背景:先前的研究提供了关于精神病合并症与性别不一致(GI)个体的生殖器性别确认手术(GGAS)之间关系的混合证据。
目的:本研究旨在调查GI人群中GGAS后的精神病合并症发生率,即抑郁症,焦虑症,创伤后应激障碍,药物滥用障碍,和自杀。
方法:基于TriNetX医疗保健数据库,一个拥有超过2.5亿患者的国际数据库,我们进行了一项横断面研究,比较有和无GGAS的GI患者的精神病合并症发生率.个体在人口统计和健康相关变量上进行匹配,其中包括心血管疾病史,糖尿病,和肥胖。
结果:主要重点是确定GGAS后精神病合并症的发生率和变化。
结果:在患有GI的个体中,该研究确定了4061个GGAS和100097个无GGAS。在GGAS后1年,抑郁症显著降低(比值比[OR],0.748;95%CI,0.672-0.833;P<0.0001),焦虑(或,0.730;95%CI,0.658-0.810;P<0.0001),物质使用障碍(或,0.730;95%CI,0.658-0.810;P<0.0001),和自杀(或,0.530;95%CI,0.425-0.661;P<.0001),这些减少在5年后得到了维持或改善,包括创伤后应激障碍(OR,0.831;95%CI,0.704-0.981;P=0.028)。
结论:研究结果表明,GGAS可能在减少胃肠道患者的精神合并症中起关键作用。
■这是评估GGAS对GI人群精神病合并症影响的最大的已知研究,提供有力的证据。由于潜在的编码不准确,对用于数据提取的CPT和ICD-10码的精度的依赖造成了限制。
结论:证据表明GGAS与GI患者精神病合并症减少之间存在显著关联。
Previous studies present mixed evidence on the relationship between psychiatric comorbidities and genital gender-affirming surgery (GGAS) in individuals with gender incongruence (GI).
This research aims to investigate the psychiatric comorbidity rates post-GGAS in the GI population-namely, depressive disorders, anxiety disorders, posttraumatic stress disorders, substance abuse disorder, and suicidality.
Based on the TriNetX health care database, an international database with >250 million patients, a cross-sectional study was executed comparing psychiatric comorbidity rates among cases of GI with and without GGAS. Individuals were matched for demographic and health-related variables, which included history of cardiovascular disease, diabetes, and obesity.
The main focus was to establish the rates and changes in psychiatric comorbidities following GGAS.
Among individuals with GI, the study identified 4061 with GGAS and 100 097 without. At 1 year post-GGAS, there was a significant decrease in depression (odds ratio [OR], 0.748; 95% CI, 0.672-0.833; P < .0001), anxiety (OR, 0.730; 95% CI, 0.658-0.810; P < .0001), substance use disorder (OR, 0.730; 95% CI, 0.658-0.810; P < .0001), and suicidality (OR, 0.530; 95% CI, 0.425-0.661; P < .0001), and these reductions were maintained or improved on at 5 years, including posttraumatic stress disorder (OR, 0.831; 95% CI, 0.704-0.981; P = .028).
The findings indicate that GGAS may play a crucial role in diminishing psychiatric comorbidities among individuals with GI.
This is the largest known study to evaluate the effect of GGAS on psychiatric comorbidities in the GI population, offering robust evidence. The reliance on the precision of CPT and ICD-10 codes for data extraction poses a limitation due to potential coding inaccuracies.
The evidence suggests a significant association between GGAS and reduced psychiatric comorbidities in individuals with GI.