医院环境中变性青少年的心理健康诊断和自杀倾向。

IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
LGBT health Pub Date : 2024-07-17 DOI:10.1089/lgbt.2023.0394
Marissa Nunes-Moreno, Anna Furniss, Samuel Cortez, Shanlee M Davis, Nadia Dowshen, Anne E Kazak, Leena Nahata, Laura Pyle, Daniel H Reirden, Beth Schwartz, Gina M Sequeira, Natalie J Nokoff
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引用次数: 0

摘要

目的:本分析旨在1)描述变性和性别多元化(TGD)青年与匹配对照组相比,在急诊科(ED)和住院病人中最常见的心理健康诊断;2)评估性别确认激素疗法(GAHT)或促性腺激素释放激素激动剂(GnRHa)处方是否会降低这些情况下的自杀风险。研究方法利用 PEDSnet 数据集(2009-2019 年),将 8-18 岁的 TGD 青少年(n = 3414,最后一次就诊时的中位年龄为 16.2 [14.4, 17.7]岁)与对照组(n = 13628,年龄为 16.6 [14.2, 18.3]岁)进行倾向得分匹配。与对照组相比,计算了TGD青少年在急诊室和住院环境中最常见精神健康诊断的相对风险。采用重复时间到事件分析法研究 GAHT 或 GnRHa 是否会降低 TGD 青少年子样本的自杀风险。结果显示与匹配的对照组相比,TGD 青少年在急诊室(5.46 [4.71-6.33] )和住院环境(6.61 [5.28-8.28] )中被诊断为精神疾病和自杀的相对风险(95% 置信区间 [CI])更高。与研究期间或开始使用 GAHT 之前从未使用过 GAHT 的 TGD 青少年相比,使用 GAHT 的 TGD 青少年的自杀风险降低了 43.6%(危险比 [HR] = 0.564 [95% CI 0.36-0.89])。与从未接受过 GnRHa 治疗的人群相比,接受过 GnRHa 治疗的 TGD 青少年的 ED 或住院自杀诊断率在统计学上有显著下降(HR = 0.79 [0.47-1.31])。结论:尽管TGD青少年在急诊室和住院环境中的精神健康诊断和自杀风险很高,但GAHT处方与自杀风险的显著降低有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mental Health Diagnoses and Suicidality Among Transgender Youth in Hospital Settings.

Purpose: The purpose of this analysis is to: 1) describe the most common mental health diagnoses in the emergency department (ED) and inpatient hospital settings among transgender and gender diverse (TGD) youth vs. matched controls and 2) evaluate if a gender-affirming hormone therapy (GAHT) or gonadotropin-releasing hormone agonist (GnRHa) prescription decreased the risk of suicidality within these settings. Methods: Using the PEDSnet dataset (years 2009-2019), TGD youth aged 8-18 (n = 3414, with a median age at last visit of 16.2 [14.4, 17.7] years, were propensity-score matched to controls (n = 13,628, age 16.6 [14.2, 18.3] years). Relative risks of the most common mental health diagnoses within ED and inpatient settings were calculated for TGD youth compared with controls. Recurrent time-to-event analysis was used to examine whether GAHT or GnRHa attenuated the risk of suicidality among subsamples of TGD youth. Results: TGD youth had a higher relative risk (95% confidence interval [CI]) of mental health diagnoses and suicidality in the ED (5.46 [4.71-6.33]) and inpatient settings (6.61 [5.28-8.28]) than matched controls. TGD youth prescribed GAHT had a 43.6% lower risk of suicidality (hazard ratio [HR] = 0.564 [95% CI 0.36-0.89]) compared with those never prescribed GAHT during our study period or before GAHT initiation. TGD youth who were prescribed GnRHa therapy had a nonstatistically significant reduction in ED or inpatient suicidality diagnoses compared with those never prescribed GnRHa (HR = 0.79 [0.47-1.31]). Conclusion: Although risk of mental health diagnoses and suicidality in ED and inpatient settings was high among TGD youth, a GAHT prescription was associated with a significant reduction in suicidality risk.

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来源期刊
LGBT health
LGBT health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
6.60
自引率
6.20%
发文量
80
期刊介绍: LGBT Health is the premier peer-reviewed journal dedicated to promoting optimal healthcare for millions of sexual and gender minority persons worldwide by focusing specifically on health while maintaining sufficient breadth to encompass the full range of relevant biopsychosocial and health policy issues. This Journal aims to promote greater awareness of the health concerns particular to each sexual minority population, and to improve availability and delivery of culturally appropriate healthcare services. LGBT Health also encourages further research and increased funding in this critical but currently underserved domain. The Journal provides a much-needed authoritative source and international forum in all areas pertinent to LGBT health and healthcare services. Contributions from all continents are solicited including Asia and Africa which are currently underrepresented in sex research.
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