Abstract
OBJECTIVE: To examine the implementation of a new psychiatric follow-up model for patients with differences of sexual development (DSD), a group of conditions affecting gender determination and differentiation, focusing on the model’s impact on patient care and residents’ training. METHODS: Data from patients monitored between March 2000 and November 2023 and 28 child and adolescent psychiatry residents in a tertiary-care center were analyzed. Data was collected before and after implementing the new model using psychiatric assessment and the Clinical Global Impression (CGI) and Global Assessment Scale (GAS). RESULTS: The patient cohort consisted of 129 patients with DSD, of whom 10 (7.75%) were lost to follow up. Of the remaining 119 patients, 89 (74.8%) were monitored by two expert specialists prior to the model’s implementation, while 30 (25.2%) were cared for by junior child and adolescent psychiatry residents under supervision following the implementation of the new model. The mean age of the patients was 10.86±6.32 years. No significant differences in the prevalence of psychiatric disorders or in CGI or GAS scores before and after implementing the new education model were found (p>0.05). The most common psychiatric diagnosis in our sample was attention-deficit/hyperactivity disorder (19.4%), followed by intellectual disability and major depressive disorder, each accounting for 14.0%. Residents reported enhanced competence in managing patients with DSD (14.3%), improved communication skills, and better identification of subthreshold psychiatric symptoms (25%), as well as a greater understanding of the multidisciplinary approach (14.3%). CONCLUSION: This study highlighted the importance of structured psychiatric support in the management of DSD. Furthermore, the education of future psychiatrists was subjectively improved.