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性别认同障碍与精神分裂症:具有共同病因机制的神经发育障碍?

Gender identity disorder and schizophrenia: neurodevelopmental disorders with common causal mechanisms?

作者信息

Rajkumar Ravi Philip

机构信息

Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantari Nagar, Pondicherry 605 006, India.

出版信息

Schizophr Res Treatment. 2014;2014:463757. doi: 10.1155/2014/463757. Epub 2014 Dec 4.

Abstract

Gender identity disorder (GID), recently renamed gender dysphoria (GD), is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological research, including brain imaging and studies of finger length ratio and handedness, suggests that both these disorders are associated with altered cerebral sexual dimorphism and changes in cerebral lateralization. Various mechanisms, such as Toxoplasma infection, reduced levels of brain-derived neurotrophic factor (BDNF), early childhood adversity, and links with autism spectrum disorders, may account for some of this overlap. The implications of this association for further research are discussed.

摘要

性别认同障碍(GID),最近更名为性别焦虑症(GD),是一种罕见的病症,其特征是性别认同与生理性别之间不一致。临床证据表明,精神分裂症在GID患者中的发生率高于普通人群,且GID患者可能具有类似精神分裂症的人格特质。相反,精神分裂症患者可能会出现性别认同和性别角色认知的改变。包括脑成像以及手指长度比例和利手研究在内的神经生物学研究表明,这两种疾病都与大脑性二态性改变和大脑半球优势化变化有关。各种机制,如弓形虫感染、脑源性神经营养因子(BDNF)水平降低、童年早期逆境以及与自闭症谱系障碍的关联,可能解释了这种重叠的部分原因。本文讨论了这种关联对进一步研究的意义。

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