TY - JOUR
AU - Sorouri Khorashad
AU - O. Kaabi
AU - M. D. Gardner
AU - D. Getahun
AU - M. Goodman
AU - T. L. Lash
AU - P. A. Lee
AU - C. McCracken
AU - J. May
AU - M. Muzik
AU - S. Vupputuri
AU - R. Yacoub
AU - D. E. Sandberg
A1 - 
AB - CONTEXT: Understanding mental health issues facing individuals with disorders/differences of sex development (DSD) is crucial for optimizing evidence-based practices in this population. OBJECTIVES: This work aimed to compare the prevalence of psychiatric diagnoses among patients diagnosed with complete androgen insensitivity syndrome (CAIS) or müllerian duct aplasia/agenesis (MA) to male and female reference groups. METHODS: A retrospective cohort study was conducted among 3 large integrated health systems. Participants included all individuals with confirmed CAIS or MA enrolled in 1 of 3 Kaiser Permanente health-care systems between January 1, 1988, and January 31, 2017. For each DSD patient, age-, race/ethnicity- and health system-matched male and female referents with typical sex development were randomly selected. Outcome measurements were mental health diagnoses and use of psychiatric medications. RESULTS: The prevalence of anxiety and depressive disorders in the CAIS and MA cohorts was approximately twice as high as in male referents without DSD, but the corresponding differences relative to female referents were less evident. A subgroup of MA patients with uterine agenesis had a higher prevalence of bipolar disorder than either reference group, but these results were accompanied by wide CIs. Women with CAIS and MA more frequently filled psychiatric medications compared to male but not female referents. CONCLUSION: On balance, these findings are reassuring, albeit requiring confirmation in other settings. Future studies using longitudinal designs and patient-reported outcomes are needed to evaluate changes in mental health status of CAIS and MA patients at different ages and different intervals following initial diagnosis.
AD - Susan B. Meister Child Health and Evaluation Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI 48109, USA.; Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.; Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT 84108, USA.; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, USA.; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA 91101, USA.; Division of Endocrinology, Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA.; Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA 30305, USA.; Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD 20852, USA.
AN - 39391975
BT - J Clin Endocrinol Metab
C5 - Healthcare Disparities
CP - 7
DA - Jun 17
DO - 10.1210/clinem/dgae720
DP - NLM
IS - 7
JF - J Clin Endocrinol Metab
LA - eng
N2 - CONTEXT: Understanding mental health issues facing individuals with disorders/differences of sex development (DSD) is crucial for optimizing evidence-based practices in this population. OBJECTIVES: This work aimed to compare the prevalence of psychiatric diagnoses among patients diagnosed with complete androgen insensitivity syndrome (CAIS) or müllerian duct aplasia/agenesis (MA) to male and female reference groups. METHODS: A retrospective cohort study was conducted among 3 large integrated health systems. Participants included all individuals with confirmed CAIS or MA enrolled in 1 of 3 Kaiser Permanente health-care systems between January 1, 1988, and January 31, 2017. For each DSD patient, age-, race/ethnicity- and health system-matched male and female referents with typical sex development were randomly selected. Outcome measurements were mental health diagnoses and use of psychiatric medications. RESULTS: The prevalence of anxiety and depressive disorders in the CAIS and MA cohorts was approximately twice as high as in male referents without DSD, but the corresponding differences relative to female referents were less evident. A subgroup of MA patients with uterine agenesis had a higher prevalence of bipolar disorder than either reference group, but these results were accompanied by wide CIs. Women with CAIS and MA more frequently filled psychiatric medications compared to male but not female referents. CONCLUSION: On balance, these findings are reassuring, albeit requiring confirmation in other settings. Future studies using longitudinal designs and patient-reported outcomes are needed to evaluate changes in mental health status of CAIS and MA patients at different ages and different intervals following initial diagnosis.
PY - 2025
SN - 0021-972X (Print); 0021-972x
SP - 1906
EP - 1914+
ST - Psychiatric Comorbidities in Women With Complete Androgen Insensitivity Syndrome or Müllerian Duct Aplasia/Agenesis
T1 - Psychiatric Comorbidities in Women With Complete Androgen Insensitivity Syndrome or Müllerian Duct Aplasia/Agenesis
T2 - J Clin Endocrinol Metab
TI - Psychiatric Comorbidities in Women With Complete Androgen Insensitivity Syndrome or Müllerian Duct Aplasia/Agenesis
U1 - Healthcare Disparities
U3 - 10.1210/clinem/dgae720
VL - 110
VO - 0021-972X (Print); 0021-972x
Y1 - 2025
ER -