Sex Differences in Psychopathology Following Potentially Traumatic Experiences

Key Points Question What is the sex-specific incidence of various forms of posttraumatic psychopathology in a population-based cohort? Findings In this cohort study of more than 1.3 million individuals, patterns of 5-year posttraumatic psychopathology incidence showed substance use disorders were most common for males and depressive disorders were the most common for females. Sex-based differences in associations of potentially traumatic events with psychopathology were more pronounced when accounting for pretrauma psychiatric disorders. Meaning These findings suggest that mental health consequences of trauma in males and females are sex-specific and wide-ranging and may provide new insights for sex-relevant potentially traumatic experiences and their mental health consequences.


Statistical Analyses Information about confidence intervals
For SMRs, we calculated 95% confidence intervals (CIs) assuming observed numbers of psychiatric diagnoses followed a Poisson distribution.Exact CIs were calculated if <10 observed psychiatric diagnoses were recorded; otherwise, CIs were based on Byar's approximation of the exact Poisson distribution. 15,16ubset analyses for exposure to toxic substance Secondary subset analyses were conducted for the exposure to toxic substance PTE.In these analyses, we used ICD-10 codes to distinguish between individuals exposed to toxic substances with abuse or overdose potential (e.g., commonly misused drugs and medications; ICD-10: T39-T43, T51) and other toxic substances with less potential for abuse or overdose (e.g., non-medicinal substances and chemicals; ICD-10: T36-T38, T44-T50, T52-T65).
with a sample size of five or less and cells in which a value presented could result in the calculation of a sample size of less than 5 in a complementary cell are presented as <10.Disorder classes are not mutually exclusive.TBI = traumatic brain injury.a Indicates multiple traumas on the day of the first-recorded trauma.b Behavioral syndromes associated with physiological disturbances and physical factors (e.g., eating disorders).

eFigure 1 .
SMRs for Psychiatric Disorder Classes Within 5 Years of First-Recorded Traumatic Event in Individuals With Pretrauma Psychopathology © 2024 [First author last name and initials or group name] et al. [Journal name].

12 Notes.
Interpersonal traumatic events are displayed in panels a-c.Non-interpersonal traumatic events are displayed in panels d-i.Disorder classes are not mutually exclusive."Physiological" refers to behavioral syndromes associated with physiological disturbances and physical factors (e.g., eating disorders, sleep disorders).CI = confidence interval; SMR = standardized morbidity ratio.

eFigure 2 .
SMRs for Psychiatric Disorder Classes Within 5 Years of First-Recorded Traumatic Event in Individuals Without Pretrauma PsychopathologyNotes. Interpersonal traumatic events are displayed in panels a-c.Non-interpersonal traumatic events are displayed in panels d-i.Disorder classes are not mutually exclusive."Physiological" refers to behavioral syndromes associated with physiological disturbances and physical factors (e.g., eating disorders, sleep disorders).CI = confidence interval; SMR = standardized morbidity ratio.

eTable 2 .
Demographic Characteristics of Men With Pretrauma Psychopathology in the Danish Health Registry Trauma Cohort and Comparison Cohort a Indicates multiple

traumas on the day of the first-recorded trauma. b Persons under the age of 14 with no income data. eTable 3. Demographic
Characteristics of Women With Pretrauma Psychopathology in the Danish Health Registry Trauma Cohort and Comparison Cohort Demographic Characteristics of Men Without Pretrauma Psychopathology in the Danish Health Registry Trauma Cohort and Comparison Cohort Notes.Cells with a sample size of five or less and cells in which a value presented could result in the calculation of a sample size of less than 5 in a complementary cell are presented as <10.TBI = traumatic brain injury.Men included in the pregnancy-related trauma category are those who experienced the stillbirth of a child.Demographic Characteristics of Women Without Pretrauma Psychopathology in the Danish Health Registry Trauma Cohort and Comparison Cohort Notes.Cells with a sample size of five or less and cells in which a value presented could result in the calculation of a sample size of less than 5 in a complementary cell are presented as <10.TBI = traumatic brain injury.Indicates multiple traumas on the day of the first-recorded trauma.b Persons under the age of 14 with no income data.eTable 6. Incidence of Psychiatric Disorders Within 5 Years of First-Recorded Traumatic Event in Men and Women With Pretrauma Psychopathology Notes.Cells with a sample size of five or less and cells in which a value presented could result in the calculation of a sample size of less than 5 in a complementary cell are presented as <10.Disorder classes are not mutually exclusive.TBI = traumatic brain injury.7. Incidence of Psychiatric Disorders Within 5 Years of First-Recorded Traumatic Event in Men and Women Without Pretrauma Psychopathology Notes.Cells with a sample size of five or less and cells in which a value presented could result in the calculation of a sample size of less than 5 in a complementary cell are presented as <10.TBI = traumatic brain injury.aIndicatesmultipletraumas on the day of the first-recorded trauma.bPersonsunder the age of 14 with no income data.eTable4.aIndicates multiple traumas on the day of the first-recorded trauma.bPersonsunder the age of 14 with no income data.eTable 5. a a Indicates multiple traumas on the day of the first-recorded trauma.bBehavioral syndromes associated with physiological disturbances and physical factors (e.g., eating disorders).eTable

eTable 8. Demographic Characteristics of Men and Women in the Danish Health Registry Trauma Cohort With Exposure to Toxic Substance
Notes.Cells with a sample size of five or less and cells in which a value presented could result in the calculation of a sample size of less than 5 in a complementary cell are presented as <10.Persons under the age of 14 with no income data.

Incidence of Psychiatric Disorders Within 5 Years Following First-Recorded Exposure to Toxic Substance in Men and Women
Behavioral syndromes associated with physiological disturbances and physical factors (e.g., eating disorders).
Notes.Disorder classes are not mutually exclusive.a eTable 10.

Standardized Morbidity Ratio (SMR) for Psychiatric Disorder Classes Within 5 Years of First-Recorded Exposure to Toxic Substance in Men and Women
Behavioral syndromes associated with physiological disturbances and physical factors (e.g., eating disorders). a