Categories Related to Gender Identity in ICD-11 and DSM-5 Sensitivity, Specificity and Ability to Predict Gender-Affirming Medical Procedures

Global crises has amounted to the forced international displacement of 25.4 million refugees. Refugees from conflict-affected areas are especially vulnerable to posttraumatic stress disorder (PTSD) compared to the general population due to their past and present hardships and history of trauma. PTSD is characterized by a constellation of symptoms identified by the Diagnostic and Statistical Manual of Mental Disorders (DSM). DSM-5 departed from DSM-IV by reclassifying PTSD as a trauma- and stressor-related disorder and introducing a fourth symptom cluster—negative alterations in mood/cognition—to the previous three-symptom cluster model. In severely traumatized refugees, this new cluster exhibited relatively high sensitivity, specificity, positive predictive power, and negative predictive power—in concordance with the range of symptoms exhibited by this population—and allowed for the applicability of the DSM-5 criteria. However, the Western sample basis of the DSM-5 might make it inferior to alternative models as a diagnostic tool for PTSD in refugees and as a springboard for treatment. In addition (and possibly due) to PTSD, refugees are at high risk for mental health distress and suffer from poor health outcomes. Optimizing diagnostic criteria and overcoming barriers to diagnosis and access to care would benefit patients and facilitate treatment.

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Screening four broad categories of eating disorders: suitability of a clinical algorithm adapted from the SCOFF questionnaire

BMC Psychiatry ◽

10.1186/s12888-019-2338-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Marie-Pierre Tavolacci ◽

André Gillibert ◽

Aurélien Zhu Soubise ◽

Sébastien Grigioni ◽

Pierre Déchelotte

Keyword(s):

Body Mass Index ◽

Eating Disorders ◽

Patient Outcomes ◽

Healthcare Professionals ◽

Youden Index ◽

Clinical Algorithm ◽

Dsm 5 ◽

Sensitivity Specificity ◽

Improve Patient ◽

Scoff Questionnaire

Abstract Background We evaluated the performance of a clinical algorithm (Expali™), combining two or more positive answers to SCOFF questionnaire with Body Mass Index (BMI), to identify four Broad Categories of eating disorders (ED) derived from DSM-5. Methods The clinical algorithm (Expali™) was developed from 104 combinations of BMI levels and answers to five SCOFF questions with at least two positive answers. Two senior ED physicians allocated each combination to one of the four Broad Categories of ED derived from DSM-5: restrictive disorder, bulimic disorder, hyperphagic disorder and other unspecified ED diagnosed by ED clinicians. The performance of Expali™ was evaluated on data from 206 patients with ED. Sensitivity, specificity values and Youden index were calculated for each category. Results The 206 patients were diagnosed as follows: 31.5% restrictive disorder, 18.9% bulimic disorder, 40.8% hyperphagic disorder and 8.8% other ED. The sensitivity of Expali™ for restrictive, bulimic, hyperphagic and other unspecified ED were respectively: 76.9, 69.2, 79.7 and 16.7%. The Youden index was respectively 0.73, 0.57, 0.67 and 0.07. Conclusions In a SCOFF-positive ED population (at least two positive answers), the clinical algorithm Expali™ demonstrated good suitability by correctly classifying three of the four Broad Categories of eating disorders (restrictive, bulimic and hyperphagic disorder). It could be useful both to healthcare professionals and the general population to enable earlier detection and treatment of ED and to improve patient outcomes.

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DSM-5 and the sexual and gender identity disorders: The verdict

PsycEXTRA Dataset ◽

10.1037/e638152013-033 ◽

2013 ◽

Cited By ~ 1

Author(s):

Kenneth J. Zucker

Keyword(s):

Gender Identity ◽

Dsm 5 ◽

And Gender ◽

Gender Identity Disorders

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Reliability and Clinical Utility of Gender Identity-Related Diagnoses: Comparisons Between the ICD-11, ICD-10, DSM-IV, and DSM-5

LGBT Health ◽

10.1089/lgbt.2020.0272 ◽

2021 ◽

Author(s):

Annelou L.C. de Vries ◽

Titia F. Beek ◽

Karlien Dhondt ◽

Henrica C.W. de Vet ◽

Peggy T. Cohen-Kettenis ◽

...

Keyword(s):

Gender Identity ◽

Clinical Utility ◽

Dsm 5 ◽

Icd 10 ◽

Dsm Iv

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The delirium screening tool 4AT in routine clinical practice: prediction of mortality, sensitivity and specificity

European Geriatric Medicine ◽

10.1007/s41999-021-00489-1 ◽

2021 ◽

Author(s):

Sigurd Evensen ◽

Anette Hylen Ranhoff ◽

Stian Lydersen ◽

Ingvild Saltvedt

Keyword(s):

Confidence Interval ◽

Sensitivity And Specificity ◽

Screening Tool ◽

Cox Regression ◽

Receiver Operating Curve ◽

Index Test ◽

Clinical Routine ◽

Dsm 5 ◽

Prediction Of Mortality ◽

Sensitivity Specificity

Abstract Purpose Delirium is common and associated with poor outcomes, partly due to underdetection. We investigated if the delirium screening tool 4 A’s test (4AT) score predicts 1 year mortality and explored the sensitivity and specificity of the 4AT when applied as part of a clinical routine. Methods Secondary analyses of a prospective study of 228 patients acutely admitted to a Medical Geriatric Ward. Physicians without formal training conducted the index test (the 4AT); a predefined cut-off ≥ 4 suggested delirium. Reference standard was delirium diagnosed by two geriatricians using the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). We calculated hazard ratios (HR) using Cox regression based on the groups 4AT = 0, 1–3, 4–7 and ≥ 8, first unadjusted, then adjusted for the covariates age, comorbidity, and personal activities of daily living. We calculated sensitivity, specificity, and the area under the receiver operating curve (AUC). Results Mean age of patients was 86.6 years, 139 (61.0%) were female, 78 (34.2%) had DSM-5 delirium; of these, 56 had 4AT-delirium. 1 year mortality was 27.6% (63 patients). Compared to 4AT score 0, the group 4AT ≥ 8 had increased 1 year mortality (HR 2.86, 95% confidence interval 1.28–6.37, p = 0.010). The effect was reduced in multiadjusted analyses (HR 1.69, 95% confidence interval 0.70–4.07, p = 0.24). Sensitivity, specificity, and AUC were 0.72, 0.84, and 0.88, respectively. Conclusions 4AT ≥ 8 indicates increased mortality, but the effect was reduced in multiadjusted analyses. 4AT had acceptable sensitivity and specificity when applied as a clinical routine.

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Epidemiology of gender dysphoria and transgender identity

Sexual Health ◽

10.1071/sh17067 ◽

2017 ◽

Vol 14 (5) ◽

pp. 404 ◽

Cited By ~ 83

Author(s):

Kenneth J. Zucker

Keyword(s):

Sex Ratio ◽

Gender Identity ◽

Gender Dysphoria ◽

Statistical Manual ◽

Transgender Identity ◽

Diagnostic And Statistical Manual ◽

Dsm 5 ◽

The Past ◽

Adolescents And Adults ◽

The Stability

This review provides an update on the epidemiology of gender dysphoria and transgender identity in children, adolescents and adults. Although the prevalence of gender dysphoria, as it is operationalised in the fifth edtion of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), remains a relatively ‘rare’ or ‘uncommon’ diagnosis, there is evidence that it has increased in the past couple of decades, perhaps reflected in the large increase in referral rates to specialised gender identity clinics. In childhood, the sex ratio continues to favour birth-assigned males, but in adolescents, there has been a recent inversion in the sex ratio from one favouring birth-assigned males to one favouring birth-assigned females. In both adolescents and adults, patterns of sexual orientation vary as a function of birth-assigned sex. Recent studies suggest that the prevalence of a self-reported transgender identity in children, adolescents and adults ranges from 0.5 to 1.3%, markedly higher than prevalence rates based on clinic-referred samples of adults. The stability of a self-reported transgender identity or a gender identity that departs from the traditional male–female binary among non-clinic-based populations remains unknown and requires further study.

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Proposing and Validating the Diagnosis Scale for Internet Gaming Disorder in Taiwanese ADHD Adolescents: Likert Scale Method Based on the DSM-5

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041492 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1492

Author(s):

Yue-Cune Chang ◽

Ruu-Fen Tzang

Keyword(s):

Children And Adolescents ◽

Short Form ◽

Internet Gaming Disorder ◽

Likert Scale ◽

Scale Model ◽

Gaming Disorder ◽

Diagnostic And Statistical Manual ◽

Dsm 5 ◽

Internet Gaming ◽

Sensitivity Specificity

The paper aims to adjust the Taiwanese version of Internet gaming disorder-short form Likert scale with Likert (IGD-SF-T-L) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria to a Likert scale model and test its psychometric property among children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD). Confirmatory factor analysis (CFA) was conducted for validity and the Cronbach’s α for reliability of IGD-SF-T-L. The ROC (receiver operating curves) was used to propose the cut-off point for assessing the instrument’s psychometric properties and its corresponding indices for the diagnostic accuracy. In total, 102 children and adolescents with ADHD were recruited. The construct validity of IGD-SF-T by CFA was model well fitted with excellent reliability (Cronbach’s α = 0.918). The ROC using the Chen’s CIAS > 56 as the state variable for IGD diagnosis showed the AUC (areas under the curves) was 0.918. The cut-off point proposed for IGD-SF-T-L to indicate a diagnosis of IGD was ≥ 10. The corresponding indices of accuracy: sensitivity, specificity, LR (likelihood ratio) +, LR-, and AUC were 0.893, 0.826, 5.134, 0.130, and 0.859, respectively. The proposed IGD-SF-T-L is an adequate, standardized psychometrical measurement for diagnosing IGD among Taiwanese adolescents with ADHD. More attention should be paid toward recent ADHD youth with Internet gaming disorder and their family.

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