Behavioral Health Diagnoses in Youth with Differences of Sex Development or Congenital Adrenal Hyperplasia Compared with Controls: A PEDSnet Study.
Behavioral Health Diagnoses in Youth with Differences of Sex Development or Congenital Adrenal Hyperplasia Compared with Controls: A PEDSnet Study.
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DOI：
10.1016/j.jpeds.2021.08.066
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Nokoff NJ
中科院分区：
文献类型：
--
作者：
Sewell R;Buchanan CL;Davis S;Christakis DA;Dempsey A;Furniss A;Kazak AE;Kerlek AJ;Magnusen B;Pajor NM;Pyle L;Pyle LC;Razzaghi H;Schwartz BI;Vogiatzi MG;Nokoff NJ
评估与PEDSnet数据库中匹配的对照组相比，性发育差异（DSD）或先天性肾上腺皮质增生（CAH）的青少年行为健康诊断的几率。从PEDSnet数据库中提取所有诊断为DSD（n= 1，216）或CAH（n= 1，647）和至少一次门诊就诊的年轻人，并使用多变量logistic回归将8个变量（1：4）与对照组（分别为n= 4，864和6，588）的倾向评分匹配。行为健康诊断的可能性进行了检查，使用广义估计方程。与匹配的对照组相比，患有DSD的青少年有更高的行为健康诊断（OR：1.7 [95% CI：1.4，2.1]，p<0.0001）和神经发育诊断（1.7 [95% CI：1.4，2.0]，P <0.0001）的几率。与匹配的对照组相比，患有CAH的青少年没有增加行为健康诊断的几率（1.0 [95% CI：0.9，1.1]，p=0.9），但发育迟缓的几率更高（1.8 [95% CI：1.4，2.4]，p<0.0001）。与匹配的对照组相比，患有DSD诊断的青少年有更高的行为健康或神经发育诊断的几率。患有CAH的青少年有更高的发育迟缓几率，这突出了两组筛查的必要性。
To evaluate the odds of a behavioral health diagnosis among youth with a difference of sex development (DSD) or congenital adrenal hyperplasia (CAH) compared with matched controls in the PEDSnet database. All youth with a diagnosis of DSD (n=1,216) or CAH (n=1,647) and at least one outpatient encounter were extracted from the PEDSnet database and propensity-score matched on 8 variables (1:4) to controls (n=4,864 and 6,588, respectively) using multivariable logistic regression. The likelihood of having behavioral health diagnoses was examined using generalized estimating equations. Youth with a DSD had higher odds of a behavioral health diagnosis (OR: 1.7 [95% CI: 1.4, 2.1], p<0.0001) and neurodevelopmental diagnosis (1.7 [95% CI: 1.4, 2.0], P < .0001 compared with matched controls. Youth with CAH did not have increased odds of a behavioral health diagnosis (1.0 [95% CI: 0.9, 1.1], p=0.9) compared with matched controls but did have higher odds of developmental delay (1.8 [95% CI: 1.4, 2.4], p<0.0001). Youth with a DSD diagnosis have higher odds of a behavioral health or neurodevelopmental diagnosis compared with matched controls. Youth with CAH have a higher odds of developmental delay, highlighting the need for screening in both groups.
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