Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation

2021 ◽  
pp. 91-98
Author(s):  
Jack L. Turban ◽  
Dana King ◽  
Jeremi M. Carswell ◽  
Alex S. Keuroghlian

BACKGROUND AND OBJECTIVES Gonadotropin-releasing hormone analogues are commonly prescribed to suppress endogenous puberty for transgender adolescents. There are limited data regarding the mental health benefits of this treatment. Our objective for this study was to examine associations between access to pubertal suppression during adolescence and adult mental health outcomes. METHODS Using a cross-sectional survey of 20 619 transgender adults aged 18 to 36 years, we examined self-reported history of pubertal suppression during adolescence. Using multivariable logistic regression, we examined associations between access to pubertal suppression and adult mental health outcomes, including multiple measures of suicidality. RESULTS Of the sample, 16.9% reported that they ever wanted pubertal suppression as part of their gender-related care. Their mean age was 23.4 years, and 45.2% were assigned male sex at birth. Of them, 2.5% received pubertal suppression. After adjustment for demographic variables and level of family support for gender identity, those who received treatment with pubertal suppression, when compared with those who wanted pubertal suppression but did not receive it, had lower odds of lifetime suicidal ideation (adjusted odds ratio = 0.3; 95% confidence interval = 0.2–0.6). CONCLUSIONS This is the first study in which associations between access to pubertal suppression and suicidality are examined. There is a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment. These results align with past literature, suggesting that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes.

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248684
Author(s):  
Hridaya Raj Devkota ◽  
Tula Ram Sijali ◽  
Ramji Bogati ◽  
Meraj Ahmad ◽  
Karuna Laxmi Shakya ◽  
...  

Background The COVID-19 pandemic has been creating a panic and distressing situations among the entire population globally including Nepal. No study has been conducted assessing the psychological impact of this pandemic on the general public in Nepal. The objective of this study is to assess the mental health status during COVID-19 outbreak and explore the potential influencing factors among the population attending the hospital fever clinics with COVID–19 symptoms. Methods A cross-sectional survey was conducted between May—June, 2020 with a sample of 645 participants aged 18 and above in 26 hospitals across Nepal. Telephone interviews were conducted using a semi-structured questionnaire along with a validated psychometric tool, the Depression, Anxiety and Stress (DASS-21) scale. The metrics and scores of symptoms and their severity were created and analyzed. Multivariate logistic regression was used to determine the association of potential covariates with outcome variables. Results The prevalence of anxiety, depression and stress were 14%, 7% and 5% respectively. In reference to Karnali, participants from Bagmati province reported higher level of anxiety (OR 3.44, 95% CI 1.31–9.06), while stress (OR 4.27, 95% CI 1.09–18.32) and depressive symptoms (OR 3.11, 95% CI 1.05–9.23) observed higher among the participants in Province 1. Women were more at risk of anxiety (OR 3.41, 95% CI 1.83–6.36) than men. Similarly, people currently living in rented houses reported more stress (OR 2.97, 95% CI 1.05–8.43) and those living far from family reported higher rates of depressive symptoms (OR 3.44, 95% CI 1.03–11.46). Conclusion The study identified increased prevalence of stress, anxiety and depressive symptoms during the initial stage of COVID-19 pandemic in Nepal. Considering the findings, there is urgent need to develop and implement appropriate community-based mental health programs targeting individuals who have had COVID-19 symptoms and who are prone to develop adverse mental health outcomes.


2020 ◽  
Vol 11 ◽  
Author(s):  
Bella Nichole Kantor ◽  
Jonathan Kantor

Pandemic coronavirus disease 2019 (COVID-19) may lead to significant mental health stresses, potentially with modifiable risk factors. We performed an internet-based cross-sectional survey of an age-, sex-, and race-stratified representative sample from the US general population. Degrees of anxiety, depression, and loneliness were assessed using the 7-item Generalized Anxiety Disorder-7 scale (GAD-7), the 9-item Patient Health Questionnaire, and the 8-item UCLA Loneliness Scale, respectively. Unadjusted and multivariable logistic regression analyses were performed to determine associations with baseline demographic characteristics. A total of 1,005 finished surveys were returned of the 1,020 started, yielding a completion rate of 98.5% in the survey panel. The mean (standard deviation) age of the respondents was 45 (16) years, and 494 (48.8%) were male. Overall, 264 subjects (26.8%) met the criteria for an anxiety disorder based on a GAD-7 cutoff of 10; a cutoff of 7 yielded 416 subjects (41.4%), meeting the clinical criteria for anxiety. On multivariable analysis, male sex (odds ratio [OR] = 0.65, 95% confidence interval [CI] [0.49, 0.87]), identification as Black (OR = 0.49, 95% CI [0.31, 0.77]), and living in a larger home (OR = 0.46, 95% CI [0.24, 0.88]) were associated with a decreased odds of meeting the anxiety criteria. Rural location (OR 1.39, 95% CI [1.03, 1.89]), loneliness (OR 4.92, 95% CI [3.18, 7.62]), and history of hospitalization (OR = 2.04, 95% CI [1.38, 3.03]) were associated with increased odds of meeting the anxiety criteria. Two hundred thirty-two subjects (23.6%) met the criteria for clinical depression. On multivariable analysis, male sex (OR = 0.71, 95% CI [0.53, 0.95]), identifying as Black (OR = 0.62, 95% CI [0.40, 0.97]), increased time outdoors (OR = 0.51, 95% CI [0.29, 0.92]), and living in a larger home (OR = 0.35, 95% CI [0.18, 0.69]) were associated with decreased odds of meeting depression criteria. Having lost a job (OR = 1.64, 95% CI [1.05, 2.54]), loneliness (OR = 10.42, 95% CI [6.26, 17.36]), and history of hospitalization (OR = 2.42, 95% CI [1.62, 3.62]) were associated with an increased odds of meeting depression criteria. Income, media consumption, and religiosity were not associated with mental health outcomes. Anxiety and depression are common in the US general population in the context of the COVID-19 pandemic and are associated with potentially modifiable factors.


2021 ◽  
pp. jech-2021-216661
Author(s):  
Jack Tsai ◽  
Minda Huang ◽  
Suja S Rajan ◽  
Eric B Elbogen

BackgroundThe Coronavirus Aid, Relief, and Economic Security Act of 2020 provided ‘economic impact payments’ (EIPs) of $1200 to US adults with annual personal income of $75 000 or less. This study examined the prospective association between EIP receipt and mental health outcomes.MethodsA nationally representative sample of 3169 middle-income and low-income US adults completed a baseline assessment of their health and well-being in May–June 2020 and a 3-month follow-up assessment during the period of the COVID-19 pandemic when EIPs were distributed.ResultsControlling for sociodemographic characteristics, EIP recipients had higher odds of reporting a positive COVID-19 test, endorsing a history of post-traumatic stress disorder and reporting any illicit drug use in the past month than participants who did not receive EIP. Participants who did not receive EIP were more likely to report a history of anxiety disorder or alcohol use disorder and recent suicidal ideation than EIP recipients. There was no association between EIP receipt and financial distress, although over one-third to over half of EIP recipients were not employed at baseline. Between baseline and 3-month follow-up, receipt of EIP was significantly associated with reduced medical conditions and alcohol use problems, but increased depression, suicidal ideation and COVID-19 era-related stress.ConclusionThe EIP provided a brief income stimulus to many adults in need but was not associated with improvements in financial distress or mental health among middle-income and low-income recipients. Long-term income security and employment may be more important to improving and sustaining positive mental health outcomes.


Psico ◽  
2021 ◽  
Vol 52 (3) ◽  
pp. e41332
Author(s):  
Marcela Mansur-Alves ◽  
Cristiano Mauro Assis Gomes ◽  
Camila Batista Peixoto ◽  
Matheus Bortolosso Bocardi ◽  
Marina Luiza Nunes Diniz ◽  
...  

As most evidence for mental health impacts of the COVID-19 crisis is cross-sectional, the present study aimed to analyze the longitudinal development of psychological suffering among 619 Brazilian adults by assessing mental health outcomes and individual factors in two periods: a year before and a month after the break of the pandemic. As major findings, pandemic psychological suffering was directly explained by previous-year suffering, conscientiousness, and pandemic perceived stress, and correlated with pandemic suicidal ideation. Pandemic perceived stress correlated with pandemic psychological distress, and was explained by previous-year suffering, neuroticism, and conscientiousness, as well as by pandemic life satisfaction and perceived pandemic impact. Finally, pandemic suicidal ideation variance was explained by prior ideation and pandemic life satisfaction. These findings are in line with current models of mental health and highlight the importance of integrating both more stable individual factors and more transient variables towards and explanation for mental health outcomes.


2021 ◽  
Vol 11 ◽  
Author(s):  
Julien Tiete ◽  
Magda Guatteri ◽  
Audrey Lachaux ◽  
Araxie Matossian ◽  
Jean-Michel Hougardy ◽  
...  

BackgroundThe literature shows the negative psychological impact of the coronavirus disease 2019 (COVID-19) outbreak on frontline healthcare workers. However, few are known about the mental health of physicians and nurses working in general hospitals during the outbreak, caring for patients with COVID-19 or not.ObjectivesThis survey assessed differences in mental health in physicians and nurses working in COVID-19 or non-COVID-19 medical care units.DesignA cross-sectional mixed-mode survey was used to assess burnout, insomnia, depression, anxiety, and stress.SettingA total of 1,244 physicians and nurses from five general hospitals in Belgium, working in COVID-19 care units (CCU), non-COVID-19 care units (NCCU), or both (CCU + NCCU) were informed of the study.ParticipantsSix hundred forty-seven healthcare workers participated in the survey (response rate = 52%).MeasurementsValidated instruments were used to assess the outcomes: the PFI (burnout/professional fulfillment), the ISI (insomnia), and the DASS-21 (depression, anxiety, and stress).ResultsResults showed high prevalence of burnout, insomnia, depression, and anxiety among participants. After adjusting for confounders, multivariate analysis of variance showed no differences between CCU, NCCU, and CCU + NCCU workers. Univariate general linear models showed higher level of burnout, insomnia, and anxiety among nurses in comparison to physicians. Being a nurse, young, isolated, with an increased workload were risk factors for worse mental health outcomes.LimitationsThe mental health of the tested sample, before the outbreak, is unknown. Moreover, this cross-sectional design provides no information on the evolution of the mental health outcomes over time.ConclusionDirectly caring for patients with COVID-19 is not associated with worse mental health outcomes among healthcare workers in general hospitals. High prevalence of burnout, insomnia, depression, and anxiety among physicians and nurses requires special attention, and specific interventions need to be implemented.Protocol RegistrationClinicalTrials.gov, identifier NCT04344145.


2020 ◽  
Author(s):  
Hridaya Raj Devkota ◽  
Tula Ram Sijali ◽  
Ramji Bogati ◽  
Meraj Ahmad ◽  
Karuna Laxmi Shakya ◽  
...  

Background: The COVID 19 pandemic has been creating a panic and distressing situations among the entire population globally including Nepal. No study has been conducted assessing the psychological impact of this pandemic on the general public in Nepal. The objective of this study is to assess the mental health status during COVID 19 outbreak and explore the potential influencing factors among the population attending the hospital fever clinics with COVID 19 symptoms. Methods: A cross sectional survey was conducted between May to June, 2020 with a sample of 645 participants aged 18 and above in 26 hospitals across Nepal. Telephone interviews were conducted using a semi-structured questionnaire along with a validated psychometric tool, the Depression, Anxiety and Stress (DASS21) scale. The metrics and scores of symptoms and their severity were created and analyzed. Multivariate logistic regression was used to determine the association of potential covariates with outcome variables. Results: The prevalence of anxiety, depression and stress were 14%, 7% and 5% respectively. Participants from Bagmati province reported higher level of anxiety (OR 3.87, 95% CI 1.42 10.59), while stress (OR 4.78, 95% CI 1.09 21.29) and depressive symptoms (OR 3.37, 95% CI 1.10 10.35) observed higher among the participants in Province 1. Women were more at risk of anxiety (OR 4.26, 95% CI 2.21 8.20) and depression (2.75, 95% CI 1.16 6.51) than men. Similarly, people with primary level education found more prone to all factors, stress (OR 20.35, 95% CI 2.06 201.19), anxiety (OR 3.10, 95% CI 1.24 7.91), and depression (OR 4.41, 95% CI 1.29 15.07). More farmers than labors showed higher odds (OR 2.25, 95% CI 1.01 5.01) for anxiety, while individuals surveyed who reported their health status as poor-had higher odds (OR 5.95, 95% CI 1.08 32.68) for depression. Also, people currently living in rented houses reported more stress (OR 3.11, 95% CI 1.07 9.05) and those living far from family reported higher rates of depressive symptoms (OR 3.57, 95% CI 1.01 12.58). Conclusion: The study identified increased prevalence of stress, anxiety and depressive symptoms during the initial stage of COVID 19 pandemic in Nepal. Considering the findings, there is urgent need to develop and implement appropriate community-based mental health programs targeting individuals who have had COVID 19 symptoms and who are prone to develop adverse mental health outcomes. Key words: COVID 19, Depression, Anxiety, Stress, Pandemic, Public Health, Nepal


2021 ◽  
Author(s):  
Zeana Samir Alkudsi ◽  
Nadin Hany Kamel ◽  
Alla El-Awaisi ◽  
Mujahed M A Shraim ◽  
Maguy ElHajj

Objective: The main aim of this study is to illustrate the prevalence of burnout and resilience among community pharmacists in Qatar during the COVID-19 pandemic. Methods: This is a cross-sectional study design that included the collection and analysis of quantitative data from community pharmacists in Qatar using a cross-sectional survey. Results: Overall, participants had a moderate level of burnout as illustrated in the mean scores of the three dimensions; 22.11±13.053 for emotional exhaustion, 7.17±6.55 for depersonalization, and 35.94±11.47 for personal accomplishment. The findings demonstrated that 15.2%, 15.6%, and 5.4% of community pharmacists had moderate levels of depression, anxiety, and stress, respectively. Further, they showed high resilience (35.7±8.57). Mental health outcomes were statistically positively correlated with fear while age was negatively correlated with depersonalization. Conclusion: This study is the first study to report the prevalence of mental health outcomes among community pharmacists during COVID-19 in Qatar. The pharmacists experienced moderate burnout but high resilience which indicates their high potential to overcome difficulties. Future interventions at the personal, national and organizational levels are needed to improve mental health during this pandemic by preventing and managing stress, improving self-efficacy and resilience, and providing adequate social support.


2016 ◽  
Vol 26 (3) ◽  
pp. 276-286 ◽  
Author(s):  
L. Saxon ◽  
N. Makhashvili ◽  
I. Chikovani ◽  
M. Seguin ◽  
M. McKee ◽  
...  

Aims.Adults who experienced the 1992 and 2008 armed conflicts in the Republic of Georgia were exposed to multiple traumatic events and stressors over many years. The aim was to investigate what coping strategies are used by conflict-affected persons in Georgia and their association with mental disorders.Method.A cross-sectional survey was conducted with 3600 adults, representing internally displaced persons (IDPs) from conflicts in the 1990s (n = 1200) and 2008 (n = 1200) and former IDPs who returned to their homes after the 2008 conflict (n = 1200). Post-traumatic stress disorder, depression, anxiety and coping strategies were measured using the Trauma Screening Questionnaire, Patient Health Questionnaire-9, Generalised Anxiety and adapted version of the Brief Coping Inventory, respectively. Descriptive and multivariate regression analyses were used.Results.Coping strategies such as use of humour, emotional support, active coping, acceptance and religion were significantly associated with better mental health outcomes. Coping strategies of behavioural and mental disengagement, denial, venting emotions, substance abuse and gambling were significantly associated with poorer mental health outcomes. The reported use of coping strategies varied significantly between men and women for 8 of the 15 strategies addressed.Conclusions.Many conflict-affected persons in Georgia are still suffering mental health problems years after the conflicts. A number of specific coping strategies appear to be associated with better mental health and should be encouraged and supported where possible.


Sign in / Sign up

Export Citation Format

Share Document