Objective

To evaluate the odds of a behavioral health diagnosis among youth with differences of sex development (DSD) or congenital adrenal hyperplasia (CAH) compared with matched controls in the PEDSnet database.

Study design

All youth with a diagnosis of DSD (n = 1216) or CAH (n = 1647) and at least 1 outpatient encounter were extracted from the PEDSnet database and propensity-score matched on 8 variables (1:4) with controls (n = 4864 and 6588, respectively) using multivariable logistic regression. The likelihood of having behavioral health diagnoses was examined using generalized estimating equations.

Results

Youth with DSD had higher odds of a behavioral health diagnosis (OR, 1.7; 95% CI, 1.4-2.1; P < .0001) and neurodevelopmental diagnosis (OR, 1.7; 95% CI, 1.4, 2.0; P < .0001) compared with matched controls. Youth with CAH did not have an increased odds of a behavioral health diagnosis (OR, 1.0; 95% CI, 0.9, 1.1; P = .9) compared with matched controls but did have higher odds of developmental delay (OR, 1.8; 95% CI, 1.4, 2.4; P < .0001).

Conclusions

Youth with DSD diagnosis have higher odds of a behavioral health or neurodevelopmental diagnosis compared with matched controls. Youth with CAH have higher odds of developmental delay, highlighting the need for screening in both groups.

中文翻译：

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与对照组相比，性别发育或先天性肾上腺增生症青少年的行为健康诊断：一项 PEDSnet 研究

 客观的

与 PEDSnet 数据库中的匹配对照相比，评估性发育差异 (DSD) 或先天性肾上腺增生 (CAH) 青少年行为健康诊断的几率。

 学习规划

从 PEDSnet 数据库中提取所有诊断为 DSD (n = 1216) 或 CAH (n = 1647) 且至少有 1 次门诊就诊的青少年，并在 8 个变量 (1:4) 上与对照 (n = 4864) 进行倾向评分匹配和 6588）使用多变量逻辑回归。使用广义估计方程检查进行行为健康诊断的可能性。

 结果

患有 DSD 的青少年获得行为健康诊断 (OR, 1.7; 95% CI, 1.4-2.1; P < .0001) 和神经发育诊断 (OR, 1.7; 95% CI, 1.4, 2.0; P < .0001) 的几率较高与匹配的对照相比。与匹配的对照组相比，患有 CAH 的青少年行为健康诊断的几率并未增加（OR，1.0；95% CI，0.9，1.1； P = .9），但发育迟缓的几率较高（OR，1.8；95） % CI，1.4，2.4； P < .0001）。

 结论

与匹配的对照组相比，患有 DSD 诊断的青少年获得行为健康或神经发育诊断的几率更高。患有 CAH 的青少年发育迟缓的几率较高，这凸显了对这两个群体进行筛查的必要性。