recommend intravenous ketamine/esketamine, rumination-focused psychotherapy, or cognitive remediation to patients with DTD. The evidence supported two of the six reviewed interventions, however it was generally weak which emphasizes the need for more good quality studies. This guideline does not cover all treatment options and should be regarded as a supplement to relevant DTD-guidelines