1,721,017 research outputs found
Hormonal Treatment Reduces Psychobiological Distress in Gender Identity Disorder, Independently of the Attachment Style
No full textIntroduction: Gender identity disorder may be a stressful situation. Hormonal treatment seemed to improve the general health as it reduces psychological and social distress. The attachment style seemed to regulate distress in insecure individuals as they are more exposed to hypothalamic-pituitary-adrenal system dysregulation and subjective stress. Aim: The objectives of the study were to evaluate the presence of psychobiological distress and insecure attachment in transsexuals and to study their stress levels with reference to the hormonal treatment and the attachment pattern. Methods: We investigated 70 transsexual patients. We measured the cortisol levels and the perceived stress before starting the hormonal therapy and after about 12 months. We studied the representation of attachment in transsexuals by a backward investigation in the relations between them and their caregivers. Main Outcome Measures: We used blood samples for assessing cortisol awakening response (CAR); we used the Perceived Stress Scale for evaluating self-reported perceived stress and the Adult Attachment Interview to determine attachment styles. Results: At enrollment, transsexuals reported elevated CAR; their values were out of normal. They expressed higher perceived stress and more attachment insecurity, with respect to normative sample data. When treated with hormone therapy, transsexuals reported significantly lower CAR (P<0.001), falling within the normal range for cortisol levels. Treated transsexuals showed also lower perceived stress (P<0.001), with levels similar to normative samples. The insecure attachment styles were associated with higher CAR and perceived stress in untreated transsexuals (P<0.01). Treated transsexuals did not expressed significant differences in CAR and perceived stress by attachment. Conclusion: Our results suggested that untreated patients suffer from a higher degree of stress and that attachment insecurity negatively impacts the stress management. Initiating the hormonal treatment seemed to have a positive effect in reducing stress levels, whatever the attachment style may be. Colizzi M, Costa R, Pace V, and Todarello O. Hormonal treatment reduces psychobiological distress in gender identity disorder, independently of the attachment style. J Sex Med 2013;10:3049-3058. © 2013 International Society for Sexual Medicine
Evaluating psychobiological and mental distress in transsexualism before and after cross-sex hormonal treatment: Lesson learned from three longitudinal studies
No full textIn the past few decades, the literature has addressed transsexual patients' quality of life, satisfaction and various other outcomes such as sexual functioning after sex reassignment surgery. Instead, the role of the cross-sex hormonal treatment alone in the well-being of transsexual patients has been the subject of very little differentiated investigation. Moreover, due to their cross-sectional design, previous studies did not demonstrate a direct effect of hormonal treatment in transsexual patients' distress. To our knowledge only three recent researches studied the transsexual patients' distress related to the hormonal treatment in a longitudinal study. In light of the importance of this information, this chapter discusses a review of these three perspective studies, two of whom were performed in partially overlapping samples from the same gender unit. Although transsexualism has been described as a diagnostic entity in its own right, not necessarily associated with severe comorbid psychiatric findings, for most patients transsexualism may be a stressful situation and may cause clinical distress or impairment in important areas of functioning. This review provides information on the prevalence and/or severity of psychobiological distress, mental distress and functional impairment in untreated transsexual patients. One of these three studies revealed that, despite the majority of transsexual patients do not suffer of a psychiatric disorder, the condition is associated with subthreshold anxiety/depression, psychological distress and functional impairment. Another of these three studies achieved the same results on the psychological distress in untreated transsexual patients, using part of the methodology of the previous study in a different sample. The last study added information about the untreated transsexual patients' stress system dysregulation, revealing that these patients show hypothalamic-pituitary-adrenal (HPA) system dysregulation and appear to notably differ from normative samples in terms of mean levels of perceived stress. In particular, untreated transsexual patients showed elevated cortisol awakening response (CAR), with cortisol levels above the normal range, and elevated perceived stress. Moreover, this review reports the role of the hormonal treatment in reducing psychobiological and mental distress in transsexualism. Specifically, when treated with hormonal treatment transsexual patients reported less anxiety, depression, psychological distress and functional impairment. Also transsexual patients showed reduced cortisol awakening response (CAR) and perceived stress levels after the beginning of the cross-sex hormonal treatment. It should be added that in all the three studies the psychobiological and mental distress scores resembled those of a general population after cross-sex hormonal treatment was initiated. Finally, the review discusses the hypothesis of a direct relation versus an indirect relation between the hormone therapy itself and the patients' wellbeing, supporting a psycho-social meaning of the hormonal treatment (indirect relation) rather than a biological effect of sex hormones (direct relation)
Dissociative symptoms in individuals with gender dysphoria: Is the elevated prevalence real?
No full textThis 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
Rapporti tra cervicodisplasia, linfocitogramma periferico e alessitimia. studio in fase II
No full textIs alexithymia related to negative symptoms of schizophrenia? A preliminary longitudinal study.
No full textFattori psicosociali e sindrome dell’intestino irritabile. Review della letteratura. Medicina Psicosomatica, 50, 1, 17-23, gennaio-marzo 2005.
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Alexythimia and psychopathology in patients with psychiatric and functional gastrointestinal disorders
No full textBACKGROUND: Alexithymia and psychopathology may influence the way individuals experience psychological distress and somatic symptoms. This study evaluated patients referred to psychiatric and gastroenterologic outpatient settings in order to investigate the levels of alexithymia and psychopathology, and the possible role of alexithymia in symptom perception and health care utilization. The association between psychiatric disorders and functional gastrointestinal disorders (FGIDs) was also assessed.
METHODS: Psychopathology (by the Revised 90-item Symptom Checklist), alexithymia (by the 20-item Toronto Alexithymia Scale), and gastrointestinal symptoms (by the Gastrointestinal Symptom Rating Scale) were evaluated in 52 psychiatric outpatients and 58 medical outpatients with FGIDs. Two comorbid subgroups of 25 psychiatric patients with FGIDs and 38 FGID patients with psychiatric disorders were formed and compared.
RESULTS: Forty-eight percent of the psychiatric patients had associated FGIDs, and 65.5% of the FGID patients had associated psychiatric disorders. The FGID patients had significantly less psychopathology, but significantly higher alexithymia and more severe gastrointestinal symptoms, than the psychiatric patients. In the comparison of the two subgroups with comorbidity, FGID patients with psychiatric disorders were still more alexithymic and had less psychopathology than psychiatric patients with FGIDs, but gastrointestinal symptoms were not significantly different.
CONCLUSION: Patients with 'functional' gastrointestinal symptoms attending a medical care service are likely to be highly alexithymic, whereas those attending a psychiatric care service are likely to show severe psychopathology. Alexithymia seems to influence the presentation of 'functional' somatic symptoms and the type of health care utilization
Emotional symptoms, quality of life and cytokine profile in hemodialysis patients.
No full textBACKGROUND:
Mental disorders are frequent in hemodialysis (HD) patients. Depression and anxiety along with physical co-morbidity affect quality of life (QOL). Uremia is associated with inflammation and release of cytokines by lymphomonocytes. Inflammatory cytokines are relevant in depression. The aim of this study was to assess the psychological alterations and QOL in HD patients, and to correlate them with pattern of cytokine production.
METHODS:
Patients: 30 HD patients and 20 subjects with CKD Stage I-II K-DOQI. Psychometric tests were administered: 1) Hospital Anxiety and Depression Scale (HADS) composed of an anxiety subscale (HADS-A) and a depression subscale (HADS-D); 2) Kidney Disease Quality of Life (KDQOL) modified, including a cognitive function subscale (KDQOL-CF). Whole blood samples collected at beginning of HD session were diluted with RPMI/heparin and incubated for 24 h in presence of lipopolysaccharide (LPS). IL-1Gamma, IL-6, TNF-alpha and IL-10 were assayed on supernatants and results were normalized per number of lymphomonocytes (ng/106 cells).
RESULTS:
A depressive mood was more frequent in HD patients (50%) than controls (20%, p < 0.0001). No difference for anxiety (HD = 43%, controls = 45%) was observed. QOL score was significantly lower in HD than controls (p = 0.006) and correlated inversely with HADS total, HADS-A and HADS-D (p < 0.0001). Albumin, Kt/V and phosphate were comparable in patients with or without anxiety or depression. Cytokine production was significantly higher in HD patients than controls (IL-1beta p = 0.05; IL-6 p = 0.010; TNF-alpha p < 0.0001; IL-10, p = 0.0019). HD patients with the HADS-A positive for anxiety showed higher IL-6 production (p = 0.026), while IL-1beta levels were not associated with symptoms of depression. KDQOL-CF correlated inversely with levels of IL-6, TNF-alpha and IL-10.
CONCLUSIONS:
HD patients have symptoms of depression and anxiety that negatively affect QOL. These symptoms are independent of the efficiency of dialysis and nutritional status. On the contrary, IL-6 is linked to the presence of psychological discomfort in these patients
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