Exploratory Analysis of Gender-Specific Symptom Burden in Child Psychiatric Care

Background: Gender plays a key role in the incidence, symptom expression, and treatment of mental disorders in children and adolescents. Consequently, we took an exploratory approach to investigating youth’s gender-specific symptom burden in a child psychiatric care unit. We compared self-reported and caregiver-reported internalizing and externalizing symptoms by gender and three age-groups (six-10, 10-14, 15-17). We investigated gender-specific child-caregiver agreement and identified gender- and age-specific symptom profiles. Methods: Data from entry assessments of participants aged six-17 were analyzed. 449 children and adolescents (M _age = 13; 63 % girls) and 180 caregivers completed the Pediatric Symptom Checklist (PSC-17; internalizing, attention and externalizing symptoms), Short Mood and Feelings Questionnaire (SMFQ; depression), Generalized Anxiety Disorder Scale (GAD-7, anxiety), International Trauma Questionnaire (ITQ; (complex) post-traumatic stress disorder), and Beck’s Depression Inventory II (BDI-II; suicidal ideation). We performed two-way ANOVAs, calculated intraclass correlation coefficients (ICC), and ran Latent Class Analyses (LCA). Results: Gender differences emerged in older participants. Girls reported higher internalizing symptoms, while boys and their caregivers reported higher externalizing symptoms. Child-caregiver agreement was generally poor. The only moderate agreement was found for suicidal ideation in boys but not in girls. Analysis of symptom profiles revealed a higher likelihood of girls and older patients expressing high levels of comorbidity. No symptom profile for high externalizing behaviour was identified. Conclusions: Results reveal a bias towards patients with internalizing symptoms in child psychiatric care, regardless of gender. Efforts must be made to detect mental disorders in girls earlier and to provide adequate care for patients with predominantly externalizing symptoms. Trial Registration: Not applicable.