Abstract：Objective To investigate the prevalence of depression and anxiety among transgender populations and the correlation with defense mechanism, so as to provide the evidence for improving mental health among transgender populations. Methods Transgender populations that visited Psychosexual Outpatient Department of Beijing Huilongguan Hospital for the first time from December 2020 to December 2021 were enrolled. Participants' demographics, depression, anxiety and type of defense mechanisms were collected using self-designed questionnaires, Self-rating Depression Scale, Self-rating Anxiety Scale and Defense Style Questionnaire (DSQ). Factors affecting depression and anxiety were identified using a multivariable logistic regression model. Results Totally 126 transgender individuals were enrolled, including 95 men (75.40%) with a mean age of (21.53±4.55) years and 31 women (24.60%) with a mean age of (23.58±5.55) years. The prevalence of depression was 46.83% among participants, including 44.07% of participants with mild depression, 30.51% with moderate depression and 25.42% with severe depression, and the prevalence of anxiety was 26.19% among participants, including 60.61% of participants with mild anxiety, 21.21% with moderate anxiety and 18.18% with severe anxiety. The detection of depression was 54.74% among men and 22.58% among women (P<0.05), and the detection of both depression (62.79% vs. 38.55%, P<0.05) and anxiety (41.86% vs. 18.07%, P<0.05) was significantly higher among transgender populations with self-injury or suicide behaviors than among those without. Multivariable logistic regression analysis showed that immature defense mechanisms increased the risk of depression (OR=1.034, 95%CI: 1.018-1.051) and anxiety (OR=1.031, 95%CI: 1.014-1.049) among transgender populations, while mature defense mechanisms reduced the risk of depression (OR=0.887, 95%CI: 0.832-0.946) and anxiety (OR=0.878, 95%CI: 0.821-0.938) among transgender populations. Conclusions The prevalence of depression and anxiety was 46.83% and 26.19% among transgender populations included in this study. Mature defense mechanisms are beneficial to reduce the risk of depression and anxiety among transgender populations.
[1] DISANTOSTEFANO J.International classification of diseases 10th revision(ICD-10)[J]. J Nurse Pract,2010,5(1):56-57. [2] 夏楠,刘爱忠.跨性别者的心理健康问题(综述)[J].中国心理卫生杂志,2021,35(3):231-235. [3] 北京同志中心,北京大学社会学系.2017年中国跨性别群体生存现状调查报告[R].2017. [4] 刘贤臣,唐茂芹,陈琨,等.SDS和CES-D对大学生抑郁症状评定结果的比较[J].中国心理卫生杂志,1995,9(1):19-20,37. [5] 乔艳阳,王健,张春雨.焦虑自评量表在公务员群体中的信效度检验及区域性常模的制定[J].心理学进展,2022,12(6):2269-2278. [6] 路敦跃,张丽杰,赵瑞,等.防御方式问卷初步试用结果[J].中国心理卫生杂志,1993,7(2):53-56,94. [7] 李宁宁. 《防御方式问卷》验证性信效度分析[D].大连:大连医科大学,2013. [8] STANTON A M, BATCHELDER A W.Differences in mental health symptom severity and care engagement among transgender and gender diverse individuals:findings from a large community health center[J]. PLoS One,2021,16(1):245-248. [9] CHANG R,ZENG C,QIAO S,et al.The mediating effect of depression on the relation between interpersonal needs and suicidal ideation among Chinese transgender women[J]. Front Public Health,2022,9(1):76-78. [10] WANG Y, HU Z.Mapping out a spectrum of the Chinese public's discrimination toward the LGBT community:results from a national survey[J]. BMC Public Health,2020,20(1):669-672. [11] HUA B,YANG V F,GOLDSEN K F.LGBT older adults at a crossroads in mainland China:the intersections of stigma,cultural values,and structural changes within a shifting context[J]. Int J Aging Hum Dev,2019,88(4):440-456. [12] WANG Y,WILSON A,CHEN R,et al.Behind the rainbow,"Tongqi" wives of men who have sex with men in China:a systematic review[J]. Front Psychol,2020,10(5):29-32. [13] HU X,WANG Y.LGB identity among young Chinese:the influence of traditional culture[J]. J Homosex,2013,60(5):667-672. [14] ZILCHA-MANO S.Toward personalized psychotherapy:the importance of the trait-like/state-like distinction for understanding therapeutic change[J]. Am Psychol,2021,76(3):516-528. [15] VAILLANT G E.Involuntary coping mechanisms:a psychodynamic perspective[J].Dialogues Clin Neurosci,2011,13(3):366-370. [16] JUN J Y,LEE Y J.Association between defense mechanisms and psychiatric symptoms in North Korean Refugees[J]. Compr Psychiatry,2015,56(3):179-182. [17] 叶帆,王江梅.心理干预结合药物治疗对青少年抑郁患者心理防御机制的影响研究[J].心理月刊,2021,16(9):43-44,56. [18] SUN M, JI H, CHEN X, et al.The factors influencing the psychological distress of transgender women in Shandong, China: a cross-sectional study[J]. BMC Public Health,2022,22(1):955-967.
