Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari, BA 70124, Italy.
Department of Medical Basic Sciences, Neuroscience and Sense Organs, University of Bari, BA 70124, Italy.
Psychiatry Res. 2015 Mar 30;226(1):173-80. doi: 10.1016/j.psychres.2014.12.045. Epub 2015 Jan 23.
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.
本研究评估了 118 名性别焦虑症患者的分离症状、儿童期创伤和身体不适，并在进行性别重置手术后的随访评估中评估了分离症状。我们使用了临床访谈（分离障碍访谈时间表）和自我报告量表（分离体验量表）。任何类型的分离障碍似乎都非常普遍（29.6%）。此外，性别焦虑症患者终生重度抑郁发作（45.8%）、自杀未遂（21.2%）和儿童期创伤（45.8%）的发生率都很高，而且所有这些情况在符合任何类型分离障碍诊断标准的患者中更为常见。最后，治疗后，患者报告的分离症状较低。研究结果证实了之前关于性别焦虑症痛苦和由于性别重置手术而改善心理健康的研究。然而，由于两种情况之间的相似性以及临床仪器应用可能存在局限性，无法进行充分的鉴别诊断，因此在性别焦虑症背景下确定分离较为困难。因此，由于身体不适是分离体验和性别焦虑症的共同特征，问题是是否应将分离视为病理性分离体验的表现，而不是性别焦虑症的真实特征。
