Clinical Outcomes Following Acute Residential Psychiatric Treatment in Transgender and Gender Diverse Adolescents
| العنوان: | Clinical Outcomes Following Acute Residential Psychiatric Treatment in Transgender and Gender Diverse Adolescents |
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| المؤلفون: | Maya Rieselbach, Ariel Sternberg, Julia E. Cohen-Gilbert, Kathryn Dingman Boger, Eleanor M. Schuttenberg, Elena R. Stein, Sabra L. Katz-Wise, Kaya Schmandt, Jessica E. Feinberg, Chad M. McWhinnie, Jennifer Urbano Blackford, Dana B Sarvey, Alexandra Potter, Mona P. Potter, Marisa M. Silveri |
| المصدر: | JAMA Network Open |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Hospitals, Psychiatric, Male, medicine.medical_specialty, Adolescent, Transgender Persons, Transgender, Medicine, Humans, Psychological abuse, Psychiatry, Residential Treatment, Depression (differential diagnoses), Original Investigation, business.industry, Research, General Medicine, Center for Epidemiologic Studies Depression Scale, Emotional dysregulation, Mental health, Online Only, Treatment Outcome, Adolescent Behavior, Anxiety, Female, medicine.symptom, business, Cohort study |
| الوصف: | Key Points Question Do transgender and gender diverse adolescents enrolled in acute residential treatment enter the program with worse psychiatric symptoms and do they remain worse after treatment, relative to cisgender adolescents? Findings In this cohort study of 200 adolescents who participated in a 2-week acute residential treatment program for psychiatric disorders, the transgender and gender diverse group exhibited significantly worse symptoms at treatment entry relative to the cisgender group. Both groups had fewer depressive and anxiety symptoms and less emotional dysregulation at treatment discharge. Meaning These findings suggest that clinical attention should focus on mental health disparities in transgender and gender diverse youth to optimize treatment approaches for this minority population. This cohort study examines mental health outcomes before and after acute residential psychiatric treatment among adolescents who are transgender and gender diverse vs cisgender. Importance Transgender and gender diverse (TGD) individuals, who have a gender identity that differs from their sex assigned at birth, are at increased risk of mental health problems, including depression, anxiety, self-injurious behavior, and suicidality, relative to cisgender peers. Objective To examine mental health outcomes among TGD vs cisgender adolescents in residential treatment. Design, Setting, and Participants This cohort study’s longitudinal design was used to compare groups at treatment entry and discharge, and 1-month postdischarge follow-up. The setting was an adolescent acute residential treatment program for psychiatric disorders. Participants were TGD or cisgender adolescents enrolled in the treatment program. Statistical analysis was performed October 2019 to March 2021. Exposure Adolescents participated in a 2-week acute residential treatment program for psychiatric disorders. Main Outcomes and Measures Primary outcomes were depressive (the Center for Epidemiologic Studies Depression Scale [CES-D]) and anxiety (the Multidimensional Anxiety Scale for Children [MASC]) symptoms, and emotional dysregulation (the Difficulties in Emotion Regulation Scale [DERS]), measured at treatment entry and discharge, and postdischarge follow-up. Age of depression onset, suicidality, self-injury, and childhood trauma also were assessed at treatment entry. Results Of 200 adolescent participants who completed treatment entry and discharge assessments, the mean (SD) age was 16.2 (1.5) years; 109 reported being assigned female at birth (54.5%), 35 were TGD (17.5%), and 66 (49.3%) completed 1-month follow-up. TGD participants had an earlier mean (SD) age of depression onset (TGD: 10.8 [2.4] years vs cisgender: 11.9 [2.3] years; difference: 1.07 years; 95% CI, 0.14-2.01 years; P = .02), higher mean (SD) suicidality scores (TGD: 44.4 [23.1] vs cisgender: 28.5 [25.4]; difference: 16.0; 95% CI, 6.4-25.5; P = .001), more self-injurious behavior (mean [SD] RBQ-A score for TGD: 3.1 [2.5] vs cisgender: 1.7 [1.9]; difference: 1.42; 95% CI, 0.69-2.21; P = .001) and more childhood trauma (eg, mean [SD] CTQ-SF score for emotional abuse in TGD: 12.7 [5.4] vs cisgender: 9.8 [4.7]; difference: 2.85; 95% CI, 1.06-4.64; P = .002). The TGD group also had higher symptom scores (CES-D mean difference: 7.69; 95% CI, 3.30 to 12.08; P |
| تدمد: | 2574-3805 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c879dde1fac33b7f7cc09310c95f423c https://pubmed.ncbi.nlm.nih.gov/34152417 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....c879dde1fac33b7f7cc09310c95f423c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 25743805 |
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