Psychiatric comorbidity in gender identity disorder

Department of Psychiatry, University Hospital, Culmannstrasse 8, Zurich CH-8091, Switzerland.
Journal of Psychosomatic Research (Impact Factor: 2.84). 04/2005; 58(3):259-61. DOI: 10.1016/j.jpsychores.2004.08.010
Source: PubMed

ABSTRACT Despite being recognized as an important prognostic factor for the outcome in gender identity disorder (GID), psychiatric comorbidity has rarely been assessed by means of standardized diagnostic instruments. The aim of this study was to assess current and lifetime psychiatric comorbidity in patients with GID.
A cross-sectional sample of 31 patients who were treated for GID was assessed by the structured clinical interview for Axis I and II (SCID-I/II) and the Hospital Anxiety and Depression Scale (HADS).
Twenty-nine percent of the patients had no current or lifetime Axis I disorder; 39% fulfilled the criteria for current and 71% for current and/or lifetime Axis I diagnosis. Forty-two percent of the patients were diagnosed with one or more personality disorders.
Lifetime psychiatric comorbidity in GID patients is high, and this should be taken into account in the assessment and treatment planning of GID patients.

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    • "GD is sometimes accompanied by psychiatric problems that may be consequences of persistent psychological difficulties due to social rejection and the incongruence between biological sex and gender identity (Simon et al., 2011). Several studies have reported that subjects with GD have shown a high prevalence of affective problems or social anxiety disorder compared to a general population (A Campo et al., 2003; Hepp et al., 2005; de Vries et al., 2011; Heylens et al., 2013). However, other studies showed a low level of psychopathology (Gomez-Gil et al., 2009; Hoshiai et al., 2010; Fisher et al., 2013). "
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    ABSTRACT: Males and females have different temperaments. In individuals with gender dysphoria (GD) there is marked incongruence between a person׳s expressed/experienced gender and their biological sex. The present study aimed to investigate the most common affective temperaments in individuals with female-to-male (FtM) GD. We performed a prospective and comparative study investigating affective temperaments in subjects with FtM GD. Eighty subjects with FtM GD and 68 female controls were enrolled. The Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) was completed by all participants. TEMPS-A scores were significantly higher in subjects with FtM GD for hyperthymic temperament (p≤0.001), whereas depressive (p≤0.001), anxious (p≤0.001), and cyclothymic (p=0.028) temperament scores were significantly higher in female controls. The study was limited by the lack of male-to-female subjects and male controls. The results of our study indicate that individuals with FtM GD have significantly higher scores of hyperthymic temperament, measured by TEMPS-A. Biological basis underlying the development of gender identity independent from the biological sex might be related with affective temperaments. Copyright © 2015 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 05/2015; 176:61-64. DOI:10.1016/j.jad.2015.02.001 · 3.71 Impact Factor
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    • "Some research reported a high prevalence of psychiatric comorbidity, including affective disorders, anxiety disorders, substance-related disorders and personality disorders (à Campo et al., 2003; Hepp et al., 2005; Heylens et al., 2014). Moreover, in some cases also a high prevalence of psychotic disorders (à Campo et al., 2003; Hepp et al., 2005), dissociative disorders (à Campo et al., 2003) and somatoform disorders (Hepp et al., 2005) was reported. Instead, other studies indicated that the majority of GD patients had no Contents lists available at ScienceDirect journal homepage: "
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    ABSTRACT: This study evaluated dissociative symptomatology, childhood trauma and body uneasiness in 118 individuals with gender dysphoria, also evaluating dissociative symptoms in follow-up assessments after sex reassignment procedures were performed. We used both clinical interviews (Dissociative Disorders Interview Schedule) and self-reported scales (Dissociative Experiences Scale). A dissociative disorder of any kind seemed to be greatly prevalent (29.6%). Moreover, individuals with gender dysphoria had a high prevalence of lifetime major depressive episode (45.8%), suicide attempts (21.2%) and childhood trauma (45.8%), and all these conditions were more frequent in patients who fulfilled diagnostic criteria for any kind of dissociative disorder. Finally, when treated, patients reported lower dissociative symptoms. Results confirmed previous research about distress in gender dysphoria and improved mental health due to sex reassignment procedures. However, it resulted to be difficult to ascertain dissociation in the context of gender dysphoria, because of the similarities between the two conditions and the possible limited application of clinical instruments which do not provide an adequate differential diagnosis. Therefore, because the body uneasiness is common to dissociative experiences and gender dysphoria, the question is whether dissociation is to be seen not as an expression of pathological dissociative experiences but as a genuine feature of gender dysphoria.
    Psychiatry Research 01/2015; 226(1). DOI:10.1016/j.psychres.2014.12.045 · 2.68 Impact Factor
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    • "To prevent mental health problems in trans individuals, it may be clinically valuable to assess interpersonal functioning by identifying at-risk populations (Sheets, Duncan, Bjornsson, Craighead, & Craighead, 2014). Because studies indicate high levels of affective disorders in trans people (Claes et al., 2015; Clements-Nolle et al., 2006; Dhejne et al., 2011; Couch et al., 2007; Hepp, Kraemer, Schnyder, Miller, & Delsignore, 2005; Heylens et al., 2014; Liu & Mustanski, 2012; Skrapec & MacKenzie, 1981) and an association between interpersonal problems and depression in the cisgender literature (Barrett & Barber, 2007), this study aims to: H1: Investigate the rates of interpersonal problems among trans people attending a gender identity clinic. H2: Compare interpersonal problems between trans women and trans men. "
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    ABSTRACT: Objectives: Trans people have been found to have high levels of depression. In view of the association between interpersonal problems and depression and the importance of interpersonal skills to navigate the transition of trans people, this study aims to investigate levels of interpersonal problems among treatment-seeking trans men and women, and the role of depression in this association. Method: 104 patients from a UK Gender Identity Clinic and 104 age and gender matched controls completed self-report measures of interpersonal problems and general psychopathology, including depression. Results: Trans people reported significantly higher scores on global interpersonal problems, and in the sociable, supportive, and involved subscales, and lower scores on the too open subscale. Depression accounted for significant differences on IIP global and the subscale open but not on IIP sociable, supportive and involved. Conclusions: Trans individuals present with interpersonal problems, which could potentially increase their vulnerability to mental health problems. Therefore, addressing interpersonal problems may help to prevent the development of depressive symptomatology and facilitate transition.
    Journal of Clinical Psychology 01/2015; DOI:10.1002/jclp.22209 · 2.12 Impact Factor
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