title: Can registry data be used as a proxy for perceived stress? A cross-sectional study.
abstract: This study explores the applicability of registry data as a proxy for perceived stress by examining the association between perceived stress measured in health surveys and registry data.
  
  
  
  Of 35,700 randomly invited participants from the 2010 Health Survey in the North Denmark Region (age 16-99 years), 21,842 answered 10 items from Cohen's Perceived Stress Scale. Respondents were divided into quartiles based on their stress score. Survey information was individually linked to national registries containing information on prescribed psychiatric medication and consultations with psychologists or psychiatrists from 2009 to 2011.
  
  
  
  The percentage of persons with prescriptions or consultations was higher (37.6%) in the highest stress score group, compared with the lowest stress score group (7.7%). Odds ratio (95% confidence interval) for the highest score compared with the lowest score was 7.3 (6.5-8.1). Different combinations of treatment showed low sensitivity (8.7%-37.6%), positive predictive value (49.4%-56.8%), and positive agreement (16.2%-42.7%) were found, whereas specificity (88.5%-98.0%) and negative agreement (85.5%-87.2%) were higher. Kappa measure showed slight to fair agreement (0.104-0.285).
  
  
  
  Participants reporting high perceived stress were more often prescribed medications and referred for consultations with psychologists or psychiatrists. However, due to low predictive values, registry data may not be suitable as a proxy for perceived stress.
authors.affiliation: Department of Social Medicine, Aalborg University Hospital, Denmark. Electronic address: lssj@rn.dk.
authors.forename: Laura Schärfe
authors.initials: LS
authors.lastname: Jensen
authors.affiliation: Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Overgaard
authors.affiliation: Department of Breast Surgery, Ringsted Hospital, Denmark.
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Garne
authors.affiliation: Research Centre for Prevention and Health, Glostrup University Hospital, Denmark.
authors.forename: Kathrine
authors.initials: K
authors.lastname: Carlsen
authors.affiliation: Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Bøggild
authors.affiliation: Department of Social Medicine, Aalborg University Hospital, Denmark; Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Fonager
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D016017:Odds Ratio; D010465:Perception; D011237:Predictive Value of Tests; D019727:Proxy; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D013315:Stress, Psychological / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: Data collection; Methods; Psychological; Stress