| 1. |
- Karamanis, Georgios, et al.
(författare)
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Cancer incidence and mortality patterns in women with anorexia nervosa
- 2014
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 134:7, s. 1751-1757
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Tidskriftsartikel (refereegranskat)abstract
- Caloric restriction in animals is an effective way to reduce carcinogenesis. Anorexia nervosa (AN) is considered a model of extreme caloric restriction in humans. The aim of our study was to assess cancer incidence and mortality in women with AN. A total of 6,009 women with at least one inpatient treatment for AN during the period 1973-2003 were included in the study. Standardized incidence ratios (SIR) and standardized mortality ratios (SMR) were calculated. Overall, there was no statistically significant difference in cancer incidence compared to women in the general population. At a statistically significant or borderline significant level, a higher incidence for lung cancer and cancer of lymphoid, hematopoietic and related tissue was observed along with a reduced breast cancer incidence. Women with AN had twice as high mortality from cancer in general, and more specifically from melanoma, cancers of genital organs and cancers of ill-defined, secondary and unspecified sites. The increased lung cancer incidence may be due to smoking habits among women with AN. The worse prognosis with higher mortality from melanoma, cancers of genital organs and cancers of ill-defined, secondary and unspecified sites may be explained by AN-specific attitudes toward seeking medical care, adherence to treatment or worse biological precondition due to starvation and cachexia.
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| 2. |
- Karamanis, Georgios
(författare)
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Gender dysphoria : Insights on etiology and outcomes
- 2023
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Gender Dysphoria (GD) is defined as significant distress or impairment caused by the discrepancy between an individual's experienced gender and the sex assigned at birth. This work explores the etiology and outcomes of GD through two studies. The first assesses its prevalence in different twin categories, and the second examines the incidence of idiopathic intracranial hypertension (IIH) in individuals undergoing gonadotropin-releasing hormone analogue (GnRHa) treatment for GD.The first study utilizes a population-based approach to analyze the prevalence of GD in twins, using data from a Swedish population-based cohort collected over a 16-year period. The objective is to assess the influence of genetic and environmental factors on the development of GD by comparing its prevalence in different-sex twins, same-sex twins, and non-twin siblings. The results indicate a higher prevalence of GD in different-sex twins and suggest a potential influence of intrauterine factors in the development of GD, necessitating further examination of current genetic and environmental theories.The second study focuses on evaluating the occurrence of IIH in individuals undergoing treatment with GnRHa for GD in Sweden between 2006 and 2016. The study did not observe any cases of IIH within the studied cohort. While better-powered studies are needed to clarify any potential association between GnRHa and IIH, the study results do not present substantial evidence to support this association.
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| 3. |
- Karamanis, Georgios, et al.
(författare)
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Gender dysphoria in twins : a register-based population study
- 2022
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Both genetic and environmental influences have been proposed to contribute to the variance of gender identity and development of gender dysphoria (GD), but the magnitude of the effect of each component remains unclear. We aimed to examine the prevalence of GD among twins and non-twin siblings of individuals with GD, using data derived from a large register-based population in Sweden over the period 2001-2016. Register data was collected from the Statistics Sweden and the National Board of Health and Welfare. The outcome of interest was defined as at least four diagnoses of GD or at least one diagnosis followed by gender-affirming treatment. A total of 2592 full siblings to GD cases were registered, of which 67 were twins; age at first GD diagnosis for the probands ranged from 11.2 to 64.2 years. No same-sex twins that both presented with GD were identified during the study period. The proportion of different-sex twins both presenting with GD (37%) was higher than that in same-sex twins (0%, Fisher's exact test p-value < 0.001) and in non-twin sibling pairs (0.16%). The present findings suggest that familial factors, mainly confined to shared environmental influences during the intrauterine period, seem to contribute to the development of GD.
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| 4. |
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| 5. |
- Papadopoulos, Fotios C, et al.
(författare)
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Childbearing and mortality among women with anorexia nervosa
- 2013
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Ingår i: International Journal of Eating Disorders. - : Wiley. - 0276-3478 .- 1098-108X. ; 46:2, s. 164-170
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the association between childbearing and mortality from anorexia nervosa (AN). METHOD: A total of 5,251 females, from a population-based Swedish registry, admitted with an AN diagnosis during the period 1973-2003 were included. Standardized mortality ratios (SMR) were estimated and hazard ratios (HR) were calculated using Cox regression. RESULTS: Nulliparous women had a sixfold higher mortality due to natural causes and ninefold higher mortality due to unnatural causes compared to the general population. Parous women had higher mortality compared to the general population only due to unnatural causes. Suicide was the most common cause of death. Childbearing was associated with a 65% lower mortality. One hundred forty four women out of 1,941 parous women were hospitalized perinatally for any psychiatric disorder (7.4%). DISCUSSION: Childbearing is associated with lower mortality among women with AN.
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| 6. |
- Özel, Faith, et al.
(författare)
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Exploring gender dysphoria and related outcomes in a prospective cohort study: protocol for the Swedish Gender Dysphoria Study (SKDS)
- 2023
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Ingår i: Bmj Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction There has been a drastic increase in the reported number of people seeking help for gender dysphoria in many countries over the last two decades. Yet, our knowledge of gender dysphoria and related outcomes is restricted due to the lack of high-quality studies employing comprehensive approaches. This longitudinal study aims to enhance our knowledge of gender dysphoria; different aspects will be scrutinised, focusing primarily on the psychosocial and mental health outcomes, prognostic markers and, secondarily, on the underlying mechanisms for its origin. Methods and analysis The Swedish Gender Dysphoria Study is an ongoing multicentre longitudinal cohort study with 501 registered participants with gender dysphoria who are 15 years old or older. Participants at different phases of their clinical evaluation process can enter the study, and the expected follow-up duration is three years. The study also includes a comparison group of 458 age- and county-matched individuals without gender dysphoria. Data on the core outcomes of the study, which are gender incongruence and experienced gender dysphoria, body satisfaction and satisfaction with gender-affirming treatments, as well as other relevant outcomes, including mental health, social functioning and life satisfaction, are collected via web surveys. Two different research visits, before and after starting on gender-affirming hormonal treatment (if applicable), are planned to collect respective biological and cognitive measures. Data analysis will be performed using appropriate biostatistical methods. A power analysis showed that the current sample size is big enough to analyse continuous and categorical outcomes, and participant recruitment will continue until December 2022. Ethics and dissemination The ethical permission for this study was obtained from the Local Ethical Review Board in Uppsala, Sweden. Results of the study will be presented at national and international conferences and published in peer-reviewed journals. Dissemination will also be implemented through the Swedish Gender Dysphoria Study network in Sweden.
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