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Schizophrenia and gender identity disorder

  • Rameez Zafar (a1)
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

References

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Borras, L., Huguelet, P. & Eytan, A. (2007) Delusional ‘pseudotranssexualism’ in schizophrenia. Psychiatry: Interpersonal and Biological Processes, 70, 175179.
Caldwell, C. & Keshavan, M. S. (1991) Schizophrenia with secondary transsexualism. Canadian Journal of Psychiatry, 36, 300301.
Manderson, L. & Kumar, S. (2001) Gender identity disorder as a rare manifestation of schizophrenia. Australian and New Zealand Journal of Psychiatry, 35, 546547.

Schizophrenia and gender identity disorder

  • Rameez Zafar (a1)

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Schizophrenia and gender identity disorder

  • Rameez Zafar (a1)
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eLetters

Delusions of Gender Change in Confined Environments

Heidi Sinclair, ST3 Psychiatry
04 September 2008

It was with great interest that I read the letter written by Dr. Zafar. In the regional secure unit where I work, we recently had two patients, out of the fourteen patients on the ward, who had delusions of gender change. Both these heterosexual young men suffered from treatment resistant schizophrenia and have spent a considerable time in prison priorto coming to the ward. They were acutely psychotic, already difficult to manage and vulnerable to physical as well as sexual attacks by other patients. The one patient believed that he was half female and half male. He isolated himself from the other patients and he made allegations that other patients were making inappropriate sexual advances towards him. The other patient believed that he was born a female. He acted on these delusional beliefs by wearing make-up and at times a full female attire. He also displayed feminine mannerisms. The fact that this was in a medium secure male environment, contributed to the challenge of treating them andmanaging their risks appropriately. Interestingly, the risk management of many other patients on the ward also became more dynamic when these patients started to disclose/act on their delusions.

The letter by Dr. Zafar made me wonder whether the incidence of delusions of gender change is much higher in patients with psychoses who are in prison or in secure units than in patients with psychoses in general adult psychiatry wards. I was also wondering whether one will be reinforcing the delusional belief of the patient when he is allowed to cross dress on the wards.
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Conflict of interest: None Declared

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Making the case for a case report

Pavan Chahl, Specialist Registrar in Psychiatry
18 August 2008

I read with great interest the letter Schizophrenia and gender identity disorder, Zafar Psychiatr Bull.2008; 32: 316-317. It reminded me of why my peers and I read the Bulletin in preference to other psychiatricjournals: because the Bulletin is a more interesting read. Every month when I receive my copy of the College journals I tend first to read the Interview section followed by the Correspondence and then the Editorial in the Bulletin, I am aware that this is what most of my peers do as well.

Over the years in the search for scientific gravitas most journals have tended not to publish case reports. They are seen to be less important since they are not quantitative. Case reports are a great way oflearning about patients and their illness, they provide a rich narrative that reminds us of why we entered psychiatry as a profession in the first place. They also allow us to look at different aspects of a case and look at the complete picture.

I am aware that one of the challenges faced by the editor of the Bulletin is to get it Indexed. Publishing more case reports will in no wayde-value the journal but it will make it an even more interesting read. Case reports will also encourage and inspire future generations to see the fascinating aspects of psychiatry. I propose publishing three case reports each month, up to 500 words in length and in a seperate section of the Bulletin. It will encourage greater discussion within the speciality and increase its reach and readership.
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Conflict of interest: None Declared

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