(PS1-C51) Morbidity Rates of Psychiatric Diagnoses of Sexual and Gender Minority Youth on a Youth-serving Inpatient Unit

Rates of self-injurious thoughts and behaviors have increased over the past two decades, with sexual and gender minority youth being at particularly high risk. Despite high rates of psychiatric hospitalization for sexual and gender minority (SGM) youth, few studies have examined psychiatric presentations in this setting. The present study aimed to examine cross-sectional differences in diagnostic presentations for SGM youth compared to non-SGM youth in a sample admitted to an adolescent psychiatric inpatient unit. Additionally, the present study sought to build upon previous research examining differences in suicidal ideation and history of suicide attempts in an inpatient care setting between SGM youth and their heterosexual and cisgender peers. Data collection occurred as part of an IRB approved chart review on a psychiatric inpatient unit for youth ages 11-18. During hospitalization, adolescents completed routine psychiatric assessments including a structured diagnostic interview, Suicidal Ideation Questionnaire-Jr (SIQ-Jr), and an abbreviated version of the Self-Injurious Thoughts and Behaviors Interview (SITBI). Chi-square and t-test analyses were conducted between patients who self-identified as gender minority and cisgender and between patients who self-identified as sexual minority and heterosexual. Sensitivity analyses revealed no change in significance of results when including youth endorsing “prefer not to answer” or “questioning” on gender or sexuality identification questions. Of the total sample (N=808), 20% (N=159) of this sample self-identify as a gender minority and 53% (N=431) self-identify as a sexual minority. Both gender and sexual minorities received significantly (p< 0.5) more diagnoses compared to cisgender and heterosexual peers, respectively. Gender minority patients endorsed significantly higher rates of MDD, manic episode(s), GAD, ADHD combined and inattentive subtypes, SAD, and OCD. Sexual minority patients endorsed significantly higher rates of MDD, manic episode(s), GAD, ADHD combined and hyperactive subtypes, SAD, and OCD. Consistent with prior work, both gender and sexual minorities endorsed significantly increased SIQ scores compared to cisgender and heterosexual patients, respectively. History of suicide attempts at lifetime, 12 months, and 30-day intervals were not significantly different between sexual minority and heterosexual patients. History of suicide attempts at 12 months and 30 days were significantly elevated in gender minority youth compared to cisgender youth. These findings are largely consistent with a broader literature demonstrating heightened risk for a broad range of outcomes across SGM youth. Future directions include examining the role of minority stressors as factors in these disparities.