J Korean Neuropsychiatr Assoc.  2014 Jan;53(1):54-57. 10.4306/jknpa.2014.53.1.54.

Electroconvulsive Therapy in a Case of Gender Dysphoria Patient with Severe Mood Dysregulation and Suicidal Ideation

• Kim JH
• Kim SH
• Park SH
• Choo IH
• Kim SG

• KMID: 1964069
• DOI: http://doi.org/10.4306/jknpa.2014.53.1.54

Abstract

Gender dysphoria is very rare, but has frequent psychiatric comorbidity. In addition, risk of suicide is higher in patients with gender dysphoria than for the general population. Treatment of gender dysphoria is not determined, and more aggressive treatment is required for patients with suicidal ideation. No case involving electroconvulsive therapy of a gender dysphoria patient has been reported in South Korea. We discuss a 24 year-old man given electroconvulsive therapy for gender dysphoria with severe mood dysregulation and suicidal ideation.

Keyword

Gender dysphoria; Suicide idea; Severe mood dysregulation; Electroconvulsive therapy

MeSH Terms

Comorbidity
Electroconvulsive Therapy*
Humans
Republic of Korea
Suicidal Ideation*
Suicide
Young Adult

Reference

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association;2013.

2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association;1994.

3. Bradley SJ, Zucker KJ. Gender identity disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 1997; 36:872–880.

4. Bakker A, van Kesteren PJ, Gooren LJ, Bezemer PD. The prevalence of transsexualism in The Netherlands. Acta Psychiatr Scand. 1993; 87:237–238.

5. Wallien MS, Swaab H, Cohen-Kettenis PT. Psychiatric comorbidity among children with gender identity disorder. J Am Acad Child Adolesc Psychiatry. 2007; 46:1307–1314.

6. Terada S, Matsumoto Y, Sato T, Okabe N, Kishimoto Y, Uchitomi Y. Factors predicting psychiatric co-morbidity in gender-dysphoric adults. Psychiatry Res. 2012; 200:469–474.

7. Zhao Y, Montoro R, Igartua K, Thombs BD. Suicidal ideation and attempt among adolescents reporting "unsure" sexual identity or heterosexual identity plus same-sex attraction or behavior: forgotten groups? J Am Acad Child Adolesc Psychiatry. 2010; 49:104–113.

8. Thirthalli J, Prasad MK, Gangadha BN. Electroconvulsive therapy (ECT) in bipolar disorder: A narrative review of literature. Asian J Psychiatr. 2012; 5:11–17.

9. Ghaziuddin N, Kutcher SP, Knapp P, Bernet W, Arnold V, Beitchman J, et al. Practice parameter for use of electroconvulsive therapy with adolescents. J Am Acad Child Adolesc Psychiatry. 2004; 43:1521–1539.

10. Reynolds WM. Suicidal Ideation Questionnaire (SIQ). Professional Manual. Psychological Assessment Resource, Inc.;1987.

11. Deogracias JJ, Johnson LL, Meyer-Bahlburg HF, Kessler SJ, Schober JM, Zucker KJ. The gender identity/gender dysphoria questionnaire for adolescents and adults. J Sex Res. 2007; 44:370–379.

12. Hepp U, Kraemer B, Schnyder U, Miller N, Delsignore A. Psychiatric comorbidity in gender identity disorder. J Psychosom Res. 2005; 58:259–261.

13. Bodlund O, Kullgren G. Transsexualism--general outcome and prognostic factors: a five-year follow-up study of nineteen transsexuals in the process of changing sex. Arch Sex Behav. 1996; 25:303–316.

14. Leibenluft E, Charney DS, Towbin KE, Bhangoo RK, Pine DS. Defining clinical phenotypes of juvenile mania. Am J Psychiatry. 2003; 160:430–437.

15. Remafedi G, French S, Story M, Resnick MD, Blum R. The relationship between suicide risk and sexual orientation: results of a population-based study. Am J Public Health. 1998; 88:57–60.

16. Safren SA, Heimberg RG. Depression, hopelessness, suicidality, and related factors in sexual minority and heterosexual adolescents. J Consult Clin Psychol. 1999; 67:859–866.

17. Hershberger SL, D'Augelli AR. The impact of victimization on the mental health and suicidality of lesbian, gay, and bisexual youths. Dev Psycol. 1995; 31:65–74.

18. Blake SM, Ledsky R, Lehman T, Goodenow C, Sawyer R, Hack T. Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: the benefits of gay-sensitive HIV instruction in schools. Am J Public Health. 2001; 91:940–946.

19. Garofalo R, Wolf RC, Kessel S, Palfrey SJ, DuRant RH. The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics. 1998; 101:895–902.

20. Weiner RD. American Psychiatric Association Committee on Electroconvulsive Therapy. The practice of electroconvulsive therapy : recommendations for treatment, training, and privileging : a task force report of the American Psychiatric Association. Washington, DC: American Psychiatric Association;2001.

21. Gómez-Gil E, Zubiaurre-Elorza L, Esteva I, Guillamon A, Godás T, Cruz Almaraz M, et al. Hormone-treated transsexuals report less social distress, anxiety and depression. Psychoneuroendocrinology. 2012; 37:662–670.