1
|
Lin IJ, Tzeng NS, Chung CH, Chien WC. Psychiatric disorders in female psychosexual disorders-a nationwide, cohort study in Taiwan : Psychiatric disorders and female psychosexual disorders. BMC Psychiatry 2021; 21:63. [PMID: 33509146 PMCID: PMC7845000 DOI: 10.1186/s12888-021-03060-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 01/18/2021] [Indexed: 12/02/2022] Open
Abstract
We aimed to investigate whether females with psychosexual disorders were associated with the risk of affective and other psychiatric disorders. A total of 2240 enrolled individuals, with 560 patients with psychosexual disorders and 1680 subjects without psychosexual disorders (1:3) matched for age and index year, from the Longitudinal Health Insurance Database, retrieved from the National Health Insurance Research Database (NHIRD), between 2000 and 2015 in Taiwan. The multivariate Cox regression model was used to compare the risk of developing psychiatric disorders during the 15 years of follow-up. There were 98 in the cohort with psychosexual disorders (736.07 per 100,000 person-year) and 119 in the non-cohort without psychosexual disorders (736.07 per 100,000 person-year) that developed psychiatric disorders. The multivariate Cox regression model revealed that the adjusted hazard ratio (HR) was 9.848 (95% CI = 7.298 - 13.291, p < 0.001), after the adjustment of age, monthly income, urbanization level, geographic region, and comorbidities. Female patients with psychosexual disorders were associated with the risk of psychiatric disorders. This finding could be a reminder for clinicians about the mental health problems in patients with psychosexual disorders.
Collapse
Affiliation(s)
- Iau-Jin Lin
- grid.260565.20000 0004 0634 0356Graduate Institute of Life Sciences, National Defense Medical Center, 9314R, No.161, Section 6, Min-Chuan East Road, Neihu District, Taipei, 11490 Taiwan, Republic of China
| | - Nian-Sheng Tzeng
- grid.260565.20000 0004 0634 0356Department of Psychiatry, School of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China ,grid.260565.20000 0004 0634 0356Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chi-Hsiang Chung
- grid.260565.20000 0004 0634 0356Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Gung Road, Neihu District, Taipei, 11490 Taiwan, Republic of China ,grid.260565.20000 0004 0634 0356School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China ,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, Republic of China
| | - Wu-Chien Chien
- Graduate Institute of Life Sciences, National Defense Medical Center, 9314R, No.161, Section 6, Min-Chuan East Road, Neihu District, Taipei, 11490, Taiwan, Republic of China. .,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Gung Road, Neihu District, Taipei, 11490, Taiwan, Republic of China. .,School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China. .,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, Republic of China.
| |
Collapse
|
2
|
Schneider MA, Andreazza T, Fontanari AMV, Costa AB, Silva DCD, Aguiar BWD, Massuda R, Pedrini M, Gama CS, Schwarz K, Kauer-Sant'Anna M, Lobato MIR. Serum concentrations of brain-derived neurotrophic factor in patients diagnosed with gender dysphoria undergoing sex reassignment surgery. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2017; 39:43-47. [PMID: 28403322 DOI: 10.1590/2237-6089-2016-0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 11/28/2016] [Indexed: 11/22/2022]
Abstract
Introduction: Transsexualism (ICD-10) is a condition characterized by a strong and persistent dissociation with one's assigned gender. Sex reassignment surgery (SRS) and hormone therapy provide a means of allowing transsexual individuals to feel more congruent with their gender and have played a major role in treatment over the past 70 years. Brain-derived neurotrophic factor (BDNF) appears to play a key role in recovery from acute surgical trauma and environmentally mediated vulnerability to psychopathology. We hypothesize that BDNF may be a biomarker of alleviation of gender incongruence suffering. Objectives: To measure preoperative and postoperative serum BDNF levels in transsexual individuals as a biomarker of alleviation of stress related to gender incongruence after SRS. Methods: Thirty-two male-to-female transsexual people who underwent both surgery and hormonal treatment were selected from our initial sample. BDNF serum levels were assessed before and after SRS with sandwich enzyme linked immunosorbent assay (ELISA). The time elapsed between the pre-SRS and post-SRS blood collections was also measured. Results: No significant difference was found in pre-SRS or post-SRS BDNF levels or with relation to the time elapsed after SRS when BDNF levels were measured. Conclusion: Alleviation of the suffering related to gender incongruence after SRS cannot be assessed by BDNF alone. Surgical solutions may not provide a quick fix for psychological distress associated with transsexualism and SRS may serve as one step toward, rather than as the conclusion of, construction of a person's gender identity.
Collapse
Affiliation(s)
- Maiko A Schneider
- Programa de Identidade de Gênero (Protig), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Tahiana Andreazza
- Programa de Identidade de Gênero (Protig), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Anna Martha V Fontanari
- Programa de Identidade de Gênero (Protig), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Angelo B Costa
- Programa de Identidade de Gênero (Protig), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Dhiordan C da Silva
- Programa de Identidade de Gênero (Protig), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Bianca W de Aguiar
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Raffael Massuda
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Mariana Pedrini
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Clarissa S Gama
- Programa de Identidade de Gênero (Protig), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Karine Schwarz
- Programa de Identidade de Gênero (Protig), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Marcia Kauer-Sant'Anna
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Maria Ines R Lobato
- Programa de Identidade de Gênero (Protig), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
3
|
Mueller A, Quadros C, Schwarz K, Brandelli Costa A, Vaitses Fontanari AM, Machado Borba Soll B, Cardoso da Silva D, Abel Schneider M, de Moura Silveira É, Kauer-Sant'Anna M, Rodrigues Lobato MI. Rumination as a Marker of Psychological Improvement in Transsexual Women Postoperative. Transgend Health 2016; 1:274-278. [PMID: 28861541 PMCID: PMC5367481 DOI: 10.1089/trgh.2016.0029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose: This study aimed to analyze rumination levels of transsexual women before and after gender affirmation surgery (GAS). Rumination scores may represent a broader measure of GAS success and an alternative to patient-reported satisfaction, quality of life, well-being, or the presence of “caseness” for anxiety or depression as previously established in the literature. Methods: Thirty-nine transsexual women were recruited. The participants completed the rumination scale of the Response Styles Questionnaire (RSQ) and were divided into three subsets according to the treatment time. Results: The rumination scores were lower in the transsexual women who had undergone surgical procedures on primary sexual characteristics and gradually decreased with each additional procedure completed with respect to secondary sexual characteristics. Conclusion: Rumination appears to comprise an important marker of improvement in post-GAS transsexual women.
Collapse
Affiliation(s)
- Andressa Mueller
- Gender Identity Program (PROTIG), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Cláudia Quadros
- Gender Identity Program (PROTIG), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Karine Schwarz
- Gender Identity Program (PROTIG), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Angelo Brandelli Costa
- Pós Graduação em Psicologia, Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS), Porto Alegre, Brazil
| | - Anna Martha Vaitses Fontanari
- Gender Identity Program (PROTIG), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Bianca Machado Borba Soll
- Gender Identity Program (PROTIG), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Dhiordan Cardoso da Silva
- Gender Identity Program (PROTIG), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Maiko Abel Schneider
- Gender Identity Program (PROTIG), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Érico de Moura Silveira
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marcia Kauer-Sant'Anna
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Inês Rodrigues Lobato
- Gender Identity Program (PROTIG), Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| |
Collapse
|
4
|
Castellini G, Lelli L, Ricca V, Maggi M. Sexuality in eating disorders patients: etiological factors, sexual dysfunction and identity issues. A systematic review. Horm Mol Biol Clin Investig 2016; 25:71-90. [DOI: 10.1515/hmbci-2015-0055] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 11/24/2015] [Indexed: 11/15/2022]
Abstract
AbstractThe scientific community appears to be less interested in sexuality of eating disorders (EDs) as compared to other psychiatric or medical comorbidities. However, a clear association between sexual problems and ED psychopathology was reported from different perspectives. The overarching goal of this systematic review was to evaluate the general approach of the scientific literature toward the topic of sexuality and EDs. In particular, four different categories of research have been individuated, encompassing the role of puberty, and sexual abuse in the pathogenesis of the disorders, sexual dysfunctions, and the association between sexual orientation and EDs psychopathology. Timing of puberty with its hormonal consequences and the changes in the way persons perceive their own body represent a crucial period of life for the onset of the disorder. Sexual abuse, and especially childhood sexual abuse are well-recognized risk factors for the development of ED, determining a worse long-term outcome. Recent research overcome the approach that considers sexual activity of EDs patients, in terms of hypersexuality and dangerous sexual behaviors, considering the sexuality of EDs persons in terms of sexual desire, satisfaction, orgasm and pain. Results from this line of research are promising, and describe a clear relationship between sexual dysfunction and the core psychopathological features of EDs, such as body image disturbances. Finally, the analysis of the literature showed an association between sexual orientation and gender dysphoria with EDs psychopathology and pathological eating behaviors, confirming the validity of research developing new models of maintaining factors of EDs related to the topic of self-identity.
Collapse
|
5
|
Miyajima E, Taira N, Koda M, Kondo T. Differences in personality traits between male-to-female and female-to-male gender identity disorder subjects. Psychiatry Res 2014; 220:496-9. [PMID: 25130781 DOI: 10.1016/j.psychres.2014.07.069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 07/17/2014] [Accepted: 07/27/2014] [Indexed: 10/25/2022]
Abstract
The present study aimed to investigate differences in personality traits among male-to-female (MtF), female-to-male (FtM) gender identity disorder (GID) subjects and non-transsexual male (M) and female (F) controls. Subjects were 72 MtF and 187 FtM GID subjects without psychiatric comorbidities together with 184 male and 159 female non-transsexual controls. Personality traits were assessed using a short version of the Temperament and Character Inventory (TCI-125). Group comparisons were made by two-way ANOVA. Statistical significances were observed as follows: 1) lower novelty seeking in FtM than in M or MtF, 2) higher reward dependence in FtM than in M, 3) higher cooperativeness in FtM than in M or MtF, 4) the highest self-transcendence in MtF among all the groups. The highest self-transcendence in MtF subjects may reflect their vulnerable identity and constrained adaptation to society as the minority. Nevertheless, higher reward dependence and cooperativeness in FtM subjects can be related to more determined motivation for the treatments of GID and might promise better social functioning and adjustment than MtF subjects.
Collapse
Affiliation(s)
- Eiichi Miyajima
- Department of Psychiatry, Clinic Omoromachi, Naha, Okinawa, Japan; Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan.
| | - Naoki Taira
- Department of Psychiatry, Amekudai Hospital, Naha, Okinawa, Japan
| | - Munenaga Koda
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan
| | - Tsuyoshi Kondo
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan
| |
Collapse
|
6
|
Colizzi M, Costa R, Todarello O. Transsexual patients' psychiatric comorbidity and positive effect of cross-sex hormonal treatment on mental health: results from a longitudinal study. Psychoneuroendocrinology 2014; 39:65-73. [PMID: 24275005 DOI: 10.1016/j.psyneuen.2013.09.029] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/11/2013] [Accepted: 09/30/2013] [Indexed: 12/20/2022]
Abstract
The aim of the present study was to evaluate the presence of psychiatric diseases/symptoms in transsexual patients and to compare psychiatric distress related to the hormonal intervention in a one year follow-up assessment. We investigated 118 patients before starting the hormonal therapy and after about 12 months. We used the SCID-I to determine major mental disorders and functional impairment. We used the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS) for evaluating self-reported anxiety and depression. We used the Symptom Checklist 90-R (SCL-90-R) for assessing self-reported global psychological symptoms. Seventeen patients (14%) had a DSM-IV-TR axis I psychiatric comorbidity. At enrollment the mean SAS score was above the normal range. The mean SDS and SCL-90-R scores were on the normal range except for SCL-90-R anxiety subscale. When treated, patients reported lower SAS, SDS and SCL-90-R scores, with statistically significant differences. Psychiatric distress and functional impairment were present in a significantly higher percentage of patients before starting the hormonal treatment than after 12 months (50% vs. 17% for anxiety; 42% vs. 23% for depression; 24% vs. 11% for psychological symptoms; 23% vs. 10% for functional impairment). The results revealed that the majority of transsexual patients have no psychiatric comorbidity, suggesting that transsexualism is not necessarily associated with severe comorbid psychiatric findings. The condition, however, seemed to be associated with subthreshold anxiety/depression, psychological symptoms and functional impairment. Moreover, treated patients reported less psychiatric distress. Therefore, hormonal treatment seemed to have a positive effect on transsexual patients' mental health.
Collapse
Affiliation(s)
- Marco Colizzi
- Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari, Bari 70124, Italy.
| | - Rosalia Costa
- Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari, Bari 70124, Italy
| | - Orlando Todarello
- Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari, Bari 70124, Italy
| |
Collapse
|
7
|
Tominaga T, Choi H, Nagoshi Y, Wada Y, Fukui K. Relationship between alexithymia and coping strategies in patients with somatoform disorder. Neuropsychiatr Dis Treat 2014; 10:55-62. [PMID: 24403835 PMCID: PMC3883553 DOI: 10.2147/ndt.s55956] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE A multidimensional intervention integrating alexithymia, negative affect, and type of coping strategy is needed for the effective treatment of somatoform disorder; however, few studies have applied this approach to the three different dimensions of alexithymia in patients with somatoform disorder. The purpose of this study was to determine the relationship between type of coping strategy and three different dimensions of alexithymia expressed in patients. PATIENTS AND METHODS A total of 196 patients with somatoform disorder completed the 20-item Toronto Alexithymia Scale, the Zung Self-Rating Depression Scale, the Spielberger State-Trait Anxiety Inventory, the Somatosensory Amplification Scale, and the Lazarus Stress Coping Inventory. The relationships between alexithymia (Toronto Alexithymia Scale - 20 score and subscales), demographic variables, and psychological inventory scores were analyzed using Pearson's correlation coefficients and stepwise multiple regression analysis. RESULTS The mean Toronto Alexithymia Scale - 20 total score (56.1±10.57) was positively correlated with the number of physical symptoms as well as with psychopathology scores (Self-Rating Depression Scale, State-Trait Anxiety Inventory trait, state, and Somatosensory Amplification Scale), but negatively correlated with planful problem solving, confrontive coping, seeking social support, and positive reappraisal coping scores. With respect to coping strategy, multiple regression analyses revealed that "difficulty in identifying feelings" was positively associated with an escape-avoidance strategy, "difficulty in describing feelings" was negatively associated with a seeking social support strategy, and "externally oriented thinking" was negatively associated with a confrontive coping strategy. CONCLUSION Alexithymia was strongly associated with the number of somatic symptoms and negative affect. Patients with high "difficulty in describing feelings" tend to rely less on seeking social support, and patients with high "externally oriented thinking" tend to rely less on confrontive coping strategies. The coping skills intervention implemented should differ across individuals and should be based on the alexithymia dimension of each patient.
Collapse
Affiliation(s)
- Toshiyuki Tominaga
- Health Management Doctor's Office (Mental Health), Salary, Personnel Health, and Welfare Division, Kyoto Prefecture, Japan ; Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hyungin Choi
- Department of Psychiatry, Iwakura Hospital, Kyoto, Japan
| | - Yasuhide Nagoshi
- Department of Psychiatry (Psychosomatic Medicine), Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Yoshihisa Wada
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kenji Fukui
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
8
|
Fontanari AMV, Andreazza T, Costa ÂB, Salvador J, Koff WJ, Aguiar B, Ferrari P, Massuda R, Pedrini M, Silveira E, Belmonte-de-Abreu PS, Gama CS, Kauer-Sant'Anna M, Kapczinski F, Lobato MIR. Serum concentrations of brain-derived neurotrophic factor in patients with gender identity disorder. J Psychiatr Res 2013; 47:1546-8. [PMID: 23702250 DOI: 10.1016/j.jpsychires.2013.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 04/18/2013] [Accepted: 04/19/2013] [Indexed: 11/28/2022]
Abstract
Gender Identity Disorder (GID) is characterized by a strong and persistent cross-gender identification that affects different aspects of behavior. Brain-derived neurotrophic factor (BDNF) plays a critical role in neurodevelopment and neuroplasticity. Altered BDNF-signaling is thought to contribute to the pathogenesis of psychiatric disordersand is related to traumatic life events. To examine serum BDNF levels, we compared one group of DSM-IV GID patients (n = 45) and one healthy control group (n = 66). Serum BDNF levels were significantly decreased in GID patients (p = 0.013). This data support the hypothesis that the reduction found in serum BDNF levels in GID patients may be related to the psychological abuse that transsexuals are exposed during their life.
Collapse
Affiliation(s)
- Anna-Martha V Fontanari
- Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Ku HL, Lin CS, Chao HT, Tu PC, Li CT, Cheng CM, Su TP, Lee YC, Hsieh JC. Brain signature characterizing the body-brain-mind axis of transsexuals. PLoS One 2013; 8:e70808. [PMID: 23923023 PMCID: PMC3724787 DOI: 10.1371/journal.pone.0070808] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 06/19/2013] [Indexed: 12/21/2022] Open
Abstract
Individuals with gender identity disorder (GID), who are commonly referred to as transsexuals (TXs), are afflicted by negative psychosocial stressors. Central to the psychological complex of TXs is the conviction of belonging to the opposite sex. Neuroanatomical and functional brain imaging studies have demonstrated that the GID is associated with brain alterations. In this study, we found that TXs identify, when viewing male-female couples in erotic or non-erotic (“neutral”) interactions, with the couple member of the desired gender in both situations. By means of functional magnetic resonance imaging, we found that the TXs, as opposed to controls (CONs), displayed an increased functional connectivity between the ventral tegmental area, which is associated with dimorphic genital representation, and anterior cingulate cortex subregions, which play a key role in social exclusion, conflict monitoring and punishment adjustment. The neural connectivity pattern suggests a brain signature of the psychosocial distress for the gender-sex incongruity of TXs.
Collapse
Affiliation(s)
- Hsiao-Lun Ku
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Integrated Brain Research Unit, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chia-Shu Lin
- Integrated Brain Research Unit, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Hsiang-Tai Chao
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Obstetrics and Gynecology, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chou-Ming Cheng
- Integrated Brain Research Unit, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Chiao Lee
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- * E-mail: (J-CH); (Y-CL)
| | - Jen-Chuen Hsieh
- Integrated Brain Research Unit, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Taiwan
- * E-mail: (J-CH); (Y-CL)
| |
Collapse
|
10
|
Bandini E, Fisher AD, Castellini G, Lo Sauro C, Lelli L, Meriggiola MC, Casale H, Benni L, Ferruccio N, Faravelli C, Dettore D, Maggi M, Ricca V. Gender Identity Disorder and Eating Disorders: Similarities and Differences in Terms of Body Uneasiness. J Sex Med 2013; 10:1012-23. [DOI: 10.1111/jsm.12062] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
11
|
Terada S, Matsumoto Y, Sato T, Okabe N, Kishimoto Y, Uchitomi Y. Suicidal ideation among patients with gender identity disorder. Psychiatry Res 2011; 190:159-62. [PMID: 21612827 DOI: 10.1016/j.psychres.2011.04.024] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 04/12/2011] [Accepted: 04/20/2011] [Indexed: 10/18/2022]
Abstract
In this study, we tried to clarify the prevalence of suicidal ideation and self-mutilation including suicide attempts among patients with gender identity disorder (GID) and the relationship of those behaviors to demographic characteristics. A total of 500 consecutive Japanese GID patients without any other psychiatric comorbidity were evaluated at the outpatient GID Clinic of Okayama University Hospital. The lifetime rate of suicidal ideation was 72.0% of the total sample. There were no significant differences in the prevalence of suicidal ideation among groups divided by sex, age, age at onset or education. The lifetime prevalence of self-mutilation including suicide attempts was 31.8% of the total sample. Low level of education was significantly related to self-mutilation among both male-to-female and female-to-male GID patients. Younger age at onset was a significant factor affecting self-mutilation only among MTF GID patients. A lack of strategies to cope with severe distress among persons with lower education might induce a high frequency of self-mutilation including suicidal attempt. GID patients with a low level education might be at high risk of self-mutilation and should be watched with special attention to self-mutilation.
Collapse
Affiliation(s)
- Seishi Terada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
| | | | | | | | | | | |
Collapse
|
12
|
|
13
|
Hoshiai M, Matsumoto Y, Sato T, Ohnishi M, Okabe N, Kishimoto Y, Terada S, Kuroda S. Psychiatric comorbidity among patients with gender identity disorder. Psychiatry Clin Neurosci 2010; 64:514-9. [PMID: 20727112 DOI: 10.1111/j.1440-1819.2010.02118.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS Psychiatric comorbidity and mental instability seem to be important unfavorable prognostic factors for long-term psychosocial adjustment in gender identity disorder (GID). However, psychiatric comorbidity in patients with GID has rarely been assessed. In this study, we investigated the psychiatric comorbidity and life events of patients with GID in Japan. METHODS A total of 603 consecutive patients were evaluated independently by at least two senior psychiatrists at the GID clinic using clinical information and results of examinations. RESULTS Using DSM-IV criteria, 579 patients (96.0%) were diagnosed with GID. Among the GID patients, 349 (60.3%) were the female-to-male (FTM) type, and 230 (39.7%) were the male-to-female (MTF) type. Current psychiatric comorbidity was 19.1% (44/230) among MTF patients and 12.0% (42/349) among FTM patients. The lifetime positive history of suicidal ideation and self mutilation was 76.1% and 31.7% among MTF patients, and 71.9% and 32.7% among FTM patients. Among current psychiatric diagnoses, adjustment disorder (6.7%, 38/579) and anxiety disorder (3.6%, 21/579) were relatively frequent. Mood disorder was the third most frequent (1.4%, 8/579). CONCLUSIONS Comparison with previous reports on the psychiatric comorbidity among GID patients revealed that the majority of GID patients had no psychiatric comorbidity. GID is a diagnostic entity in its own right, not necessarily associated with severe comorbid psychological findings.
Collapse
Affiliation(s)
- Masahiko Hoshiai
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Takeda M, Kurita H. Editorial. Psychiatry Clin Neurosci 2010; 64:1-3. [PMID: 20416022 DOI: 10.1111/j.1440-1819.2009.02051.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|