Lars Christian Kvalbein-Olsen

• Kvalbein-Olsen, Lars Christian; Aakhus, Eivind; Haavet, Ole Rikard & Werner, Erik Lønnmark (2026). Joint consultations with general practitioners and geriatric psychiatrists for older adults with depression: a focus group study. BMC Primary Care. doi: 10.1186/s12875-025-03169-2. Full text in Research Archive
• Kvalbein-Olsen, Lars Christian; Aakhus, Eivind; Haavet, Ole Rikard; Mdala, Ibrahimu & Werner, Erik Lønnmark (2025). Joint consultations in a structured GP-patient-geriatric-psychiatrist model for late-life depression: a cluster RCT. BMC Primary Care. 26(1). doi: 10.1186/s12875-025-03002-w. Full text in Research Archive Show summary

  Background Depression in older adults is mainly treated in general practice but is often constrained by limited resources in primary healthcare services and suboptimal access to assistance from specialized care. This study aimed to evaluate the effectiveness of a structured collaborative model between GPs and geriatric psychiatrists compared to standard follow-up for individuals aged ≥ 65 with depression. Methods Patients with moderate depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] scores of 10–19) were invited to participate in a cluster-randomized controlled trial evaluating a structured collaborative intervention model involving GPs and geriatric psychiatrists. The core component of the intervention consisted of two consecutive joint consultations with the GP, patient, and geriatric psychiatrist, supplemented by individual GP-patient consultations. PHQ-9 assessments were conducted at baseline and at 6, 12, and 18 months. The primary outcome was a ≥ 50% reduction in PHQ-9 scores. Results 35 general practitioners initially agreed to participate, yet only 19 managed to recruit one or more depressed patients. Consequently, a total of 34 patients were enrolled in the study, with 30 providing survey responses during the follow-up period for subsequent analysis. Binary analysis (≥ 50% symptom reduction) showed a greater likelihood of improvement in the intervention group compared to the control, though this difference did not reach statistical significance. Notably, both groups showed significant mean PHQ-9 score reductions (3.4 and 4.0, respectively) at 18 months, but differences in mean PHQ-9 scores between the groups across all time points were not statistically significant. Conclusion This study did not yield significant results for the collaborative model implemented. Major challenges in the recruitment process likely contributed to the low participation rate, which may explain the absence of positive findings. Trial registration The study was registered the 15.09.2019 in ClinicalTrials.gov with ID: NCT04078282.

• Kvalbein-Olsen, Lars Christian; Aakhus, Eivind; Haavet, Ole Rikard & Werner, Erik Lønnmark (2022). Unrecognised depression among older people: a cross-sectional study from Norwegian general practice. British Journal of General Practice Open. 7(1). doi: 10.3399/BJGPO.2022.0135. Full text in Research Archive Show summary

  Background Depression is common in old age and is associated with both disability, increased mortality and increased impairment from physical diseases. Aim To estimate the prevalence of depression among old patients in Norwegian general practice, to evaluate the extent they talk about it during their consultation, if it was previously known or suspected by their general practitioner (GP), and how frequent the depressed patients visit their GP. Design and setting Cross-sectional study among patients and GPs at 18 primary care clinics in the south of Norway. Method Patients ≥65 years who visited their GP were asked to complete the Patient Health Questionaire-9 (PHQ9). The GPs reported what kind of issues the patient presented at the consultation, if a current depression were known, and the consultation frequency. Results 44 (11%) of 383 patients reported moderate or severe depressive symptoms (PHQ9≥10). Among the cases with data from both patient and GP (369), 38 patients (10%) reported moderately depressive symptoms. Of these only 12 (32%) mentioned psychological problems to their GP during their consultation, 12 (32%) were neither known to the GP with previous depression nor suspected by the GP of having a current one, and 68% of them visit their GP ≥ 5 times a year. Conclusion Elderly patients tend to speak little of their depression to the GP. Almost 1 of 3 elderly patients with moderate depressive symptoms were unrecognized by their GP. GPs should more often suspect potential mental health problems in old patients who come frequently to visits. Copyright © 2022, The Authors. This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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• Kvalbein-Olsen, Lars Christian (2026). Depression in Older Adults in General Practice and a Structured Collaborative Model With General Practitioners and Psychiatrists. Universitetet i Oslo. ISSN 9788234808388. Full text in Research Archive Show summary

  Depression among older adults is common in general practice but often remains unrecognised and insufficiently treated. This thesis examined the prevalence and recognition of depressive symptoms in older patients in Norwegian general practice and explored whether collaboration between general practitioners (GPs) and geriatric psychiatrists through joint consultations could improve care. A cross-sectional study showed that 11.4% of patients aged ≥65 years had moderate or more severe depressive symptoms. Among patients with moderate depressive symptoms, more than two-thirds did not discuss mental health during consultations, and in nearly one-third of cases the depression was not recognised by the GP. A cluster randomised intervention study evaluated joint consultations between GPs and geriatric psychiatrists. Although the intervention group showed a tendency toward greater improvement than the control group, the results were not statistically significant. Focus group interviews with participating physicians identified time pressure and patients’ somatic focus as barriers to recognising depression. Participants also experienced the joint consultations as valuable for strengthening both interprofessional collaboration and the doctor–patient relationship. Overall, the findings illustrate the complexity of managing late-life depression in general practice.

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