Exploratory Analysis of Gender-Specific Symptom Burden in Child Psychiatric Care

Exploratory Analysis of Gender-Specific Symptom Burden in Child Psychiatric Care | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Exploratory Analysis of Gender-Specific Symptom Burden in Child Psychiatric Care Moritz Russo, Dina Weindl-Wagner, Alexander Haselgruber, Karin Zajec, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8861753/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background: Gender plays a key role in the incidence, symptom expression, and treatment of mental disorders in children and adolescents. Consequently, we took an exploratory approach to investigating youth’s gender-specific symptom burden in a child psychiatric care unit. We compared self-reported and caregiver-reported internalizing and externalizing symptoms by gender and three age-groups (six-10, 10-14, 15-17). We investigated gender-specific child-caregiver agreement and identified gender- and age-specific symptom profiles. Methods: Data from entry assessments of participants aged six-17 were analyzed. 449 children and adolescents (M age = 13; 63 % girls) and 180 caregivers completed the Pediatric Symptom Checklist (PSC-17; internalizing, attention and externalizing symptoms), Short Mood and Feelings Questionnaire (SMFQ; depression), Generalized Anxiety Disorder Scale (GAD-7, anxiety), International Trauma Questionnaire (ITQ; (complex) post-traumatic stress disorder), and Beck’s Depression Inventory II (BDI-II; suicidal ideation). We performed two-way ANOVAs, calculated intraclass correlation coefficients (ICC), and ran Latent Class Analyses (LCA). Results: Gender differences emerged in older participants. Girls reported higher internalizing symptoms, while boys and their caregivers reported higher externalizing symptoms. Child-caregiver agreement was generally poor. The only moderate agreement was found for suicidal ideation in boys but not in girls. Analysis of symptom profiles revealed a higher likelihood of girls and older patients expressing high levels of comorbidity. No symptom profile for high externalizing behaviour was identified. Conclusions: Results reveal a bias towards patients with internalizing symptoms in child psychiatric care, regardless of gender. Efforts must be made to detect mental disorders in girls earlier and to provide adequate care for patients with predominantly externalizing symptoms. Trial Registration: Not applicable. Gender differences Child Psychiatry Internalizing symptoms Externalizing symptoms Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryInformation.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 17 Mar, 2026 Editor invited by journal 18 Feb, 2026 Editor assigned by journal 17 Feb, 2026 Submission checks completed at journal 17 Feb, 2026 First submitted to journal 12 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8861753","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":607849331,"identity":"ebd10a9d-8e8b-4c27-af80-25497371fdb8","order_by":0,"name":"Moritz Russo","email":"","orcid":"","institution":"Faculty of Psychology","correspondingAuthor":false,"prefix":"","firstName":"Moritz","middleName":"","lastName":"Russo","suffix":""},{"id":607849334,"identity":"4dfbc3f6-ae76-4865-9e72-5d32e9a694ba","order_by":1,"name":"Dina Weindl-Wagner","email":"","orcid":"","institution":"Faculty of Psychology","correspondingAuthor":false,"prefix":"","firstName":"Dina","middleName":"","lastName":"Weindl-Wagner","suffix":""},{"id":607849336,"identity":"14306de0-b061-4ec7-8035-060379bbb11f","order_by":2,"name":"Alexander Haselgruber","email":"","orcid":"","institution":"Federal Clinic Baden-Mödling","correspondingAuthor":false,"prefix":"","firstName":"Alexander","middleName":"","lastName":"Haselgruber","suffix":""},{"id":607849337,"identity":"ca64f797-8ee2-4e40-a985-0cc67fc3bf9b","order_by":3,"name":"Karin Zajec","email":"","orcid":"","institution":"Federal Clinic Baden-Mödling","correspondingAuthor":false,"prefix":"","firstName":"Karin","middleName":"","lastName":"Zajec","suffix":""},{"id":607849338,"identity":"f29b79b5-c282-4f26-9f3a-7a9db64802ee","order_by":4,"name":"Judith Noske","email":"","orcid":"","institution":"Federal Clinic Baden-Mödling","correspondingAuthor":false,"prefix":"","firstName":"Judith","middleName":"","lastName":"Noske","suffix":""},{"id":607849339,"identity":"c1eaaa45-b3be-452c-ad2c-d69b1b297be2","order_by":5,"name":"Brigitte Lueger-Schuster","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABZElEQVRIie2RP0vDQBTAXzhol4OsCZXkK1w4SC2GfpYrhUzxD3TpIDRQSBZx7sfQxTklUJdzPxexuDg4tOhwYrG+VmkTyQcQzA/uD3f3u3v3HkBNzR+EgRGD2MyauzX6PZjYMjxQrQjcICUFb7HjopIVlA2VCtufKintVj5+nuuVA4R687fhA7jp3cx+18EpV8fTnJ4FYKaZ8brYKZ3LXnKIgXFUOD+QA2DyJGxREXZu1InIKQvBkoJYhcCkkTBUejGhfstOxOjKwgmInPkqYtMJywEUQIUyQqX9YX8KcCfUt7VYMz7ZKmtwFRBdUsaPqAgMzDeWMX5bUd+iImPMili2wCQwBY3CK50LIwERci8hjUELZgIvifgRDfvMki8bpU89if+V+4zR5tNSB45rNsfXS32OgaXSu9dBl5lpxBdi1XWc2zxXw2LGG9a2x0bo70r/lAnLXYLsUm7oKqWmpqbm3/MFBX98Y8fqbSMAAAAASUVORK5CYII=","orcid":"","institution":"Faculty of Psychology","correspondingAuthor":true,"prefix":"","firstName":"Brigitte","middleName":"","lastName":"Lueger-Schuster","suffix":""}],"badges":[],"createdAt":"2026-02-12 11:53:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8861753/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8861753/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105035076,"identity":"87eb8779-2f1a-47bc-84f0-1e9d12eac7a2","added_by":"auto","created_at":"2026-03-20 07:25:25","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":926401,"visible":true,"origin":"","legend":"","description":"","filename":"Exploratoryanalysisofgenderspecificsymptomburdeninchildpsychiatriccare.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8861753/v1_covered_1c6eccbc-3b13-434e-82b2-16dc91d23aa5.pdf"},{"id":104987725,"identity":"a792b519-38f3-48fa-bfa4-19497d9545f1","added_by":"auto","created_at":"2026-03-19 14:52:10","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":29433,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryInformation.docx","url":"https://assets-eu.researchsquare.com/files/rs-8861753/v1/d070ab246fdfed2691c6748c.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Exploratory Analysis of Gender-Specific Symptom Burden in Child Psychiatric Care","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Gender differences, Child Psychiatry, Internalizing symptoms, Externalizing symptoms","lastPublishedDoi":"10.21203/rs.3.rs-8861753/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8861753/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Gender plays a key role in the incidence, symptom expression, and treatment of mental disorders in children and adolescents. Consequently, we took an exploratory approach to investigating youth’s gender-specific symptom burden in a child psychiatric care unit. We compared self-reported and caregiver-reported internalizing and externalizing symptoms by gender and three age-groups (six-10, 10-14, 15-17). We investigated gender-specific child-caregiver agreement and identified gender- and age-specific symptom profiles.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Data from entry assessments of participants aged six-17 were analyzed. 449 children and adolescents (M\u003csub\u003eage\u0026nbsp;\u003c/sub\u003e= 13; 63 % girls) and 180 caregivers completed the Pediatric Symptom Checklist (PSC-17; internalizing, attention and externalizing symptoms), Short Mood and Feelings Questionnaire (SMFQ; depression), Generalized Anxiety Disorder Scale (GAD-7, anxiety), International Trauma Questionnaire (ITQ; (complex) post-traumatic stress disorder), and Beck’s Depression Inventory II (BDI-II; suicidal ideation). We performed two-way ANOVAs, calculated intraclass correlation coefficients (ICC), and ran Latent Class Analyses (LCA).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Gender differences emerged in older participants. Girls reported higher internalizing symptoms, while boys and their caregivers reported higher externalizing symptoms. Child-caregiver agreement was generally poor. The only moderate agreement was found for suicidal ideation in boys but not in girls. Analysis of symptom profiles revealed a higher likelihood of girls and older patients expressing high levels of comorbidity. No symptom profile for high externalizing behaviour was identified.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e Results reveal a bias towards patients with internalizing symptoms in child psychiatric care, regardless of gender. Efforts must be made to detect mental disorders in girls earlier and to provide adequate care for patients with predominantly externalizing symptoms.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial Registration: \u003c/strong\u003eNot applicable.\u003c/p\u003e","manuscriptTitle":"Exploratory Analysis of Gender-Specific Symptom Burden in Child Psychiatric Care","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-19 14:52:05","doi":"10.21203/rs.3.rs-8861753/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-03-17T13:15:02+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-18T12:20:06+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-18T00:06:37+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-18T00:06:32+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2026-02-12T11:43:51+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7da0d696-fd52-4fe9-94c9-a5944c115f30","owner":[],"postedDate":"March 19th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-19T14:52:06+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-19 14:52:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8861753","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8861753","identity":"rs-8861753","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}