Gender dysphoria and psychiatric comorbidities in childhood: a systematic review

IF 3.6 4区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY
Tabitha Frew, C. Watsford, Iain Walker
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引用次数: 6

Abstract

ABSTRACT Objective: To appraise the methodological quality of studies on the prevalence of psychiatric comorbidities for children presenting with gender dysphoria, including diagnosis and management. Study design: A systematic review of 15 articles on psychiatric comorbidities for children diagnosed with gender dysphoria between the ages of two – 12 years. Data sources: A systematic literature search of Medline, PsychINFO, CINAHL, Scopus and Web of Science for English-only studies published from 1980 to 2019, supplemented by other sources. Of 736 studies, 721 were removed following title, abstract or full-text review. Results: Ten studies were retrospectively-oriented clinical case series or observational studies. There were few randomised, controlled trials. Over 80% of the data came from gender clinics in the United States and the Netherlands. Funding or conflicts of interest were often not declared. Mood and anxiety disorders were the most common psychiatric conditions studied. There was little research on complex comorbidities. One quarter of studies made a diagnosis by a comprehensive psychological assessment. A wide range of psychological tests was used for screening or diagnostic purposes. Over half of the studies diagnosed gender dysphoria using evidence-based criteria. A quarter of the studies mentioned treating serious psychopathology prior to addressing gender dysphoria. KEY POINTS What is already known about this topic: Children with gender dysphoria are likely to experience profound psychological and physical difficulties. Gender clinics around the world have different ways of assessing and treating children with gender dysphoria. Children often rely on caregivers and health professionals to make treatment decisions on their behalf. What this topic adds: Children with gender dysphoria often experience a range of psychiatric comorbidities, with a high prevalence of mood and anxiety disorders, trauma, eating disorders and autism spectrum conditions, suicidality and self-harm. It is vitally important to consider psychiatric comorbidities when prioritising and sequencing treatments for children with gender dysphoria. The development of international treatment guidelines would provide greater consistency across diagnosis, treatment and ongoing management.
儿童性别焦虑症与精神病合并症:一项系统综述
摘要目的:评估儿童性别焦虑症精神合并症患病率研究的方法学质量,包括诊断和治疗。研究设计:对15篇关于2至12岁被诊断为性别焦虑症儿童的精神病合并症的文章进行系统综述。数据来源:对Medline、PsychINFO、CINAHL、Scopus和Web of Science 1980年至2019年发表的纯英语研究进行系统的文献检索,并辅以其他来源。在736项研究中,721项在标题、摘要或全文审查后被删除。结果:10项研究为回顾性临床病例系列或观察性研究。很少有随机对照试验。超过80%的数据来自美国和荷兰的性别诊所。资金或利益冲突往往没有申报。情绪和焦虑障碍是研究中最常见的精神疾病。关于复杂合并症的研究很少。四分之一的研究通过全面的心理评估做出了诊断。广泛的心理测试被用于筛查或诊断目的。超过一半的研究使用循证标准诊断性别焦虑症。四分之一的研究提到在解决性别焦虑之前治疗严重的精神病理学。关键点关于这个话题已经知道的是:患有性别焦虑症的儿童可能会经历深刻的心理和身体困难。世界各地的性别诊所有不同的方法来评估和治疗患有性别焦虑症的儿童。儿童通常依靠照顾者和卫生专业人员代表他们做出治疗决定。本主题补充道:患有性别焦虑症的儿童通常会经历一系列精神合并症,情绪和焦虑障碍、创伤、饮食障碍和自闭症谱系疾病、自杀和自残的患病率很高。在对患有性别焦虑症的儿童进行优先治疗和排序时,考虑精神合并症至关重要。国际治疗指南的制定将在诊断、治疗和持续管理方面提供更大的一致性。
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来源期刊
Australian Journal of Psychology
Australian Journal of Psychology PSYCHOLOGY, MULTIDISCIPLINARY-
CiteScore
5.50
自引率
0.00%
发文量
19
期刊介绍: Australian Journal of Psychology is the premier scientific journal of the Australian Psychological Society. It covers the entire spectrum of psychological research and receives articles on all topics within the broad scope of the discipline. The journal publishes high quality peer-reviewed articles with reviewers and associate editors providing detailed assistance to authors to reach publication. The journal publishes reports of experimental and survey studies, including reports of qualitative investigations, on pure and applied topics in the field of psychology. Articles on clinical psychology or on the professional concerns of applied psychology should be submitted to our sister journals, Australian Psychologist or Clinical Psychologist. The journal publishes occasional reviews of specific topics, theoretical pieces and commentaries on methodological issues. There are also solicited book reviews and comments Annual special issues devoted to a single topic, and guest edited by a specialist editor, are published. The journal regards itself as international in vision and will accept submissions from psychologists in all countries.
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