Behavioral Health Diagnoses in Youth with Gender Dysphoria Compared with Controls: A PEDSnet Study.
Behavioral Health Diagnoses in Youth with Gender Dysphoria Compared with Controls: A PEDSnet Study.
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DOI：
10.1016/j.jpeds.2021.09.032
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Nokoff NJ
中科院分区：
文献类型：
--
作者：
Nunes-Moreno M;Buchanan C;Cole FS;Davis S;Dempsey A;Dowshen N;Furniss A;Kazak AE;Kerlek AJ;Margolis P;Pyle L;Razzaghi H;Reirden DH;Schwartz B;Sequeira GM;Nokoff NJ
为了评估与来自六个儿科卫生系统的大型电子健康记录数据集中的匹配对照相比，诊断为性别焦虑的青少年中精神或神经发育诊断的几率，PEDSnet。我们假设，与对照组相比，患有性别焦虑症的青少年有更高的精神和神经发育诊断的几率。从PEDSnet数据库中提取所有诊断为性别焦虑的青少年（n= 4，173，末次访视时年龄16.2 ± 3.4）和至少一次门诊就诊，并使用多变量logistic回归将8个变量的倾向评分与无性别焦虑的对照组（n= 16，648，末次访视时年龄16.2 ± 4.8）匹配。使用广义估计方程检查了精神病和神经发育诊断的几率。患有性别焦虑的青少年有更高的精神病（OR：4.0 [95%CI：3.8，4.3] p<0.0001）和神经发育诊断（1.9 [1.7，2.0]，p<0.0001）的几率。患有性别焦虑的青年更有可能在所有精神障碍子类别中得到诊断，特别是情绪障碍（7.3 [6.8，7.9]，p<0.0001）和焦虑（5.5 [5.1，5.9]，p<0.0001）的几率特别高。有性别焦虑的青少年患自闭症谱系障碍的几率更大（2.6，[2.2，3.0]，p<0.0001）。在大型儿科卫生系统中，与没有性别焦虑的青少年相比，患有性别焦虑的青少年有更大的精神病和几种神经发育诊断的可能性。需要进一步的研究来评估随着时间的推移，获得性别肯定护理的心理健康变化。
To assess the odds of a psychiatric or neurodevelopmental diagnosis among youth with a diagnosis of gender dysphoria compared to matched controls in a large electronic health record dataset from six pediatric health systems, PEDSnet. We hypothesized that youth with gender dysphoria would have higher odds of having psychiatric and neurodevelopmental diagnoses than controls. All youth with a diagnosis of gender dysphoria (n=4,173 age at last visit 16.2 ± 3.4) and at least one outpatient encounter were extracted from the PEDSnet database and propensity-score matched on 8 variables to controls without gender dysphoria (n=16,648, age at last visit 16.2 ± 4.8) using multivariable logistic regression. The odds of having psychiatric and neurodevelopmental diagnoses were examined using generalized estimating equations. Youth with gender dysphoria had higher odds of psychiatric (OR: 4.0 [95% CI: 3.8, 4.3] p<0.0001) and neurodevelopmental diagnoses (1.9 [1.7, 2.0], p<0.0001). Youth with gender dysphoria were more likely to have a diagnosis across all psychiatric disorder sub-categories, with particularly high odds of mood disorder (7.3 [6.8, 7.9], p<0.0001) and anxiety (5.5 [5.1, 5.9], p<0.0001). Youth with gender dysphoria had a greater odds of autism spectrum disorder (2.6, [2.2, 3.0], p<0.0001). Youth with gender dysphoria at large pediatric health systems have greater odds of psychiatric and several neurodevelopmental diagnoses compared to youth without gender dysphoria. Further studies are needed to evaluate changes in mental health over time with access to gender affirming care.
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影响因子：
3.9
作者：
de Vries, Annelou L. C.;Noens, Ilse L. J.;Cohen-Kettenis, Peggy T.;van Berckelaer-Onnes, Ina A.;Doreleijers, Theo A.
通讯作者：
Doreleijers, Theo A.
影响因子：
4.9
作者：
Almeida, Joanna;Johnson, Renee M.;Corliss, Heather L.;Molnar, Beth E.;Azrael, Deborah
通讯作者：
Azrael, Deborah
DOI：
10.1016/j.jaac.2016.10.016
发表时间：
2017-02-01
影响因子：
13.3
作者：
Durwood, Lily;McLaughlin, Katie A.;Olson, Kristina R.
通讯作者：
Olson, Kristina R.
影响因子：
3.9
作者：
Heylens, Gunter;Aspeslagh, Lore;Elaut, Els
通讯作者：
Elaut, Els
影响因子：
2
作者：
Austin, Peter C.
通讯作者：
Austin, Peter C.