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Bilello D, Townsend E, Broome MR, Armstrong G, Burnett Heyes S. Friendships and peer relationships and self-harm ideation and behaviour among young people: a systematic review and narrative synthesis. Lancet Psychiatry 2024; 11:633-657. [PMID: 39025094 DOI: 10.1016/s2215-0366(24)00170-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/03/2024] [Accepted: 05/20/2024] [Indexed: 07/20/2024]
Abstract
Friendships and peer relationships have an important role in the experience of self-harm ideation and behaviour in young people, yet they typically remain overlooked. This systematic review and narrative synthesis explores the extant literature on this topic to identify important relationships between these constructs. We did a keyword search of peer-reviewed empirical articles relating to friendships and peer relationships and self-harm ideation and behaviour in young people (aged 11-25 years). We identified 90 articles with evidence primarily from adolescents aged 11-18 years, including mixed genders and a majority of White individuals. Findings highlight substantive relationships between the key constructs, showing that: characteristics of friends and peers, including their self-harm ideation and behaviour, relate to and predict ego self-harm ideation and behaviour; friends and peers are important sources of support; and evidence on causal mechanisms is scarce but highlights potential peer selection and influence processes. Studies of the friends and peers of young people with self-harm ideation and behaviour highlight that: friends' attitudes to self-harm and suicide influence their responses to peers with self-harm ideation and behaviour; and friends who are bereaved and friend supporters experience negative outcomes such as symptoms of depression, anxiety, PTSD, and grief, alongside difficult emotions. Despite substantial heterogeneity across samples, study designs, and definition or measurement of the primary constructs, this work presents an initial step in organising a complex literature on a crucially important topic, which can help to inform future research and evidence-based interventions.
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Affiliation(s)
- Delfina Bilello
- School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK; Self-Harm Research Group, University of Nottingham, Nottingham, UK.
| | - Ellen Townsend
- Self-Harm Research Group, University of Nottingham, Nottingham, UK
| | - Matthew R Broome
- School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Stephanie Burnett Heyes
- School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK
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Camp J, Durante G, Cooper A, Smith P, Rimes KA. Clinical outcomes for sexual and gender minority adolescents in a dialectical behaviour therapy programme. Behav Cogn Psychother 2024; 52:337-355. [PMID: 38586939 PMCID: PMC7616180 DOI: 10.1017/s135246582400016x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
BACKGROUND Sexuality and gender minoritised (SGM) adolescents are at increased risk of self-injury and suicide, and experience barriers to accessing mental health support. Dialectical behaviour therapy (DBT) is an effective treatment for self-injury and emotion dysregulation in adolescent populations, but few studies have published outcomes of DBT for SGM young people. AIMS This study aimed to investigate treatment outcomes and completion for SGM adolescents and their cisgender and heterosexual peers, in the National & Specialist CAMHS, DBT service (UK). METHOD Treatment completion, and opting out before and during treatment were examined for sexual and gender identity groups, as well as changes by the end of treatment in emotion dysregulation, self-injury, in-patient bed-days, emergency department attendances, and borderline personality disorder, depression and anxiety symptoms. RESULTS SGM adolescents were over-represented in this service, even after considering their increased risk for self-injury. No statistically significant differences were found for treatment completion between the sexual orientation and gender identity groups, although there were patterns indicating possible lower treatment uptake and completion that warrant further investigation. Clinical outcomes for treatment-completers showed improvement by the end of DBT for each group, with few exceptions. DISCUSSION These results are from relatively small subsamples, and it was not possible to separate by sex assigned at birth. Findings should be treated tentatively and as early indications of effect sizes to inform future studies. This study suggests that DBT could be a useful treatment for SGM adolescents in a highly specialist treatment setting.
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Affiliation(s)
- J Camp
- National & Specialist CAMHS, DBT Service, South London & Maudsley NHS Foundation Trust, Micheal Rutter Centre, Maudsley Hospital, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - G Durante
- Department of Psychology, Goldsmiths University of London, Lewisham Way, London, UK
| | - A Cooper
- Department of Psychology, Goldsmiths University of London, Lewisham Way, London, UK
| | - P Smith
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - K A Rimes
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
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Wurm M, Högström J, Tillfors M, Lindståhl M, Norell A. An exploratory study of stressors, mental health, insomnia, and pain in cisgender girls, cisgender boys, and transgender and gender diverse (TGD) youth. Scand J Psychol 2024. [PMID: 38803086 DOI: 10.1111/sjop.13029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 03/28/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Transgender and gender-diverse (TGD) youth experience more stressors and are therefore at a higher risk of health problems compared with their cisgender peers. The aim of this study was to investigate the prevalence of TGD youth in a general population sample and to explore a wide variety of health-related factors. We investigate differences in stressors and health outcomes between TGD youth and cisgender girls and boys and the influence of stressors and demographic factors on health outcome in the whole group. METHODS Cross-sectional survey data from a Swedish school-based study were used (N = 3,067, M = 17.8 years). Those who had reported their gender identity as "other" or other than their assigned gender (N = 41) were compared with cisgendered girls (n = 1,544) and boys (n = 1,482). Regression models in the whole group explored if demographics and stressors statistically predicted health outcomes. RESULTS In comparison with cisgender girls and boys, TGD youth (1.3% of the whole sample) reported a higher prevalence of self-harm and pain problems. Both TGD youth and cisgender girls more frequently reported insomnia, social anxiety, depressive symptoms, pain, and stressors compared with cisgender boys. When only demographic variables were entered, but not when stressors were added to the model, being TGD magnified the odds of depressive symptoms, sub-diagnostic social anxiety, and pain problems. Stressors magnified the odds of reporting health problems for the whole group. CONCLUSION TGD youth generally reported more stressors, which negatively influence health outcomes. Results are important for professionals who meet TGD youth.
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Affiliation(s)
- Matilda Wurm
- School of Behavioural, Social, and Legal Sciences, Örebro University, Örebro, Sweden
| | - Jens Högström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Maria Tillfors
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Miriam Lindståhl
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Annika Norell
- School of Behavioural, Social, and Legal Sciences, Örebro University, Örebro, Sweden
- Department of Health Sciences, Kristianstad University, Kristianstad, Sweden
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Amos N, Hill AO, Lyons A, Bigby C, Carman M, Parsons M, Bourne A. Factors Associated With Experiences of Harassment or Abuse Among Lesbian, Gay, Bisexual, Trans, Queer, and Asexual Young People With Disability in Australia. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:2189-2213. [PMID: 38069494 PMCID: PMC10993630 DOI: 10.1177/08862605231216690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Lesbian, gay, bisexual, trans, queer, and asexual (LGBTQA+) young people with disability are known to experience higher rates of harassment or abuse than LGBTQA+ young people without disability. This study focused on participants in Australia and identified factors associated with harassment or abuse among LGBTQA+ adolescents and young adults who reported a disability as well as associations with mental health outcomes. Analyses were conducted from a national survey that included 2,500 LGBTQA+ people who reported a disability and were aged 14 to 21 years. Measures included experiences in the past 12 months of verbal and physical harassment or abuse due to one's sexual orientation or gender identity, sexual harassment or abuse, mental health, suicidality, and sociodemographic traits. Overall, 48.4% of participants with disability reported experiencing verbal harassment or abuse, 12.4% physical harassment or abuse, and 29.7% sexual assault or harassment. In multivariable regression analyses, verbal harassment or abuse was significantly more likely among trans men, participants with an intellectual disability, and those who were "out" to most or all of their family. Physical harassment or abuse was significantly more likely among participants with a physical or sensory disability. Sexual harassment or abuse was significantly more likely among trans women and participants with a physical or sensory disability. Participants who experienced harassment or abuse were also significantly more likely to have attempted suicide in the past 12 months. These findings will assist policymakers and practitioners in identifying contexts linked to a heightened risk of abuse among LGBTQA+ young people with disability and further underscore an immediate need to address and prevent harm in this population.
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Affiliation(s)
| | - Adam O. Hill
- La Trobe University, Bundoora, VIC, Australia
- St Luke’s International University, Tokyo, Japan
| | | | | | | | | | - Adam Bourne
- La Trobe University, Bundoora, VIC, Australia
- Kirby Institute, UNSW Sydney, Sydney NSW, Australia
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Campbell C, Dodd J, Francetic I. Outcomes for university students following emergency care presentation for deliberate self-harm: a retrospective observational study of emergency departments in England for 2017/2018. BMJ Open 2024; 14:e078672. [PMID: 38320836 PMCID: PMC10860022 DOI: 10.1136/bmjopen-2023-078672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/18/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES Identify university-aged students and contrast their healthcare provision and outcomes with other patients in the same age group attending emergency departments for deliberate self-harm. DESIGN Retrospective cross-sectional observational study. SETTING Patients visiting 129 public hospital emergency departments across England between April 2017 and March 2018. PARTICIPANTS 14 074 patients aged 18-23 visiting emergency departments for conditions linked to deliberate self-harm, 1016 of which were identified as university-aged students. OUTCOME MEASURES We study various outcomes across the entire patient pathway in the emergency department: waiting time to initial assessment on arrival at the emergency department, count of investigations delivered, discharge destination (patients refusing treatment or leave before being seen, referred to another provider or admitted to inpatient care, discharged with no follow-up) and unplanned follow-up visit within 7 days. RESULTS We find a statistically significant difference of 0.262 (-0.491 to -0.0327) less investigations delivered to students compared with non-students (about 8% compared with the baseline number of investigations for non-students). Stratified analyses reveal that this difference is concentrated among students visiting the emergency department outside of regular working hours (-0.485 (-0.850 to -0.120)) and students visiting for repeated deliberate self-harm episodes (-0.881 (-1.510 to -0.252)). Unplanned reattendance within 7 days is lower among students visiting emergency departments during out of hours (-0.0306 (-0.0576 to -0.00363)), while students arriving by ambulance are less likely to be referred to another provider (-0.0708 (-0.140 to -0.00182)) compared with non-students. CONCLUSIONS We find evidence of less-intense investigations being delivered to patients aged 18-23 identified as students compared with non-students visiting emergency departments after an episode of deliberate self-harm. Given the high risk of suicide attempts after episodes of deliberate self-harm among students, our findings may highlight the need for more focused interventions on this group of patients.
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Affiliation(s)
- Catherine Campbell
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
| | - Joe Dodd
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
| | - Igor Francetic
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
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Eisenberg J, Felleman S, Bear B, Mercier R, Kazak AE, Schwartz BI. Psychological Symptoms and Service Utilization in Prepubertal and Pubertal Transgender and Gender-Diverse Patients. J Pediatr Adolesc Gynecol 2024; 37:45-50. [PMID: 37871845 DOI: 10.1016/j.jpag.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 10/25/2023]
Abstract
STUDY OBJECTIVE To describe the demographic characteristics and psychological symptoms of gender-diverse patients and to compare symptoms between prepubertal and pubertal subgroups METHODS: This was a retrospective chart review of all gender-diverse patients seen by at least 1 provider at the Nemours Gender Wellness Program from March 2015 to December 2020. The extracted data included demographic and psychosocial characteristics at baseline and 1-year follow-up visits. Pubertal status was determined by Tanner staging by a pediatric endocrinologist or gynecologist. Descriptive statistics were used to compare these variables between prepubertal and pubertal subgroups. RESULTS Our sample included 177 individuals at baseline and 96 subjects at the 1-year follow-up visit. Most patients were White (83.0%), non-Hispanic (92.0%), transgender male (72.9%), and pubertal (90.4%). Compared with prepubertal patients, at the baseline visit, pubertal patients had significantly higher rates of current (68.1% vs 17.6%, P < .001) and lifetime (80.0% vs 23.5%, P < .001) depressive symptoms, current anxiety symptoms (70.0% vs 41.2%, P = .01), lifetime suicide attempts (12.5% vs 0%, P < .001), and a formal diagnosis of an eating disorder (5.0% vs 0%, P < .001). Symptoms did not change significantly over time from baseline to the 1-year follow-up visit. CONCLUSION We found elevated rates of psychological symptoms and diagnoses in gender-diverse youth, with higher rates in pubertal compared with prepubertal patients. By elucidating how the psychosocial characteristics of gender-diverse children and adolescents differ based on pubertal status, these data can be used to improve current outreach and treatment strategies for transgender pediatric patients.
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Affiliation(s)
- Julia Eisenberg
- Department of Obstetrics & Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sarah Felleman
- Department of Obstetrics & Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Benjamin Bear
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, Delaware
| | - Rebecca Mercier
- Department of Obstetrics & Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, Delaware; Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Beth I Schwartz
- Department of Obstetrics & Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Division of Adolescent Medicine & Pediatric Gynecology, Nemours Children's Health, Wilmington, Delaware.
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Camp J, Morris A, Wilde H, Smith P, Rimes KA. Gender- and Sexuality-Minoritised Adolescents in DBT: A Reflexive Thematic Analysis of Minority-Specific Treatment Targets and Experience. COGNITIVE BEHAVIOUR THERAPIST 2023; 16:s1754470x23000326. [PMID: 38125010 PMCID: PMC7615396 DOI: 10.1017/s1754470x23000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Gender- and sexuality-minoritised (GSM) adolescents are at increased risk of self-harm and suicidal behaviours compared to their cisgender and heterosexual peers. This increased risk is thought to be explained in part by exposure to stigma and societal oppression. Dialectical Behaviour Therapy (DBT) is an evidence-based intervention for self-harm and suicidal behaviour that may have advantages for supporting GSM young people in distress. No study has yet sought to understand what GSM-associated difficulties may be important to consider in DBT for adolescents, or the experiences of GSM young people in a standard DBT programme. Therefore, this study aimed to understand the experiences of GSM young people in DBT and what difficulties and dilemmas associated with their gender and sexuality diversity were thought by them to be important to target in DBT. Qualitative interviews were conducted with 14 GSM young people in a comprehensive DBT programme and were analysed using Reflexive Thematic Analysis. The analysis was supported by two further GSM young people who had finished DBT. The findings were split into three overarching themes (Identity, Impact of Others, and Space for Sexual and Gender Identity in DBT), each with themes within. The identity-based theme included "identity confusion and acceptance"; the relationship-based themes included "cis-Heterosexism" and "community connectedness"; and the space within DBT themes included "negotiating focus and targeting in DBT" and "creating safety in DBT". Findings are discussed in relation to implications and recommendations for therapists working with GSM young people within and outside of DBT.
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Affiliation(s)
- J Camp
- Department of Psychology, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, SE5 8AB
- National & Specialist CAMHS, DBT Service, South London & Maudsley NHS Foundation Trust, Michael Rutter Centre, Maudsley Hospital, London, SE5 8AZ
| | - A Morris
- National & Specialist CAMHS, DBT Service, South London & Maudsley NHS Foundation Trust, Michael Rutter Centre, Maudsley Hospital, London, SE5 8AZ
| | - H Wilde
- National & Specialist CAMHS, DBT Service, South London & Maudsley NHS Foundation Trust, Michael Rutter Centre, Maudsley Hospital, London, SE5 8AZ
| | - P Smith
- Department of Psychology, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, SE5 8AB
| | - K A Rimes
- Department of Psychology, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, SE5 8AB
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McEvoy D, Brannigan R, Cooke L, Butler E, Walsh C, Arensman E, Clarke M. Risk and protective factors for self-harm in adolescents and young adults: An umbrella review of systematic reviews. J Psychiatr Res 2023; 168:353-380. [PMID: 37972513 DOI: 10.1016/j.jpsychires.2023.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/13/2023] [Accepted: 10/13/2023] [Indexed: 11/19/2023]
Abstract
We conducted an umbrella review to synthesise the evidence from systematic reviews and meta-analyses that examined the risk and protective factors for self-harm in young people. We searched six different databases and used the AMSTAR-2 checklist for quality assessment. The importance of each risk and protective factor was determined based on (1) the number of times it was identified by general reviews examining any risk or protective factor, and (2) the effect sizes from meta-analyses. There were 61 systematic reviews included in this review. The most frequently identified risk factors for self-harm in young people included childhood abuse, depression/anxiety, bullying, trauma, psychiatric illnesses, substance use/abuse, parental divorce, poor family relationships, lack of friends, and exposure to self-harm behaviour in others. The risk factors with the strongest evidence for an association with self-harm were behavioural disorders, personality disorders and depression or anxiety. There was a dearth of systematic reviews examining protective factors but good family/friend relationships were most frequently identified. There was also evidence to show that non-suicidal and suicidal self-harm shared many of the same risk factors. Clinicians and other professionals who work with young people should be particularly cognisant of the psychiatric and adverse life event risk factors as well as the substance use, education-related and individual-level (e.g. being LGB) risk factors for self-harm. Knowledge of risk factors for self-harm can potentially be used to inform the design and implementation of prevention measures and further research is needed on the protective factors for self-harm.
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Affiliation(s)
- David McEvoy
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Ross Brannigan
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Lorcan Cooke
- School of Medicine, Royal College of Surgeons Ireland (RCSI), Dublin, 2, Ireland.
| | - Emma Butler
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Cathal Walsh
- Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Ella Arensman
- School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland; National Suicide Research Foundation (NSRF), Western Gateway Building, University College Cork, Ireland.
| | - Mary Clarke
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
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Marconi E, Monti L, Marfoli A, Kotzalidis GD, Janiri D, Cianfriglia C, Moriconi F, Costa S, Veredice C, Sani G, Chieffo DPR. A systematic review on gender dysphoria in adolescents and young adults: focus on suicidal and self-harming ideation and behaviours. Child Adolesc Psychiatry Ment Health 2023; 17:110. [PMID: 37735422 PMCID: PMC10515052 DOI: 10.1186/s13034-023-00654-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/30/2023] [Indexed: 09/23/2023] Open
Abstract
INTRODUCTION Gender dysphoria (GD) is characterized by the incongruence between one's experienced and expressed gender and assigned-sex-at-birth; it is associated with clinically significant distress. In recent years, the number of young patients diagnosed with GD has increased considerably. Recent studies reported that GD adolescents present behavioural and emotional problems and internalizing problems. Furthermore, this population shows a prevalence of psychiatric symptoms, like depression and anxiety. Several studies showed high rates of suicidal and non-suicidal self-injurious thoughts and behaviour in GD adolescents. To increase understanding of overall mental health status and potential risks of young people with GD, this systematic review focused on risk of suicide and self-harm gestures. METHODS We followed the PRISMA 2020 statement, collecting empirical studies from four electronic databases, i.e., PubMed, Scopus, PsycINFO, and Web of Science. RESULTS Twenty-one studies on GD and gender nonconforming identity, suicidality, and self-harm in adolescents and young adults met inclusion criteria. Results showed that GD adolescents have more suicidal ideation, life-threatening behaviour, self-injurious thoughts or self-harm than their cisgender peers. Assessment methods were heterogeneous. CONCLUSION A standardised assessment is needed. Understanding the mental health status of transgender young people could help develop and provide effective clinical pathways and interventions.
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Affiliation(s)
- Elisa Marconi
- Clinical Psychology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168, Rome, Italy.
| | - Laura Monti
- Clinical Psychology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168, Rome, Italy
| | - Angelica Marfoli
- Catholic University of the Sacred Heart-Rome, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Georgios D Kotzalidis
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), University of Rome "La Sapienza", Via Di Grottarossa1035-1039, 00198, Rome, Italy
- Department of Psychiatry, Department of Neuroscience, Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168, Rome, Italy
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Heart-Rome, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Delfina Janiri
- Department of Psychiatry, Department of Neuroscience, Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168, Rome, Italy
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Heart-Rome, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Cecilia Cianfriglia
- Catholic University of the Sacred Heart-Rome, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Federica Moriconi
- Clinical Psychology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168, Rome, Italy
| | - Stefano Costa
- UOSD Operative Unit Psychiatry and Psychotherapy for Adolescents, Azienda USL Di Bologna, Ospedale MaggioreLargo Bartolo Nigrisoli, 2, 40133, Bologna, Italy
| | - Chiara Veredice
- Pediatric Neuropsychiatry Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Department of Neuroscience, Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168, Rome, Italy
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Heart-Rome, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- Clinical Psychology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168, Rome, Italy
- Departement of Life Sciences and Public Health Department, Catholic University of Sacred Heart, 00168, Rome, Italy
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Corlett S, Stutterheim SE, Whiley LA. “I only wanted one thing and that was to be who I am now”: Being a trans young adult and (re)negotiating vocational identity. GENDER WORK AND ORGANIZATION 2023. [DOI: 10.1111/gwao.12976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Sara Corlett
- Department of Social Psychology Faculty of Psychology Universidad de Sevilla Sevilla Spain
- Department of Health Promotion & Care and Public Health Institute Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht The Netherlands
| | - Sarah E. Stutterheim
- Department of Health Promotion & Care and Public Health Institute Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht The Netherlands
| | - Lilith A. Whiley
- Department of Management University of Sussex Business School University of Sussex Brighton UK
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Pawer S, Rajabali F, Zheng A, Smith J, Purssell R, Pike I. Analyses of Child and Youth Self-Poisoning Hospitalizations by Substance and Socioeconomic Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137003. [PMID: 34208955 PMCID: PMC8297021 DOI: 10.3390/ijerph18137003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 11/27/2022]
Abstract
Child and youth self-poisoning is a growing public health issue in many regions of the world, including British Columbia (BC), Canada, where 15–19-year-olds have the highest rates of self-poisoning hospitalizations compared with those of all other ages. The purpose of this study was to identify what substances children and youth commonly used to poison themselves in BC and how socioeconomic status may impact self-poisoning risk. Self-poisoning hospitalization rates among 10–14 and 15–19-year-olds from 1 April 2012 to 31 March 2020 were calculated by substance using ICD-10-CA codes X60-X69 and T36-T65, as well as by socioeconomic status using the Institut National de Santé Publique du Québec’s Deprivation Index. Nonopioid analgesics, antipyretics, and antirheumatics were the most common substances involved, with rates of 27.6 and 74.3 per 100,000 population among 10–14 and 15–19-year-olds, respectively, followed by antiepileptic, sedative–hypnotic, antiparkinsonism, and psychotropic drugs, with rates of 20.2 and 68.1 per 100,000 population among 10–14 and 15–19-year-olds, respectively. In terms of socioeconomic status, rates were highest among 10–19-year-olds living in neighbourhoods with the fewest social connections (243.7 per 100,000 population). These findings can inform poisoning prevention strategies and relevant policies, thereby reducing the number of self-poisoning events among children and youth.
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Affiliation(s)
- Samantha Pawer
- BC Injury Research and Prevention Unit, BC Children’s Hospital, Vancouver, BC V6H 3V4, Canada; (S.P.); (A.Z.); (J.S.); (I.P.)
| | - Fahra Rajabali
- BC Injury Research and Prevention Unit, BC Children’s Hospital, Vancouver, BC V6H 3V4, Canada; (S.P.); (A.Z.); (J.S.); (I.P.)
- Correspondence: ; Tel.: +1-604-875-3572
| | - Alex Zheng
- BC Injury Research and Prevention Unit, BC Children’s Hospital, Vancouver, BC V6H 3V4, Canada; (S.P.); (A.Z.); (J.S.); (I.P.)
| | - Jennifer Smith
- BC Injury Research and Prevention Unit, BC Children’s Hospital, Vancouver, BC V6H 3V4, Canada; (S.P.); (A.Z.); (J.S.); (I.P.)
| | - Roy Purssell
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada;
- British Columbia Drug and Poison Information Centre, BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, BC V5Z 4R4, Canada
| | - Ian Pike
- BC Injury Research and Prevention Unit, BC Children’s Hospital, Vancouver, BC V6H 3V4, Canada; (S.P.); (A.Z.); (J.S.); (I.P.)
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada
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12
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Williams AJ, Jones C, Arcelus J, Townsend E, Lazaridou A, Michail M. A systematic review and meta-analysis of victimisation and mental health prevalence among LGBTQ+ young people with experiences of self-harm and suicide. PLoS One 2021; 16:e0245268. [PMID: 33481862 PMCID: PMC7822285 DOI: 10.1371/journal.pone.0245268] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND LGBTQ+ youth have higher rates of self-harm and suicide than cisgender, heterosexual peers. Less is known about prevalence of risks within these populations. OBJECTIVES The first systematic review and meta-analysis to investigate the prevalence of risks among young people throughout the LGBTQ+ umbrella with experiences across the dimension of self-harm, suicidal ideation and suicide behaviour; and how they may differ between LGBTQ+ umbrella groups. DATA SOURCES MEDLINE, Scopus, EMBASE, PsycINFO, and Web of Science searches were run to identify quantitative research papers (database inception to 31st January, 2020). STUDY ELIGIBILITY CRITERIA Articles included were empirical quantitative studies, which examined risks associated with self-harm, suicidal ideation or suicidal behaviour in LGBTQ+ young people (12-25 years). SYNTHESIS METHODS 2457 articles were identified for screening which was completed by two independent reviewers. 104 studies met inclusion criteria of which 40 had data which could be meta-analysed in a meaningful way. This analysis represents victimisation and mental health difficulties as risks among LGBTQ+ youth with self-harm and suicide experiences. Random-effects modelling was used for the main analyses with planned subgroup analyses. RESULTS Victimisation and mental health were key risk factors across the dimension self-harm and suicide identified through all analyses. A pooled prevalence of 0.36 was indicated for victimisation and 0.39 for mental health difficulties within LGBTQ+ young people with experiences of self-harm or suicide. Odds ratios were calculated which demonstrated particularly high levels of victimisation (3.74) and mental health difficulties (2.67) when compared to cisgender, heterosexual counterparts who also had these experiences. CONCLUSIONS Victimisation and mental health difficulties are highly prevalent among LGBTQ+ youth with experiences of self-harm and suicide. Due to inconsistency of reporting, further risk synthesis is limited. Given the global inclusion of studies, these results can be considered across countries and inform policy and suicide prevention initiatives. PROSPERO REGISTRATION NUMBER CRD42019130037.
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Affiliation(s)
- A. Jess Williams
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
- School of Psychology, Self-Harm Research Group, University of Nottingham, Nottingham, United Kingdom
| | - Christopher Jones
- School of Psychology, Centre for Applied Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Jon Arcelus
- School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Ellen Townsend
- School of Psychology, Self-Harm Research Group, University of Nottingham, Nottingham, United Kingdom
| | - Aikaterini Lazaridou
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Maria Michail
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
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13
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Self-Injurious Thoughts and Behaviors Among Sexual and Gender Minority Youth: a Systematic Review of Recent Research. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00295-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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14
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Aldridge Z, Patel S, Guo B, Nixon E, Pierre Bouman W, Witcomb GL, Arcelus J. Long‐term effect of gender‐affirming hormone treatment on depression and anxiety symptoms in transgender people: A prospective cohort study. Andrology 2020; 9:1808-1816. [DOI: 10.1111/andr.12884] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/27/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Zoë Aldridge
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
- School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK
| | - Shireen Patel
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
| | - Boliang Guo
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
| | - Elena Nixon
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
| | - Walter Pierre Bouman
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
- Nottingham Centre for Transgender Health Nottingham UK
| | | | - Jon Arcelus
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
- Nottingham Centre for Transgender Health Nottingham UK
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15
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Zucker KJ. Adolescents with Gender Dysphoria: Reflections on Some Contemporary Clinical and Research Issues. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1983-1992. [PMID: 31321594 DOI: 10.1007/s10508-019-01518-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 05/07/2023]
Abstract
This article provides an overview of five contemporary clinical and research issues pertaining to adolescents with a diagnosis of gender dysphoria: (1) increased referrals to specialized gender identity clinics; (2) alteration in the sex ratio; (3) suicidality; (4) "rapid-onset gender dysphoria" (ROGD) as a new developmental pathway; (5) and best practice clinical care for adolescents who may have ROGD.
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Affiliation(s)
- Kenneth J Zucker
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.
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