title: Psychiatric characteristics in transsexual individuals: multicentre study in four European countries.
abstract: BACKGROUND
  Research into the relationship between gender identity disorder and psychiatric problems has shown contradictory results.
  
  
  OBJECTIVE
  To investigate psychiatric problems in adults fulfilling DSM-IV-TR criteria for a diagnosis of gender identity disorder.
  
  
  METHODS
  Data were collected within the European Network for the Investigation of Gender Incongruence using the Mini International Neuropsychiatric Interview - Plus and the Structured Clinical Interview for DSM-IV Axis II Disorders (n = 305).
  
  
  RESULTS
  In 38% of the individuals with gender identity disorder a current DSM-IV-TR Axis I diagnosis was found, mainly affective disorders and anxiety disorders. Furthermore, almost 70% had a current and lifetime diagnosis. All four countries showed a similar prevalence, except for affective and anxiety disorders, and no difference was found between individuals with early-onset and late-onset disorder. An Axis II diagnosis was found in 15% of all individuals with gender identity disorder, which is comparable to the general population.
  
  
  CONCLUSIONS
  People with gender identity disorder show more psychiatric problems than the general population; mostly affective and anxiety problems are found.
authors.affiliation: Gunter Heylens, MD, Els Elaut, MSc, Department of Sexology and Gender Problems, University Hospital Ghent, Belgium; Baudewijntje P. C. Kreukels, PhD, Department of Medical Psychology, VU University Hospital, Amsterdam, The Netherlands; Muirne C. S. Paap, PhD, Department of Research Methodology, Measurement and Data Analysis, Behavioural Sciences, Susanne Cerwenka, Mr.Sc, Hertha Richter-Appelt, PhD, Department of Sex Research and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Germany; Peggy T. Cohen-Kettenis, PhD, Department of Medical Psychology, VU University Hospital Amsterdam, The Netherlands; Ira R. Haraldsen, MD, PhD, Department of Neuropsychiatry and Psychosomatic Medicine, Rikshospitalet Oslo, Norway; Griet De Cuypere, MD, PhD, Department of Sexology and Gender Problems, University Hospital Ghent, Belgium.
authors.forename: Gunter
authors.initials: G
authors.lastname: Heylens
authors.forename: Els
authors.initials: E
authors.lastname: Elaut
authors.forename: Baudewijntje P C
authors.initials: BP
authors.lastname: Kreukels
authors.forename: Muirne C S
authors.initials: MC
authors.lastname: Paap
authors.forename: Susanne
authors.initials: S
authors.lastname: Cerwenka
authors.forename: Hertha
authors.initials: H
authors.lastname: Richter-Appelt
authors.forename: Peggy T
authors.initials: PT
authors.lastname: Cohen-Kettenis
authors.forename: Ira R
authors.initials: IR
authors.lastname: Haraldsen
authors.forename: Griet
authors.initials: G
authors.lastname: De Cuypere
mesh_terms: D000328:Adult; D017668:Age of Onset; D016009:Chi-Square Distribution; D016000:Cluster Analysis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007391:International Cooperation; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D012720:Severity of Illness Index; D057829:Gender-Affirming Procedures / Q000706:statistics & numerical data; D063106:Transgender Persons / Q000523:psychology / Q000706:statistics & numerical data*; D014189:Transsexualism / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult