Psychiatric comorbidity among patients with gender identity disorder.
OBJECTIVE
Psychiatric comorbidity and mental instability seem to be important unfavorable prognostic factors for long-term psychosocial adjustment in gender identity disorder (GID). However, psychiatric comorbidity in patients with GID has rarely been assessed. In this study, we investigated the psychiatric comorbidity and life events of patients with GID in Japan.


METHODS
A total of 603 consecutive patients were evaluated independently by at least two senior psychiatrists at the GID clinic using clinical information and results of examinations.


RESULTS
Using DSM-IV criteria, 579 patients (96.0%) were diagnosed with GID. Among the GID patients, 349 (60.3%) were the female-to-male (FTM) type, and 230 (39.7%) were the male-to-female (MTF) type. Current psychiatric comorbidity was 19.1% (44/230) among MTF patients and 12.0% (42/349) among FTM patients. The lifetime positive history of suicidal ideation and self mutilation was 76.1% and 31.7% among MTF patients, and 71.9% and 32.7% among FTM patients. Among current psychiatric diagnoses, adjustment disorder (6.7%, 38/579) and anxiety disorder (3.6%, 21/579) were relatively frequent. Mood disorder was the third most frequent (1.4%, 8/579).


CONCLUSIONS
Comparison with previous reports on the psychiatric comorbidity among GID patients revealed that the majority of GID patients had no psychiatric comorbidity. GID is a diagnostic entity in its own right, not necessarily associated with severe comorbid psychological findings.
Hoshiai
Masahiko
M
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Matsumoto
Yosuke
Y
Sato
Toshiki
T
Ohnishi
Masaru
M
Okabe
Nobuyuki
N
Kishimoto
Yuki
Y
Terada
Seishi
S
Kuroda
Shigetoshi
S
D000275:Adjustment Disorders / Q000453:epidemiology / Q000523:psychology; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000453:epidemiology; D011379:Prognosis; D012652:Self Mutilation / Q000453:epidemiology / Q000523:psychology; D013405:Suicide / Q000523:psychology; D014189:Transsexualism / Q000523:psychology; D055815:Young Adult