The risk of psychosis for transgender individuals:A Dutch national cohort study
Background The stressful minority position of transgender persons may result in a high risk of psychosis. Conflicting data suggest that the observed risk depends on setting of recruitment. We assessed the relative risk of non-affective psychotic disorder (NAPD) in a large, representative cohort of transgender persons. Methods This cohort was composed using: data on legal sex change from the Dutch population registry and data on dispensing of cross-sex hormones (route 1), and a registry of insurance claims from mental health care including persons with a diagnosis of gender identity disorder (D... Mehr ...
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Dokumenttyp: | Artikel |
Erscheinungsdatum: | 2023 |
Reihe/Periodikum: | Termorshuizen , F , De Vries , A L C , Wiepjes , C M & Selten , J P 2023 , ' The risk of psychosis for transgender individuals : A Dutch national cohort study ' , Psychological Medicine , vol. 53 , no. 16 , pp. 7923 - 7932 . https://doi.org/10.1017/S0033291723002088 |
Schlagwörter: | Epidemiology / minority stress / psychotic disorder / social defeat / transgender persons |
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-28612776 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | https://cris.maastrichtuniversity.nl/en/publications/d7abe7fc-8e43-4004-9a93-8b5040de0604 |
Background The stressful minority position of transgender persons may result in a high risk of psychosis. Conflicting data suggest that the observed risk depends on setting of recruitment. We assessed the relative risk of non-affective psychotic disorder (NAPD) in a large, representative cohort of transgender persons. Methods This cohort was composed using: data on legal sex change from the Dutch population registry and data on dispensing of cross-sex hormones (route 1), and a registry of insurance claims from mental health care including persons with a diagnosis of gender identity disorder (DSM-IV) or gender dysphoria (DSM-5) (route 2). They were matched by sex at birth, calendar year and country of birth to controls from the general population. Transgender persons (N = 5564) and controls (N = 27 820), aged 16-60 years at 1 January 2011, were followed until the first insurance claim for NAPD in 2011-2019. Results The incidence rate ratio (IRR) of NAPD for transgender persons selected exclusively through route 1 (N = 3859, IRR = 2.00, 95%-CI 1.52-2.63) was increased, but significantly lower than the IRRs for those selected exclusively through route 2 (N = 694, IRR = 22.15, 95%-CI 13.91-35.28) and for those found by both routes (N = 1011, IRR = 5.17, 95%-CI 3.57-7.49; p value for differences in IRR < 0.001). Conclusions This study supports the social defeat-hypothesis of NAPD. The results also show the presence of a substantial number of transgender persons with severe psychiatric problems who have not (yet) taken steps to gender-affirmative care.