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Mental Health of a Large Group of Adults With Disorders of Sex Development in Six European Countries.
Psychosom Med. 2019 Jun 19;:
Authors: de Vries ALC, Roehle R, Marshall L, Frisén L, van de Grift TC, Kreukels BPC, Bouvattier C, Köhler B, Thyen U, Nordenström A, Rapp M, Cohen-Kettenis PT, dsd-LIFE group.
Abstract
OBJECTIVE: To evaluate psychiatric symptomatology among 1022 persons with various disorders of sex development (DSD).
METHODS: The study was a European multicenter cross-sectional clinical evaluation in six countries (dsd-LIFE). The mean age of participants was 32.1 years (SD 13.4). The cohort consisted of 325 individuals with Turner Syndrome, 219 individuals with Klinefelter syndrome (KS), females with various XY-DSD conditions 107 with and 67 without androgenisation, 87 males with XY-DSD conditions and 221 females with congenital adrenal hyperplasia. The Hospital Anxiety and Depression Scale, the Short Autism Spectrum Quotient, the Adult Attention Deficit Hyperactivity Disorder Self-Report Scale, and self-reported mental health history were used to assess psychiatric symptomatology.
RESULTS: Across the six DSD diagnostic groups, clinical cutoff symptom scores were reached in 19.5% of participants for anxiety, in 7.1% for depression, in 4.1% for ADHD, and in 9.1% for autism. Mean depression and anxiety scores were higher compared to population norms in males with KS and males with XY-DSD. Compared to participants with other DSD conditions, men with KS reported significantly more mental health symptoms. Self-esteem, satisfaction with care, body dissatisfaction and experiences of shame were associated with psychiatric symptomatology in many DSD conditions.
CONCLUSION: A substantial minority of adults with DSD, with KS in particular, suffers from psychiatric morbidity. Across DSD conditions adults may share feelings of shame. Developing a positive self-esteem and body image may be challenging. Multidisciplinary DSD care that involves specialized mental health support can be of important value.
TRIAL REGISTRATION: German Clinical Trials Register DRKS00006072.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
PMID: 31232913 [PubMed – as supplied by publisher]
via https://www.ncbi.nlm.nih.gov/pubmed/31232913?dopt=Abstract