{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T19:24:48Z","timestamp":1787599488230,"version":"build-2736575974"},"reference-count":51,"publisher":"Walter de Gruyter GmbH","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpem-2024-0338_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Existing literature lacks data on a subgroup exhibiting psychiatric symptoms below the DSM-5 diagnostic threshold within differences of sexual development (DSD) cases. Our study aims to assess parental knowledge, attitudes toward DSD, and parental perceptions of emotional and behavioral states through a transdiagnostic perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2024-0338_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was conducted with a total of 35 parents of children with DSD. Two groups were established via k-means clustering, based on psychiatric symptomatology levels, derived from The Strength and Difficulties Questionnaire\u00a0\u2013 Parent Form and The Revised Children\u2019s Anxiety and Depression Scale\u00a0\u2013 Parent Form: with one group exhibiting lower reported psychiatric symptoms (LPS=27) and the other demonstrating higher psychiatric symptoms (HPS=8) by parents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2024-0338_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our study found that many parents were hesitant to disclose DSD diagnoses to their children, believing them to be too young to comprehend the information (42.9\u202f%) and that they were unaware of the available support that could be provided by the medical team in disclosing the diagnosis (25.7\u202f%). Our study found no differences in DSM-5 diagnoses between HPS and LPS groups (p&gt;0.05), with ADHD being the most prevalent diagnosis (21.7\u202f%) and a significant overrepresentation of children with a discrepancy between assigned gender at birth and gender upbringing in the HPS group compared to the LPS group (p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2024-0338_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study emphasizes the necessity of a transdiagnostic approach in psychiatry to move beyond binary conceptualizations and better understand the complexities of individuals with DSD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpem-2024-0338","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T12:02:21Z","timestamp":1728475341000},"page":"1066-1076","source":"Crossref","is-referenced-by-count":0,"title":["Through the eyes of the parents: a transdiagnostic psychiatric perspective for children with differences of sexual development"],"prefix":"10.1515","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4938-4346","authenticated-orcid":false,"given":"Burcu","family":"Ozbaran","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry , Ege University Faculty of Medicine , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4580-7655","authenticated-orcid":false,"given":"Birsen","family":"Senturk-Pilan","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry , Ege University Faculty of Medicine , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4702-0944","authenticated-orcid":false,"given":"Oyku","family":"Yavuz-Kan","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry , Izmir Bayrakli City Hospital, University of Health Sciences , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7289-4355","authenticated-orcid":false,"given":"Begum","family":"Yulug-Tas","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry , Izmir Tepecik Education and Research Hospital, University of Health Sciences , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2148-2363","authenticated-orcid":false,"given":"Ipek","family":"Inal-Kaleli","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry , Ege University Faculty of Medicine , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4770-0365","authenticated-orcid":false,"given":"Eren","family":"Er","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology , Izmir Bayrakli City Hospital, University of Health Sciences , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7037-2713","authenticated-orcid":false,"given":"Samim","family":"Ozen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology , Ege University Faculty of Medicine , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6108-0591","authenticated-orcid":false,"given":"Damla","family":"Goksen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology , Ege University Faculty of Medicine , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1330-6397","authenticated-orcid":false,"given":"Sukran","family":"Darcan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology , Ege University Faculty of Medicine , Izmir , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"2026082419020883016_j_jpem-2024-0338_ref_001","doi-asserted-by":"crossref","unstructured":"Hughes, IA, Houk, C, Ahmed, SF, Lee, PA, Lawson Wilkins Pediatric Endocrine Society\/European Society for Paediatric Endocrinology Consensus Group. Consensus statement on management of intersex disorders. J Pediatr Urol 2006;2:148\u201362. https:\/\/doi.org\/10.1016\/j.jpurol.2006.03.004.","DOI":"10.1016\/j.jpurol.2006.03.004"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_002","doi-asserted-by":"crossref","unstructured":"Cools, M, Nordenstr\u00f6m, A, Robeva, R, Hall, J, Westerveld, P, Fl\u00fcck, C, et al.. Caring for individuals with a difference of sex development (DSD): a Consensus Statement. Nat Rev Endocrinol 2018;14:415\u201329. https:\/\/doi.org\/10.1038\/s41574-018-0010-8.","DOI":"10.1038\/s41574-018-0010-8"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_003","doi-asserted-by":"crossref","unstructured":"Erdo\u011fan, S, Kara, C, U\u00e7akt\u00fcrk, A, Ayd\u0131n, M. Etiological classification and clinical assessment of children and adolescents with disorders of sex development. J Clin Res Pediatr Endocrinol 2011;3:77\u201383. https:\/\/doi.org\/10.4274\/jcrpe.v3i2.16.","DOI":"10.4274\/jcrpe.v3i2.16"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_004","doi-asserted-by":"crossref","unstructured":"Lee, PA, Houk, CP, Ahmed, SF, Hughes, IA. International consensus Conference on intersex organized by the Lawson Wilkins pediatric endocrine society and the European society for paediatric endocrinology. Consensus statement on management of intersex disorders. International consensus Conference on intersex. Pediatrics 2006;118:e488\u2013500. https:\/\/doi.org\/10.1542\/peds.2006-0738.","DOI":"10.1542\/peds.2006-0738"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_005","doi-asserted-by":"crossref","unstructured":"Lee, PA, Nordenstr\u00f6m, A, Houk, CP, Ahmed, SF, Auchus, R, Baratz, A, et al.. Global disorders of sex development update since 2006: perceptions, approach and care. Horm Res Paediatr 2016;85:158\u201380. https:\/\/doi.org\/10.1159\/000442975.","DOI":"10.1159\/000442975"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_006","doi-asserted-by":"crossref","unstructured":"Johnson, EK, Rosoklija, I, Finlayson, C, Chen, D, Yerkes, EB, Madonna, MB, et al.. Attitudes towards \u2018disorders of sex development\u2019 nomenclature among affected individuals. J Pediatr Urol 2017;13:608.e1\u2013608.e8. https:\/\/doi.org\/10.1016\/j.jpurol.2017.03.035.","DOI":"10.1016\/j.jpurol.2017.03.035"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_007","doi-asserted-by":"crossref","unstructured":"Lin-Su, K, Lekarev, O, Poppas, DP, Vogiatzi, MG. Congenital adrenal hyperplasia patient perception of \u2018disorders of sex development\u2019 nomenclature. Int J Pediatr Endocrinol 2015;2015:9. https:\/\/doi.org\/10.1186\/s13633-015-0004-4.","DOI":"10.1186\/s13633-015-0004-4"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_008","doi-asserted-by":"crossref","unstructured":"Tiryaki, S, Tekin, A, Ya\u011fmur, \u0130, \u00d6zen, S, \u00d6zbaran, B, G\u00f6k\u015fen, D, et al.. Parental perception of terminology of disorders of sex development in western Turkey. J Clin Res Pediatr Endocrinol 2018;10:216\u201322. https:\/\/doi.org\/10.4274\/jcrpe.0007.","DOI":"10.4274\/jcrpe.0007"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_009","doi-asserted-by":"crossref","unstructured":"Bennecke, E, K\u00f6hler, B, R\u00f6hle, R, Thyen, U, Gehrmann, K, Lee, P, et al.. Disorders or differences of sex development? Views of affected individuals on DSD terminology. J Sex Res 2021;58:522\u201331. https:\/\/doi.org\/10.1080\/00224499.2019.1703130.","DOI":"10.1080\/00224499.2019.1703130"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_010","doi-asserted-by":"crossref","unstructured":"Medi\u00e5, LM, Fauske, L, Sigurdardottir, S, Feragen, KJB, Heggeli, C, W\u00e6hre, A. \u2018It was Supposed to be a Secret\u2019: a study of disclosure and stigma as experienced by adults with differences of sex development. Health Psychol Behav Med 2022;10:579\u201395. https:\/\/doi.org\/10.1080\/21642850.2022.2102018.","DOI":"10.1080\/21642850.2022.2102018"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_011","doi-asserted-by":"crossref","unstructured":"Rolston, AM, Gardner, M, Vilain, E, Sandberg, DE. Parental reports of stigma associated with child\u2019s disorder of sex development. Internet J Endocrinol 2015;2015:980121. https:\/\/doi.org\/10.1155\/2015\/980121.","DOI":"10.1155\/2015\/980121"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_012","doi-asserted-by":"crossref","unstructured":"Van Batavia, JP, Kolon, TF. Fertility in disorders of sex development: a review. J Pediatr Urol 2016;12:418\u201325. https:\/\/doi.org\/10.1016\/j.jpurol.2016.09.015.","DOI":"10.1016\/j.jpurol.2016.09.015"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_013","doi-asserted-by":"crossref","unstructured":"Kleinemeier, E, J\u00fcrgensen, M, Lux, A, Widenka, PM, Thyen, U, Disorders of Sex Development Network Working Group. Psychological adjustment and sexual development of adolescents with disorders of sex development. J Adolesc Health Off Publ Soc Adolesc Med 2010;47:463\u201371. https:\/\/doi.org\/10.1016\/j.jadohealth.2010.03.007.","DOI":"10.1016\/j.jadohealth.2010.03.007"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_014","doi-asserted-by":"crossref","unstructured":"Cohen-Kettenis, PT, Pf\u00e4fflin, F. Transgenderism and intersexuality in childhood and adolescence: making choices. Thousands Oaks, California and London: SAGE Publications; 2003:249 p.","DOI":"10.4135\/9781452233628"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_015","doi-asserted-by":"crossref","unstructured":"\u015eent\u00fcrk Pilan, B, \u00d6zbaran, B, \u00c7elik, D, \u00d6zcan, T, \u00d6zen, S, G\u00f6k\u015fen, D, et al.. Psychiatric view for disorders of sex development: a 12-year experience of a multidisciplinary team in a university hospital. J Pediatr Endocrinol Metab JPEM 2020;33:605\u201311. https:\/\/doi.org\/10.1515\/jpem-2019-0513.","DOI":"10.1515\/jpem-2019-0513"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_016","doi-asserted-by":"crossref","unstructured":"Mueller, SC, Ng, P, Sinaii, N, Leschek, EW, Green-Golan, L, VanRyzin, C, et al.. Psychiatric characterization of children with genetic causes of hyperandrogenism. Eur J Endocrinol 2010;163:801\u201310. https:\/\/doi.org\/10.1530\/eje-10-0693.","DOI":"10.1530\/EJE-10-0693"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_017","doi-asserted-by":"crossref","unstructured":"Bohet, M, Besson, R, Jardri, R, Manouvrier, S, Catteau-Jonard, S, Cartigny, M, et al.. Mental health status of individuals with sexual development disorders: a review. J Pediatr Urol 2019;15:356\u201366. https:\/\/doi.org\/10.1016\/j.jpurol.2019.04.010.","DOI":"10.1016\/j.jpurol.2019.04.010"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_018","doi-asserted-by":"crossref","unstructured":"Sauer-Zavala, S, Gutner, CA, Farchione, TJ, Boettcher, HT, Bullis, JR, Barlow, DH. Current definitions of \u201ctransdiagnostic\u201d in treatment development: a search for consensus. Behav Ther 2017;48:128\u201338. https:\/\/doi.org\/10.1016\/j.beth.2016.09.004.","DOI":"10.1016\/j.beth.2016.09.004"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_019","unstructured":"G\u00f6kler, B, \u00dcnal, F, Pehlivant\u00fcrk, B, K\u00fclt\u00fcr, E\u00c7, Akdemir, D, Taner, Y. Okul \u00c7a\u011fi \u00c7ocuklari \u0130\u00e7in Duygulanim Bozukluklari ve \u015eizofreni G\u00f6r\u00fc\u015fme \u00c7izelgesi -\u015eimdi ve Ya\u015fam Boyu \u015eekli- T\u00fcrk\u00e7e uyarlamasinin Ge\u00e7erlik ve G\u00fcvenirli\u011fi. [Reliability and validity of Schedule for affective disorders and Schizophrenia for school age children\u2013present and Lifetime version\u2013Turkish version (K-SADS-PL-T)]. \u00c7ocuk Ve Gen\u00e7 Ruh Sa\u011fli\u011fi Derg 2004;11:109\u201316."},{"key":"2026082419020883016_j_jpem-2024-0338_ref_020","doi-asserted-by":"crossref","unstructured":"Kaufman, J, Birmaher, B, Brent, D, Rao, U, Flynn, C, Moreci, P, et al.. Schedule for affective disorders and Schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997;36:980\u20138. https:\/\/doi.org\/10.1097\/00004583-199707000-00021.","DOI":"10.1097\/00004583-199707000-00021"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_021","doi-asserted-by":"crossref","unstructured":"\u00dcnal, F, \u00d6ktem, F, \u00c7etin \u00c7uhadaro\u011flu, F, \u00c7engel K\u00fclt\u00fcr, SE, Akdemir, D, Foto \u00d6zdemir, D, et al.. Reliability and validity of the schedule for affective disorders and Schizophrenia for school-age children-present and lifetime version, DSM-5 november 2016-Turkish adaptation (K-SADS-PL-DSM-5-T). Turk Psikiyatri Derg Turk J Psychiatry 2019;30:42\u201350. https:\/\/doi.org\/10.5080\/u23408.","DOI":"10.5080\/u23408"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_022","doi-asserted-by":"crossref","unstructured":"Goodman, R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 2001;40:1337\u201345. https:\/\/doi.org\/10.1097\/00004583-200111000-00015.","DOI":"10.1097\/00004583-200111000-00015"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_023","doi-asserted-by":"crossref","unstructured":"Goodman, R, Scott, S. Comparing the strengths and difficulties questionnaire and the child behavior checklist: is small beautiful? J Abnorm Child Psychol 1999;27:17\u201324. https:\/\/doi.org\/10.1023\/a:1022658222914.","DOI":"10.1023\/A:1022658222914"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_024","unstructured":"G\u00fcvenir, T, \u00d6zbek, A, Baykara, B, Arkar, H, \u015eent\u00fcrk, B, \u0130nceka\u015f, S. G\u00fc\u00e7ler ve g\u00fc\u00e7l\u00fckler anketi\u2019nin (GGA) T\u00fcrk\u00e7e uyarlamasinin psikometrik \u00f6zellikleri. [Psychometric properties of the Turkish version of the Strengths and Difficulties Questionnaire (SDQ). \u00c7ocuk Ve Gen\u00e7 Ruh Sa\u011fli\u011fi Derg 2008;15:65\u201374."},{"key":"2026082419020883016_j_jpem-2024-0338_ref_025","doi-asserted-by":"crossref","unstructured":"Chorpita, BF, Moffitt, CE, Gray, J. Psychometric properties of the revised child anxiety and depression scale in a clinical sample. Behav Res Ther 2005;43:309\u201322. https:\/\/doi.org\/10.1016\/j.brat.2004.02.004.","DOI":"10.1016\/j.brat.2004.02.004"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_026","doi-asserted-by":"crossref","unstructured":"Gormez, V, Kilincaslan, A, Orengul, A, Ebesutani, C, Kaya, I, Ceri, V, et al.. Psychometric properties of the Turkish version of the revised child anxiety and depression scale\u00a0\u2013 child version in a clinical sample. Psychiatry Clin Psychopharmacol 2017;27:84\u201392. https:\/\/doi.org\/10.1080\/24750573.2017.1297494.","DOI":"10.1080\/24750573.2017.1297494"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_027","doi-asserted-by":"crossref","unstructured":"Weidler, EM, Peterson, KE. The impact of culture on disclosure in differences of sex development. Semin Pediatr Surg 2019;28:150840. https:\/\/doi.org\/10.1016\/j.sempedsurg.2019.150840.","DOI":"10.1016\/j.sempedsurg.2019.150840"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_028","doi-asserted-by":"crossref","unstructured":"Callens, N, Kreukels, BPC, van de GriftVoices, TCY. Sexual health and transition care needs in adolescents with intersex\/differences of sex development-a pilot study. J Pediatr Adolesc Gynecol 2021;34:176\u201389.e2. https:\/\/doi.org\/10.1016\/j.jpag.2020.11.001.","DOI":"10.1016\/j.jpag.2020.11.001"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_029","doi-asserted-by":"crossref","unstructured":"Lampalzer, U, Briken, P, Schweizer, K. \u2018That decision really was mine\u2026\u2019. Insider perspectives on health care controversies about intersex\/diverse sex development. Cult Health Sex 2021;23:472\u201383. https:\/\/doi.org\/10.1080\/13691058.2021.1892828.","DOI":"10.1080\/13691058.2021.1892828"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_030","doi-asserted-by":"crossref","unstructured":"Sandberg, DE, Gardner, M, Cohen-Kettenis, PT. Psychological aspects of the treatment of patients with disorders of sex development. Semin Reprod Med 2012;30:443\u201352. https:\/\/doi.org\/10.1055\/s-0032-1324729.","DOI":"10.1055\/s-0032-1324729"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_031","doi-asserted-by":"crossref","unstructured":"Wechsung, K, Marshall, L, J\u00fcrgensen, M, Neumann, U. Diagnosis of DSD in children\u00a0\u2013 development of new tools for a structured diagnostic and information management program within the empower-DSD study. J Clin Med 2022;11:3859. https:\/\/doi.org\/10.3390\/jcm11133859.","DOI":"10.3390\/jcm11133859"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_032","unstructured":"Kemp, BD. Sex, lies and androgen insensitivity syndrome. CMAJ Can Med Assoc J J Assoc Medicale Can. 1996;154:1829. author reply 1833."},{"key":"2026082419020883016_j_jpem-2024-0338_ref_033","doi-asserted-by":"crossref","unstructured":"Crissman, HP, Warner, L, Gardner, M, Carr, M, Schast, A, Quittner, AL, et al.. Children with disorders of sex development: a qualitative study of early parental experience. Int J Pediatr Endocrinol 2011;2011:10. https:\/\/doi.org\/10.1186\/1687-9856-2011-10.","DOI":"10.1186\/1687-9856-2011-10"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_034","doi-asserted-by":"crossref","unstructured":"McCauley, E. Challenges in educating patients and parents about differences in sex development. Am J Med Genet C Semin Med Genet 2017;175:293\u20139. https:\/\/doi.org\/10.1002\/ajmg.c.31563.","DOI":"10.1002\/ajmg.c.31563"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_035","unstructured":"Jessica Kingsley Publishers - USA [Internet]. Counseling transgender and non-binary youth. [cited 2024 Aug 31]. Available from: https:\/\/us.jkp.com\/products\/counseling-transgender-and-nonbinary-youth."},{"key":"2026082419020883016_j_jpem-2024-0338_ref_036","doi-asserted-by":"crossref","unstructured":"Iijima, M, Arisaka, O, Minamoto, F, Arai, Y. Sex differences in children\u2019s free drawings: a study on girls with congenital adrenal hyperplasia. Horm Behav 2001;40:99\u2013104. https:\/\/doi.org\/10.1006\/hbeh.2001.1670.","DOI":"10.1006\/hbeh.2001.1670"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_037","doi-asserted-by":"crossref","unstructured":"Quenneville, AF, Kalogeropoulou, E, Nicastro, R, Weibel, S, Chanut, F, Perroud, N. Anxiety disorders in adult ADHD: a frequent comorbidity and a risk factor for externalizing problems. Psychiatr Res 2022;310:114423. https:\/\/doi.org\/10.1016\/j.psychres.2022.114423.","DOI":"10.1016\/j.psychres.2022.114423"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_038","doi-asserted-by":"crossref","unstructured":"Riglin, L, Leppert, B, Dardani, C, Thapar, AK, Rice, F, O\u2019Donovan, MC, et al.. ADHD and depression: investigating a causal explanation. Psychol Med 2021;51:1890\u20137. https:\/\/doi.org\/10.1017\/s0033291720000665.","DOI":"10.1017\/S0033291720000665"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_039","doi-asserted-by":"crossref","unstructured":"Cai, J, Zhu, G, Tian, H, Yuan, J, Gao, H, Sun, L, et al.. Mental health status of children with disorders of sexual development and their correlates. Front Public Health 2022;10:756382. https:\/\/doi.org\/10.3389\/fpubh.2022.756382.","DOI":"10.3389\/fpubh.2022.756382"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_040","doi-asserted-by":"crossref","unstructured":"Laggari, V, Diareme, S, Christogiorgos, S, Deligeoroglou, E, Christopoulos, P, Tsiantis, J, et al.. Anxiety and depression in adolescents with polycystic ovary syndrome and Mayer-Rokitansky-K\u00fcster-Hauser syndrome. J Psychosom Obstet Gynaecol 2009;30:83\u20138. https:\/\/doi.org\/10.1080\/01674820802546204.","DOI":"10.1080\/01674820802546204"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_041","doi-asserted-by":"crossref","unstructured":"Ediati, A, Faradz, SMH, Juniarto, AZ, van der Ende, J, Drop, SLS, Dessens, AB. Emotional and behavioral problems in late-identified Indonesian patients with disorders of sex development. J Psychosom Res 2015;79:76\u201384. https:\/\/doi.org\/10.1016\/j.jpsychores.2014.12.007.","DOI":"10.1016\/j.jpsychores.2014.12.007"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_042","doi-asserted-by":"crossref","unstructured":"\u00d6zbaran, B, \u00d6zen, S, G\u00f6k\u015fen, D, Korkmaz, \u00d6, Onay, H, \u00d6zkinay, F, et al.. Psychiatric approaches for disorders of sex development: experience of a multidisciplinary team. JCRPE J Clin Res Pediatr Endocrinol 2013;5:229\u201335. https:\/\/doi.org\/10.4274\/jcrpe.1044.","DOI":"10.4274\/Jcrpe.1044"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_043","doi-asserted-by":"crossref","unstructured":"Cortese, S, Adamo, N, Del Giovane, C, Mohr-Jensen, C, Hayes, AJ, Carucci, S, et al.. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatr 2018;5:727\u201338. https:\/\/doi.org\/10.1016\/s2215-0366(18)30269-4.","DOI":"10.1016\/S2215-0366(18)30269-4"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_044","doi-asserted-by":"crossref","unstructured":"Kishi, T, Ikuta, T, Matsuda, Y, Sakuma, K, Okuya, M, Nomura, I, et al.. Pharmacological treatment for bipolar mania: a systematic review and network meta-analysis of double-blind randomized controlled trials. Mol Psychiatr 2022;27:1136\u201344. https:\/\/doi.org\/10.1038\/s41380-021-01334-4.","DOI":"10.1038\/s41380-021-01334-4"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_045","doi-asserted-by":"crossref","unstructured":"Helmchen, H, Linden, M. Subthreshold disorders in psychiatry: clinical reality, methodological artifact, and the double-threshold problem. Compr Psychiatr 2000;41:1\u20137. https:\/\/doi.org\/10.1016\/s0010-440x(00)80001-2.","DOI":"10.1016\/S0010-440X(00)80001-2"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_046","doi-asserted-by":"crossref","unstructured":"van Os, J, Guloksuz, S, Vijn, TW, Hafkenscheid, A, Delespaul, P. The evidence\u2010based group\u2010level symptom\u2010reduction model as the organizing principle for mental health care: time for change? World Psychiatr 2019;18:88\u201396. https:\/\/doi.org\/10.1002\/wps.20609.","DOI":"10.1002\/wps.20609"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_047","doi-asserted-by":"crossref","unstructured":"Oexle, N, Ribeiro, W, Fisher, HL, Gronholm, PC, Laurens, KR, Pan, P, et al.. Childhood bullying victimization, self-labelling, and help-seeking for mental health problems. Soc Psychiatr Psychiatr Epidemiol 2020;55:81\u20138. https:\/\/doi.org\/10.1007\/s00127-019-01743-5.","DOI":"10.1007\/s00127-019-01743-5"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_048","doi-asserted-by":"crossref","unstructured":"K\u00e4llm\u00e9n, H, Hallgren, M. Bullying at school and mental health problems among adolescents: a repeated cross-sectional study. Child Adolesc Psychiatr Ment Health 2021;15:74. https:\/\/doi.org\/10.1186\/s13034-021-00425-y.","DOI":"10.1186\/s13034-021-00425-y"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_049","doi-asserted-by":"crossref","unstructured":"Ye, Z, Wu, D, He, X, Ma, Q, Peng, J, Mao, G, et al.. Meta-analysis of the relationship between bullying and depressive symptoms in children and adolescents. BMC Psychiatr 2023;23:215. https:\/\/doi.org\/10.1186\/s12888-023-04681-4.","DOI":"10.1186\/s12888-023-04681-4"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_050","doi-asserted-by":"crossref","unstructured":"Earnshaw, VA, Reisner, SL, Menino, D, Poteat, VP, Bogart, LM, Barnes, TN, et al.. Stigma-based bullying interventions: a systematic review. Dev Rev DR 2018;48:178\u2013200. https:\/\/doi.org\/10.1016\/j.dr.2018.02.001.","DOI":"10.1016\/j.dr.2018.02.001"},{"key":"2026082419020883016_j_jpem-2024-0338_ref_051","doi-asserted-by":"crossref","unstructured":"de Vries, ALC, Roehle, R, Marshall, L, Fris\u00e9n, L, van de Grift, TC, Kreukels, BPC, et al.. Mental health of a large group of adults with disorders of sex development in six European countries. Psychosom Med 2019;81:629\u201340. https:\/\/doi.org\/10.1097\/psy.0000000000000718.","DOI":"10.1097\/PSY.0000000000000718"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpem-2024-0338\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpem-2024-0338\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T19:02:16Z","timestamp":1787598136000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpem-2024-0338\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,10]]},"references-count":51,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,10,10]]},"published-print":{"date-parts":[[2024,12,17]]}},"alternative-id":["10.1515\/jpem-2024-0338"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2024-0338","relation":{},"ISSN":["0334-018X","2191-0251"],"issn-type":[{"value":"0334-018X","type":"print"},{"value":"2191-0251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,10]]}}}