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Long-term follow-up of the TIPS early detection in psychosis study: effects on 10-year outcome.

https://arctichealth.org/en/permalink/ahliterature126256
Source
Am J Psychiatry. 2012 Apr;169(4):374-80
Publication Type
Article
Date
Apr-2012
Author
Wenche Ten Velden Hegelstad
Tor K Larsen
Bjørn Auestad
Julie Evensen
Ulrik Haahr
Inge Joa
Jan O Johannesen
Johannes Langeveld
Ingrid Melle
Stein Opjordsmoen
Jan Ivar Rossberg
Bjørn Rishovd Rund
Erik Simonsen
Kjetil Sundet
Per Vaglum
Svein Friis
Thomas McGlashan
Author Affiliation
Division of Psychiatry, Stavanger University Hospital, Regional Center for Clinical Research in Psychosis, Health West, Norway. wenchetenvelden@me.com
Source
Am J Psychiatry. 2012 Apr;169(4):374-80
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adult
Denmark
Early Diagnosis
Female
Follow-Up Studies
Humans
Male
Norway
Outcome and Process Assessment (Health Care) - statistics & numerical data
Prognosis
Psychotic Disorders - diagnosis
Abstract
Early detection in first-episode psychosis confers advantages for negative, cognitive, and depressive symptoms after 1, 2, and 5 years, but longitudinal effects are unknown. The authors investigated the differences in symptoms and recovery after 10 years between regional health care sectors with and without a comprehensive program for the early detection of psychosis.
The authors evaluated 281 patients (early detection, N=141) 18 to 65 years old with a first episode of nonaffective psychosis between 1997 and 2001. Of these, 101 patients in the early-detection area and 73 patients in the usual-detection area were followed up at 10 years, and the authors compared their symptoms and recovery.
A significantly higher percentage of early-detection patients had recovered at the 10-year follow-up relative to usual-detection patients. This held true despite more severely ill patients dropping out of the study in the usual-detection area. Except for higher levels of excitative symptoms in the early-detection area, there were no symptom differences between the groups. Early-detection recovery rates were higher largely because of higher employment rates for patients in this group.
Early detection of first-episode psychosis appears to increase the chances of milder deficits and superior functioning. The mechanisms by which this strategy improves the long-term prognosis of psychosis remain speculative. Nevertheless, our findings over 10 years may indicate that a prognostic link exists between the timing of intervention and outcome that deserves additional study.
Notes
Comment In: Am J Psychiatry. 2012 Sep;169(9):992; author reply 992-322952080
Comment In: Am J Psychiatry. 2012 Apr;169(4):345-722476671
PubMed ID
22407080 View in PubMed
Less detail

Reliability and Hierarchical Structure of DSM-5 Pathological Traits in a Danish Mixed Sample.

https://arctichealth.org/en/permalink/ahliterature276683
Source
J Pers Disord. 2016 Feb;30(1):112-29
Publication Type
Article
Date
Feb-2016
Author
Sune Bo
Bo Bach
Erik Lykke Mortensen
Erik Simonsen
Source
J Pers Disord. 2016 Feb;30(1):112-29
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Adult
Denmark
Diagnostic and Statistical Manual of Mental Disorders
Factor Analysis, Statistical
Female
Humans
Language
Male
Personality
Personality Disorders - diagnosis - psychology
Personality Inventory - standards
Reproducibility of Results
Sampling Studies
Self Report
Translations
Abstract
In this study we assessed the DSM-5 trait model in a large Danish sample (n = 1,119) with respect to reliability of the applied Danish version of the Personality Inventory for DSM-5 (PID-5) self-report form by means of internal consistency and item discrimination. In addition, we tested whether the five-factor structure of the DSM-5 trait model can be replicated in a Danish independent sample using the PID-5 self-report form. Finally, we examined the hierarchical structure of DSM-5 traits. In terms of internal consistency and item discrimination, the applied PID-5 scales were generally found reliable and functional; our data resembled the five-factor structure of previous findings, and we identified a hierarchical structure from one to five factors that was conceptually reasonable and corresponded with existing findings. These results support the new DSM-5 trait model and suggest that it can be generalized to other languages and cultures.
PubMed ID
25905735 View in PubMed
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Pathways to care for first-episode psychosis in an early detection healthcare sector: part of the Scandinavian TIPS study.

https://arctichealth.org/en/permalink/ahliterature70615
Source
Br J Psychiatry Suppl. 2005 Aug;48:s24-8
Publication Type
Article
Date
Aug-2005
Author
Jan Olav Johannessen
Tor K Larsen
Inge Joa
Ingrid Melle
Svein Friis
Stein Opjordsmoen
Bjørn Rishovd Rund
Erik Simonsen
Per Vaglum
Thomas H McGlashan
Author Affiliation
Division of Psychiatry, General Hospital of Rogaland, Armauer Hanssens vei 20, 4000 Stavanger, Norway. jojo@sir.no
Source
Br J Psychiatry Suppl. 2005 Aug;48:s24-8
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Critical Pathways - organization & administration
Delivery of Health Care - organization & administration - standards
Early Diagnosis
Female
Health Services Accessibility
Humans
Male
Middle Aged
Norway
Patient Acceptance of Health Care
Patient Care Team - organization & administration
Psychotic Disorders - diagnosis - therapy
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Abstract
BACKGROUND: Early detection programmes aim to reduce the duration of untreated psychosis (DUP) by public education and by prompt access to treatment via active outreach detection teams. AIMS: To determine whether those with first-episode psychosis in an early detection healthcare area with existing referral channels differ from those who access care via detection teams. METHOD: Those with first-episode psychosis recruited via detection teams were compared with those accessing treatment via conventional channels, at baseline and after 3 months of acute treatment. RESULTS: Patients recruited via detection teams are younger males with a longer DUP, a less dramatic symptom picture and better functioning; however they recover more slowly, and have more symptoms at 3-month follow-up. CONCLUSIONS: After establishing low threshold active case-seeking detection teams, we found clear differences between those patients entering treatment via detection teams v. those obtaining treatment via the usual channels. Such profiling may be informative for early detection service development.
PubMed ID
16055803 View in PubMed
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Empirical evidence for a four factor framework of personality disorder organization: multigroup confirmatory factor analysis of the Millon Clinical Multiaxial Inventory-III personality disorder scales across Belgian and Danish data samples.

https://arctichealth.org/en/permalink/ahliterature145052
Source
J Pers Disord. 2010 Feb;24(1):128-50
Publication Type
Article
Date
Feb-2010
Author
Gina Rossi
Ask Elklit
Erik Simonsen
Author Affiliation
Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Department of Clinical and Life Span Psychology, Brussels, Belgium. grossi@vub.ac.be
Source
J Pers Disord. 2010 Feb;24(1):128-50
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Belgium
Denmark
Factor Analysis, Statistical
Female
Humans
Male
Middle Aged
Models, Psychological
Personality Assessment - statistics & numerical data
Personality Disorders - diagnosis - psychology
Personality Tests
Psychometrics
Translations
Young Adult
Abstract
The factor structure of the Millon Clinical Multiaxial Inventory-III (Millon, Millon, Davis, & Grossman, 2006) personality disorder scales was analyzed using multigroup confirmatory factor analysis on data obtained from a Danish (N = 2030) and a Belgian (N = 1210) sample. Two-, three-, and four factor models, a priori specified using structures found by Dyce, O'Connor, Parkins, and Janzen (1997), were fitted to the data. The best fitting model was a four factor structure (RMSEA = .066, GFI = .98, CFI = .93) with partially invariant factor loadings. The robustness of this four-factor model clearly supports the efforts to organize future personality disorder description in a four-factor framework by corroborating four domains that were predominant in dimensional models (Widiger & Simonsen, 2005): Factor 1, 2, 3, and 4 respectively corresponded to emotional dysregulation versus stability, antagonism versus compliance, extraversion versus introversion, and constraint versus impulsivity.
PubMed ID
20205502 View in PubMed
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Incidence and prevalence rates of personality disorders in Denmark-A register study.

https://arctichealth.org/en/permalink/ahliterature263627
Source
Nord J Psychiatry. 2014 Nov;68(8):543-8
Publication Type
Article
Date
Nov-2014
Author
Liselotte Pedersen
Erik Simonsen
Source
Nord J Psychiatry. 2014 Nov;68(8):543-8
Date
Nov-2014
Language
English
Publication Type
Article
Keywords
Adult
Denmark - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Personality Disorders - epidemiology
Prevalence
Registries - statistics & numerical data
Abstract
Personality disorders (PDs) are prevalent in about one in every 10 adults. Prior to the introduction of the ICD-10 in Denmark, the incidence rate for PD (including schizotypal) among psychiatric patients was approximately 12% and the prevalence rate 14%.
The aim of the present clinical epidemiology study is to investigate the use of ICD-10 PD as primary and secondary diagnoses in years 1995, 2000 and 2006, comorbid disorders and their relation to age and gender.
The study includes all adult patients admitted to any psychiatric hospital (inpatients and outpatients) in Denmark.
Both incidence and prevalence rates of PD diagnoses decrease over the study period. It is evident that all specific diagnoses significantly decrease or remain stable whereas the unspecified and mixed type significantly increases constituting up to 50% of diagnoses. Emotionally unstable PD stands out as the single most prevalent covering around one third of PD diagnoses. A decrease is found in the prevalence of patients receiving a PD diagnosis as a primary diagnosis, but an increase as a secondary diagnosis (most often as comorbid to depression or anxiety disorder). Differences are found in relation to gender and age.
PDs are among the most prevalent disorders; however, rates are decreasing in psychiatric settings. There seem to be a rather huge gap between clinical evaluation and research data on prevalence of PDs. Clinicians need more education and sufficient time for in-depth personality assessment of PDs in all patient groups.
PubMed ID
24520919 View in PubMed
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Determinants of duration of untreated psychosis among first-episode psychosis patients in Denmark: A nationwide register-based study.

https://arctichealth.org/en/permalink/ahliterature295757
Source
Schizophr Res. 2018 02; 192:154-158
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
02-2018
Author
Lene Halling Hastrup
Ulrik Helt Haahr
Jens Einar Jansen
Erik Simonsen
Author Affiliation
Psychiatric Research Unit, Region Zealand Psychiatry, Denmark. Electronic address: lhhs@regionsjaelland.dk.
Source
Schizophr Res. 2018 02; 192:154-158
Date
02-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Age of Onset
Awareness
Demography
Denmark - epidemiology
Early Intervention (Education)
Female
Humans
Male
Psychiatric Status Rating Scales
Psychotic Disorders - diagnosis - epidemiology - psychology
Registries
Young Adult
Abstract
Information on determinants of duration of untreated psychosis (DUP) is still needed to inform campaigns targeting people with first episode psychosis (FEP). This nation-wide study analysed the association between demographic factors (age, sex, ethnicity, marital status, and geographic area), premorbid and illness-related factors (global functional level, substance misuse, and contact to police), healthcare factors (referral source and first FEP contact) and DUP.
The study population of 1266 patients aged 15-25years diagnosed with FEP (ICD10 F20.0-F20.99) was drawn from the Danish National Indicator Project during 2009-2011. The study population was combined with data from national administrative registers. A multinomial regression model was estimated to analyse the impact of demographic, premorbid and illness-related, and healthcare factors on DUP.
One third of the population had a DUP below 6months. DUP longer than 12months was associated with older age at onset, being female, having cannabis misuse, and living in peripheral municipalities. Being charged by the criminal authorities during one year before FEP was associated with a DUP over 6months.
DUP is related to a number of demographic, premorbid and healthcare factors. These findings suggest that future information campaigns should focus on increasing the awareness of early signs of psychosis not only among mental health professionals but also other professionals in contact with adolescents such as the police. It may also be useful to consider how to target information campaigns towards persons living in peripheral areas.
PubMed ID
28578812 View in PubMed
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The alternative DSM-5 personality disorder traits criterion: A comparative examination of three self-report forms in a Danish population.

https://arctichealth.org/en/permalink/ahliterature278993
Source
Personal Disord. 2016 Apr;7(2):124-35
Publication Type
Article
Date
Apr-2016
Author
Bo Bach
Jessica L Maples-Keller
Sune Bo
Erik Simonsen
Source
Personal Disord. 2016 Apr;7(2):124-35
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Denmark - epidemiology
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Male
Middle Aged
Personality Disorders - classification - epidemiology
Personality Inventory - standards
Psychiatric Status Rating Scales - standards
Psychometrics - instrumentation
Reproducibility of Results
Self Report
Young Adult
Abstract
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013a) offers an alternative model for Personality Disorders (PDs) in Section III, which consists in part of a pathological personality traits criterion measured with the Personality Inventory for DSM-5 (PID-5). The PID-5 selfreport instrument currently exists in the original 220-item form, a short 100-item form, and a brief 25-item form. For clinicians and researchers, the choice of a particular PID- 5 form depends on feasibility, but also reliability and validity. The goal of the present study was to examine the psychometric qualities of all 3 PID-5 forms, simultaneously, based on a Danish sample (N = 1376) of 451 psychiatric outpatients and 925 community-dwelling participants. Scale reliability and factorial validity were satisfactory across all 3 PID-5 forms. The correlational profiles of the short and brief PID-5 forms with clinician-rated PD dimensions were nearly identical with that of the original PID-5 (rICC = .99 and .95, respectively). All 3 forms discriminated appropriately between psychiatric patients and community-dwelling individuals. This supports that all 3 PID-5 forms can be used to reliably and validly assess PD traits and provides initial support for the use of the abbreviated PID-5 forms in a European population. However, only the original 220-item form and the short 100-item form capture all 25 trait facets, and the brief 25-item form may be ideally limited to preliminary screening or situations with substantial time restrictions.
PubMed ID
26642229 View in PubMed
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Early Predictors of Ten-Year Course in First-Episode Psychosis.

https://arctichealth.org/en/permalink/ahliterature279449
Source
Psychiatr Serv. 2016 Apr 01;67(4):438-43
Publication Type
Article
Date
Apr-01-2016
Author
Svein Friis
Ingrid Melle
Jan Olav Johannessen
Jan Ivar Røssberg
Helene Eidsmo Barder
Julie Horgen Evensen
Ulrik Haahr
Wenche Ten Velden Hegelstad
Inge Joa
Johannes Langeveld
Tor Ketil Larsen
Stein Opjordsmoen
Bjørn Rishovd Rund
Erik Simonsen
Per Wiggen Vaglum
Thomas H McGlashan
Source
Psychiatr Serv. 2016 Apr 01;67(4):438-43
Date
Apr-01-2016
Language
English
Publication Type
Article
Keywords
Adult
Denmark - epidemiology
Disease Progression
Female
Humans
Longitudinal Studies
Male
Middle Aged
Norway - epidemiology
Outcome Assessment (Health Care) - statistics & numerical data
Prognosis
Psychotic Disorders - diagnosis - drug therapy - epidemiology
Remission Induction
Schizophrenia - diagnosis - drug therapy - epidemiology
Social Skills
Time Factors
Abstract
Identifying patients at risk of poor outcome at an early stage of illness can aid in treatment planning. This study sought to create a best-fit statistical model of known baseline and early-course risk factors to predict time in psychosis during a ten-year follow-up period after a first psychotic episode.
Between 1997 and 2000, 301 patients with DSM-IV nonorganic, nonaffective first-episode psychosis were recruited consecutively from catchment area-based sectors in Norway and Denmark. Specialized mental health personnel evaluated patients at baseline, three months, and one, two, five, and ten years (N=186 at ten years). Time in psychosis was defined as time with scores =4 on any of the Positive and Negative Syndrome Scale items P1, P3, P5, P6, and G9. Evaluations were retrospective, based on clinical interviews and all available clinical information. During the first two years, patients were also evaluated by their clinicians at least biweekly. Baseline and early-course predictors of long-term course were identified with linear mixed-model analyses.
Four variables provided significant, additive predictions of longer time in psychosis during the ten-year follow-up: deterioration in premorbid social functioning, duration of untreated psychosis (DUP) of =26 weeks, core schizophrenia spectrum disorder, and no remission within three months.
First-episode psychosis patients should be followed carefully after the start of treatment. If symptoms do not remit within three months with adequate treatment, there is a considerable risk of a poor long-term outcome, particularly for patients with a deterioration in premorbid social functioning, a DUP of at least half a year, and a diagnosis within the core schizophrenia spectrum.
PubMed ID
26567932 View in PubMed
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Cost-effectiveness of early intervention in first-episode psychosis: economic evaluation of a randomised controlled trial (the OPUS study).

https://arctichealth.org/en/permalink/ahliterature118731
Source
Br J Psychiatry. 2013 Jan;202(1):35-41
Publication Type
Article
Date
Jan-2013
Author
Lene Halling Hastrup
Christian Kronborg
Mette Bertelsen
Pia Jeppesen
Per Jorgensen
Lone Petersen
Anne Thorup
Erik Simonsen
Merete Nordentoft
Author Affiliation
Region Zealand, Psychiatric Research Unit, Roskilde, Denmark. lhhs@regionsjaelland.dk
Source
Br J Psychiatry. 2013 Jan;202(1):35-41
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Community Mental Health Services - economics - organization & administration
Cost-Benefit Analysis
Denmark
Diagnosis-Related Groups - economics
Early Medical Intervention - economics
Family Therapy - economics
Health Care Costs - statistics & numerical data
Health Services - utilization
Humans
Intention to Treat Analysis
Middle Aged
Outcome and Process Assessment (Health Care)
Patient Care Team - economics
Patient Education as Topic - economics
Psychotic Disorders - economics - therapy
Schizophrenia - economics - therapy
Single-Blind Method
Socialization
Young Adult
Abstract
Information about the cost-effectiveness of early intervention programmes for first-episode psychosis is limited.
To evaluate the cost-effectiveness of an intensive early-intervention programme (called OPUS) (trial registration NCT00157313) consisting of enriched assertive community treatment, psychoeducational family treatment and social skills training for individuals with first-episode psychosis compared with standard treatment.
An incremental cost-effectiveness analysis of a randomised controlled trial, adopting a public sector perspective was undertaken.
The mean total costs of OPUS over 5 years (€123,683, s.e. = 8970) were not significantly different from that of standard treatment (€148,751, s.e. = 13073). At 2-year follow-up the mean Global Assessment of Functioning (GAF) score in the OPUS group (55.16, s.d. = 15.15) was significantly higher than in standard treatment group (51.13, s.d. = 15.92). However, the mean GAF did not differ significantly between the groups at 5-year follow-up (55.35 (s.d. = 18.28) and 54.16 (s.d. = 18.41), respectively). Cost-effectiveness planes based on non-parametric bootstrapping showed that OPUS was less costly and more effective in 70% of the replications. For a willingness-to-pay up to €50,000 the probability that OPUS was cost-effective was more than 80%.
The incremental cost-effectiveness analysis showed that there was a high probability of OPUS being cost-effective compared with standard treatment.
PubMed ID
23174515 View in PubMed
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17 records – page 1 of 2.