Cohort description: The Danish study of Functional Disorders

Dantoft, Thomas Meinertz; Ebstrup, Jeanette Frost; Linneberg, Allan; Skovbjerg, Sine; Madsen, Anja Lykke; Mehlsen, Jesper; Brinth, Louise; Eplov, Lene Falgaard; Carstensen, Tina Birgitte Wisbech; Schröder, Andreas; Fink, Per; Mortensen, Erik Lykke; Hansen, Torben; Pedersen, Oluf; Jørgensen, Torben

doi:10.2147/clep.s129335

Cited by 75 publications

(87 citation statements)

References 69 publications

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“…This study was designed as a cross-sectional two-phase study (Fig. 2) using data from the Danish Study of Functional Disorders (DanFunD) part two cohort 77 . In brief, the cohort was established from 2012 to 2015 with the purpose of investigating FSD in the general Danish population.…”

Section: Methodsmentioning

confidence: 99%

Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD

Petersen

Schröder

Jørgensen

et al. 2020

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prevalence of functional somatic syndromes (fSS) in the general population varies with observed overlap between syndromes. However, studies including a range of fSS are sparse. We investigated prevalence and characteristics of various fSS and the unifying diagnostic construct bodily distress syndrome (BDS), and identified mutual overlap of the FSS and their overlap with BDS. We included a stratified subsample of 1590 adults from a randomly selected Danish general population sample (n = 7493). Telephonic diagnostic interviews performed by three trained physicians were used to identify individuals with FSS and BDS. Prevalence of overall FSS was 9.3%; 3.8% for irritable bowel, 2.2% for chronic widespread pain, 6.1% for chronic fatigue, 1.5% for whiplash associated disorders, and 0.9% for multiple chemical sensitivity. Prevalence of BDS was 10.7% where 2.0% had the multi-organ type. fSS were highly overlapping with low likelihood of having a "pure" type. Diagnostic agreement of FSS and BDS was 92.0%. Multi-syndromatic FSS and multi-organ BDS were associated with female sex, poor health, physical limitations, and comorbidity. fSS are highly prevalent and overlapping, and multi-syndromatic cases are most affected. BDS captured the majority of FSS and may improve clinical management, making the distinction between multi-and mono-syndromatic patients easier. Functional somatic syndromes (FSS), such as irritable bowel syndrome (IBS), fibromyalgia/chronic widespread pain (FM/CWP), chronic fatigue syndrome (CFS), whiplash associated disorders (WAD), and multiple chemical sensitivity (MCS), are prevalent in various medical settings and cause great impairment in patients and high health care costs for society. A variety of other terms are used in the literature for these syndromes, central sensitization syndromes 1 and medically unexplained symptoms 2 among others, which underlines the very different conceptualization of these health conditions in current medicine. However, regardless the clinician's a-priori conceptualisation, the present lack of objective clinical signs or reproducible paraclinical findings constitutes a diagnostic challenge as the diagnoses in clinical practise rely on subjective symptom reports, exclusion of relevant differential diagnoses, and the medical history 3-9. Reviews on IBS, FM, and CFS have shown varying prevalence in general populations: 1-45% for IBS 6,10-13 , 0.5-9% for FM 5,14-16 , and 0.1-2.8% for CFS 17-20. One population-based study has found a prevalence of WAD of 1.4-2.9% 21. For MCS, reviews of population-based prevalence also vary tremendously: One review presented prevalence of physician-diagnosed MCS of 0.5% reviews while another have reported a prevalence of MCS of between 1 and 15% 22,23. The considerable variation in prevalence may be attributed to the different diagnostic criteria used for each FSS. Furthermore, a substantial overlap of symptoms between various FSS diagnoses has been shown, indicating

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Section: Methodsmentioning

confidence: 99%

Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD

Petersen

Schröder

Jørgensen

et al. 2020

Sci Rep

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“…These comprise the Danish study of functional disorders (DanFunD) [16], Malmö Diet and Cancer Study (MDCS) [17], Genesis/Genediab [18], Innovative Medicines Initiative – Surrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools (IMI-SUMMIT) Consortia (Europe/UK-based consortia on diabetes studies) [19] and Greenlandic Inuit populations ( n = 2605) [20]. The DanFunD, MDCS and Greenlandic studies were population based, whereas the Genesis/Genediab studies involved people with type 1 diabetes and the IMI-SUMMIT comprised four type 1 and five type 2 diabetes studies.…”

Section: Methodsmentioning

confidence: 99%

A novel rare CUBN variant and three additional genes identified in Europeans with and without diabetes: results from an exome-wide association study of albuminuria

et al. 2018

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Aims/hypothesisIdentifying rare coding variants associated with albuminuria may open new avenues for preventing chronic kidney disease and end-stage renal disease, which are highly prevalent in individuals with diabetes. Efforts to identify genetic susceptibility variants for albuminuria have so far been limited, with the majority of studies focusing on common variants.MethodsWe performed an exome-wide association study to identify coding variants in a two-stage (discovery and replication) approach. Data from 33,985 individuals of European ancestry (15,872 with and 18,113 without diabetes) and 2605 Greenlanders were included.ResultsWe identified a rare (minor allele frequency [MAF]: 0.8%) missense (A1690V) variant in CUBN (rs141640975, β = 0.27, p = 1.3 × 10−11) associated with albuminuria as a continuous measure in the combined European meta-analysis. The presence of each rare allele of the variant was associated with a 6.4% increase in albuminuria. The rare CUBN variant had an effect that was three times stronger in individuals with type 2 diabetes compared with those without (pinteraction = 7.0 × 10−4, β with diabetes = 0.69, β without diabetes = 0.20) in the discovery meta-analysis. Gene-aggregate tests based on rare and common variants identified three additional genes associated with albuminuria (HES1, CDC73 and GRM5) after multiple testing correction (pBonferroni < 2.7 × 10−6).Conclusions/interpretationThe current study identifies a rare coding variant in the CUBN locus and other potential genes associated with albuminuria in individuals with and without diabetes. These genes have been implicated in renal and cardiovascular dysfunction. The findings provide new insights into the genetic architecture of albuminuria and highlight target genes and pathways for the prevention of diabetes-related kidney disease.Electronic supplementary materialThe online version of this article (10.1007/s00125-018-4783-z) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

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“…However, patients in the clinician-referred group underwent the interview face-to-face, whereas patients in the self-referred group underwent the interview via video conferencing. The video-based SCAN interview was modified and shortened based on a procedure from a large Danish epidemiology study 21 (1-2 h) compared with the longer face-to-face interview (3-4 h). This modification pertained primarily to the length of history taking and amount of psychoeducation provided at the time of the interview.…”

Section: Referral and Assessment Proceduresmentioning

confidence: 99%

Accuracy of self-referral in health anxiety: comparison of patients self-referring to internet-delivered treatment versus patients clinician-referred to face-to-face treatment

et al. 2019

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Background Severe health anxiety is a chronic and costly disorder if untreated. Patient self-referral may lower barriers to treatment and decrease diagnostic delay. Aims This study evaluated the accuracy of self-referral for severe health anxiety and compared characteristics of patients self-referred to internet-delivered treatment with patients referred by a clinician to face-to-face treatment. Method Two trials in the same clinic employed different referral methods for health anxiety, namely self-referral and clinician-referral (trial registration: clinicaltrials.gov: NCT01158430 and NCT02735434). The trials were conducted at different time points but with largely comparable eligibility criteria. The accuracy of the recruitment methods was compared by looking at the number of eligible patients in the two trials. Patients completed a baseline questionnaire and subsequently underwent a diagnostic interview by experienced clinicians. Mean differences in self-report and clinical data explored between-group demographic and clinical characteristics. Results In total, 101/151 (67%) self-referred patients were eligible compared with 126/254 (50%) clinician-referred patients (P = 0.001). Self-referred patients were 3.4 years older (P = 0.008) and had a somewhat higher educational level (P = 0.030). Patients who self-referred reported significantly higher levels of health anxiety, emotional distress and somatic symptoms compared with clinician-referred patients. Yet, they had less clinician-assessed comorbid anxiety disorders (P<0.001) and better physical health-related quality of life (P<0.001) suggesting a more distinct symptom profile. Conclusions Self-referral was found to be an accurate method to recruit highly relevant patients with treatment-demanding health anxiety. Thus, both self-referral and clinician-referral seem feasible and valid referral methods, but they may recruit patients with slightly different characteristics. Declaration of interest None.

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Cohort description: The Danish study of Functional Disorders

Cited by 75 publications

References 69 publications

Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD

Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD

A novel rare CUBN variant and three additional genes identified in Europeans with and without diabetes: results from an exome-wide association study of albuminuria

Accuracy of self-referral in health anxiety: comparison of patients self-referring to internet-delivered treatment versus patients clinician-referred to face-to-face treatment

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