Abdo C H, Hounie A, de Tubino Scanavino M, Miguel E C
Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Acta Psychiatr Scand. 2001 Jun;103(6):471-3; discussion 473. doi: 10.1034/j.1600-0447.2001.00294.x.
There have been reports of obsessive-compulsive disorder (OCD) patients with comorbid paraphilias. In this paper, two cases of comorbidity between OCD and transvestism are reported with the aim of discussing possible explanations for this association.
Longitudinal case studies of two patients with OCD and tranvestism according to the DSM-IV were assessed using semi-structured interviews.
Both patients presented with OCD and comorbid transvestism with different clinical features and treatment response. The case whose cross-dressing was more egodystonic responded better to treatment.
It is possible that some cases of transvestism are OCD-related while others are more related to a gender identity disorder. A dimensional approach focusing on common phenomenological and neurobiological substrates is suggested as particularly useful for clinical management and future research of both disorders.
有报告称强迫症（OCD）患者合并性偏好障碍。本文报告两例强迫症与异装癖共病的病例，旨在探讨这种关联的可能解释。
根据《精神疾病诊断与统计手册第四版》（DSM-IV），对两名患有强迫症和异装癖的患者进行纵向病例研究，采用半结构化访谈进行评估。
两名患者均表现为强迫症合并异装癖，具有不同的临床特征和治疗反应。异装行为更不符合自我价值观的患者对治疗反应更好。
有些异装癖病例可能与强迫症相关，而另一些则与性别认同障碍关系更大。建议采用一种关注共同现象学和神经生物学基础的维度方法，这对这两种疾病的临床管理和未来研究特别有用。
