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  Vol. 127 No. 6, June 2009 TABLE OF CONTENTS
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Prevalence and Sex Differences of Psychiatric Disorders in Young Adults Who Had Intermittent Exotropia as Children

Jeff A. McKenzie, BA; Jason A. Capo, MD; Kevin J. Nusz, MD; Nancy N. Diehl, BS; Brian G. Mohney, MD

Arch Ophthalmol. 2009;127(6):743-747.

Objective  To evaluate the prevalence and sex differences of mental disorders diagnosed among young adults who had intermittent exotropia (IXT) as children.

Methods  The medical records of all children (<19 years) diagnosed as having IXT as residents of Olmsted County, Minnesota, from January 1, 1975, through December 31, 1994, and their randomly selected nonstrabismic birth- and sex-matched controls (1:1) were retrospectively reviewed.

Results  A mental health disorder was diagnosed in 97 (53.0%) of the 183 patients with childhood IXT followed to a mean age of 22 years compared with 55 (30.1%) controls (P < .001). Patients with IXT were 2.7 (95% confidence interval, 1.7-4.1) times more likely to develop a psychiatric illness than controls. A mental health disorder was diagnosed in 63% (41 of 65) and 47% (56 of 118) of males and females with IXT, respectively, compared with 33% (22 of 66) and 28% (33 of 117) of male and female controls, respectively. Additionally, males with IXT had a greater use of psychotropic medication (P = .003), psychiatric emergency department visits (P < .001), psychiatric hospital admissions (P = .04), suicide attempts (P = .004), and suicidal ideation (P = .002) than controls, and females with IXT had more suicidal ideation (P = .02) than controls.

Conclusions  Children diagnosed as having IXT, especially males, are more likely to develop mental illness by the third decade of life compared with children without strabismus.


Author Affiliations: College of Medicine (Mr McKenzie and Dr Capo), Department of Ophthalmology (Drs Nusz and Mohney), and Division of Biostatistics (Ms Diehl), Mayo Clinic and Mayo Foundation, Rochester, Minnesota.



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