Psychosis and societal prescriptions of gender; a study of 174 inpatients (original) (raw)
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Schizophrenia Research and Treatment, 2012
Recent studies have begun to look at gender differences in schizophrenia and first-episode psychosis in an attempt to explain the heterogeneity of the illness. However, a number of uncertainties remain. This paper tries to summarize the most important findings in gender differences in schizophrenia and first-psychosis episodes. Several studies indicate that the incidence of schizophrenia is higher in men. Most of the studies found the age of onset to be earlier in men than in women. Findings on symptoms are less conclusive, with some authors suggesting that men suffer more negative symptoms while women have more affective symptoms. Premorbid functioning and social functioning seem to be better in females than males. However, cognitive functioning remains an issue, with lack of consensus on differences in neuropsychological profile between women and men. Substance abuse is more common in men than women with schizophrenia and first-episode psychosis. In terms of the disease course, women have better remission and lower relapse rates. Lastly, there is no evidence of specific gender differences in familial risk and obstetric complications. Overall, gender differences have been found in a number of variables, and further study in this area could help provide useful information with a view to improving our care of these patients.
2016
Aim. Patients with chronic mental disorders often can suffer from sexual dysfunction. Nevertheless, the sexual functioning of new patients with first-episode psychosis has been little explored. The aim of this study was to investigate gender differences in sexual functioning in people with first-episode psychosis. Methods. A group of 40 males and 37 females with first-episode psychosis took part in the research. We administered a psychiatric protocol composed of the PANSS, UKU and SCID-DSM-IV diagnosis. Results. We found that the 42.5% of the male group had sexual dysfunctions while the percentage of the female group was 37.8%. The correlation between sexual dysfunctions and psychopathology did not reveal any association in males. However, in females, general psychopathology and positive symptoms are linked to the alteration of vaginal lubrication: (r=0.547; p=0.003) and (r=0.485; p=0.011), although orgasm alteration was also associated with general psychopathology (r=0.500; p=0.013). Moreover, we found a relation between the alteration of vaginal lubrication with depression (r=0.627; p<0.0001) and disorder of volition (r=0.600; p<0.001). Discussion and conclusions. These data suggest that the association between sexual dysfunctions and psychopathology regarded only women. Therefore, during the taking charge of patients it is fundamental to consider the gender-specific relationship between psychopathology and sexual problems.
Gender identity disorders as a secondary symptom of psychosis, and in particular, schizophrenia
Psychol Med, 2001
Objective It is suggested that the duration of untreated psychosis (DUP) is directly correlated to the outcome of the illness. This study examines the effect of DUP on the acute response of patients with first-episode psychosis. Method In this naturalistic study, 55 Asian patients with firstepisode psychosis were assessed weekly for 6 weeks on the Positive and Negative Syndrome Scale (PANSS), Simpson-Angus Rating Scale, Barnes Akathisia Rating Scale and the Abnormal Involuntary Movement Scale. Clinical response was defined as a 20% or greater reduction in PANSS from baseline. Results After 6 weeks, the response rate was 67% (n ¼ 37). The responders had a mean DUP of 14.7 ± 20.2 months and a median of 6 months. This was significantly shorter when compared to the mean DUP 37.3 (SD ¼ 32.7) months, median of 36 months of the nonresponders (Mann-Whitney U-test, P ¼ 0.37). There was no significant difference in the mean daily dose of antipsychotics, the mean Simpson-Angus Scale, the Barnes Akathisia Scale and the Abnormal Involuntary Movement Scale scores between the responders and nonresponders. Conclusions The study results suggest that DUP is a predictor of acute response in first episode psychosis.
PubMed, 2015
Aim: Patients with chronic mental disorders often can suffer from sexual dysfunction. Nevertheless, the sexual functioning of new patients with first-episode psychosis has been little explored. The aim of this study was to investigate gender differences in sexual functioning in people with first-episode psychosis. Methods: A group of 40 males and 37 females with first-episode psychosis took part in the research. We administered a psychiatric protocol composed of the PANSS, UKU and SCID-DSM-IV diagnosis. Results: We found that the 42.5% of the male group had sexual dysfunctions while the percentage of the female group was 37.8%. The correlation between sexual dysfunctions and psychopathology did not reveal any association in males. However, in females, general psychopathology and positive symptoms are linked to the alteration of vaginal lubrication: (r=0.547; p=0.003) and (r=0.485; p=0.011), although orgasm alteration was also associated with general psychopathology (r=0.500; p=0.013). Moreover, we found a relation between the alteration of vaginal lubrication with depression(r=0.627; p<0.0001) and disorder of volition (r=0.600; p<0.001). Discussion and conclusions: These data suggest that the association between sexual dysfunctions and psychopathology regarded only women. Therefore, during the taking charge of patients it is fundamental to consider the gender-specific relationship between psychopathology and sexual problems.
Gender Identity Disorder with Comorbid Psychosis-A Case Report
IOSR Journals , 2019
Gender Dysphoria (GD) refers to a complex disorder marked by persistent unhappiness with once designated birth sex (natal sex) and a desire to live and be socially identified as an individual of the opposite sex. Such a feeling may result in severe distress and impairment of normal functioning in the individuals, thereby, making them vulnerable to various forms of mental and physical disorders. GD is seen to have onset mostly from the early childhood. However, in many cases the onset of clinically significant symptoms may appear in adolescence or even in adulthood. Clinician, therefore, should not be biased with the presentation of cases. Interview regarding Gender Dysphoria should be made for every case, irrespective of their presentation. Early detection and proper counseling for the individuals and their close ones, can go a long way in reducing the levels of stress in such cases and can significantly improve the outcome.
Sexual Expression and It’s Determinants, in People Diagnosed with Psychotic Disorders
Community Mental Health Journal, 2018
This qualitative study aims to explore the difficulties people with a psychotic disorder have in sexual expression, and associated determinants. Twenty-eight semi-structured interviews were conducted and analyzed using the Grounded Theory method. Almost all participants experienced unfulfilled needs in sexual expression. These unfulfilled needs were associated with a range of factors, including antipsychotic medication, psychotic symptoms, sexual abuse, social skills and stigma, all of which may converge on a pathway involving (sexual) self-esteem. Further research is required to better understand the role of self-esteem in relation to sexual needs and expression in people with psychotic disorders.
Gender dysphoria in adolescents with psychotic disorders – symptom or co-occurring phenomenon?
Psychiatria i Psychologia Kliniczna
The occurrence of gender dysphoria symptoms in adolescents presenting psychotic disorders generates great diagnostic and therapeutic difficulties. They are related not only to the question of what is the nature of the reported dissatisfaction with one’s biological sex, but also to the normative period of uncertainty and searching in the process of psychosexual development in a young person. In this context, reaching a decision on gender correction treatment requires a particularly thorough analysis, a precise differential diagnosis and, above all, stabilisation of the psychological state as well as prolonged observation and exclusion of the delusional basis of gender dysphoria. It strikes us as particularly important to provide such patients with appropriate care. Allowing for gender correction, in the absence of a confirmed causal relationship between the two disorders, seems to be an appropriate, although debatable, therapeutic approach. Refusing medical interventions in adolescen...
Frontiers in Psychiatry, 2021
A considerable body of literature reports that individuals with psychotic disorders often suffer from sexual dysfunctions (SDs), with these representing a major unmet need. Long-term antipsychotic drug treatment may be the main cause for SDs in psychotic patients, through a plethora of different mechanisms, including prolactin dyscrasia, histamine-mediated sedation, and serotonin-induced sexual demotivation. However, a few pieces of evidence treat sexuality in patients at risk or the onset of psychosis. For this purpose, we systematically reviewed literature of the last 10 years in order to investigate sexuality in ultra-high risk (UHR) for psychosis and first-episode psychosis (FEP). We included in our review 34 articles fitting our research criteria on SDs in UHR and FEP. Evidence of SDs in the transition from UHR to FEP emerges through the selected studies. In FEP, sexuality is affected by the severity of the psychotic symptoms and, in some cases, by the iatrogenic effects of psy...
LGBT health, 2017
Controversy exists as to if, and when, gender affirmative (GA) treatment should be offered to individuals with gender dysphoria (GD) and co-existing psychosis. Concerns exist regarding a high risk of misdiagnosis, regret afterward due to impulsive decision making, and deterioration of psychotic symptoms. This case series aims at extending the sparse literature on GA treatment in this population by identifying challenges in diagnosis and treatment and offering recommendations to overcome them. The authors present case descriptions of two transgender men and two transgender women in the age range of 29-57 years with a diagnosis of GD and a schizophrenia-related diagnosis. All had undergone GA treatment with a minimum follow-up of 3 years. The gender diagnosis was complicated by the fact that feelings of GD were only shared after the onset of psychosis, and GA treatment was hampered by the persistence of mild psychotic symptoms despite antipsychotic treatment. Close communication with ...
The expression of sexuality in people with psychosis: Breaking the taboos
McGANN E, (2000) Journal of Advanced Nursing 32(1), 132-138 The expression of sexuality in people with psychosis: hreaking the tahoos While mental health professionals should recognize that people suffering from schizophrenia have sexual and relationship requirements, there appears to be a failure to address adequately the subject of human sexuality, particularly in the area of psychosocial rehabilitation. The broad aim of this small study was to identify the sexual and relationship needs of people being cared for in hospital and preparing for a return to community living. The objectives of the study were to discover the clients' sexual expressions in the past and present, and to try to elicit hopes and aspirations for the future. An attempt was made to uncover some of the obstacles to the expression of sexuality and explore some of the clients' subjective experiences of the issues. The number of respondents was 11 from a possible 15, Data were collected through: a questionnaire on demo- graphic characteristics; an adapted version of a questionnaire investigating the determinant factors of sexual behaviour through life; and a semi-structured interview devised to elicit subjective experiences regarding sexual expression. The findings show that people with psychotic illness are prepared to discuss issues relating to sex and relationship matters. No interviews had to be prematurely terminated. No exacerbations of symptoms were noted. All of the respondents showed an openness to discuss a range of intimate feelings. Most respondents seemed hopeful about the opportunity to form intimate and fulfilling relationships in the future, A drive towards more rigorous holistic nursing assessments and appropriate psychosocial responses is proposed. Keywords: schizophrenia, psychosis, sexuality, sexual health, relationships, nursing care