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Voices change my name

Published online by Cambridge University Press:  01 September 2022

C. Vallecillo Adame*
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
T. Jiménez Aparicio
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
C. De Andrés Lobo
Affiliation:
Hospital Clínico Universitario de Valladolid, Psiquiatría, VALLADOLID, Spain
A. Gonzaga Ramírez
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
M. Queipo De Llano De La Viuda
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
G. Guerra Valera
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
I. Santos Carrasco
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
J. Gonçalves Cerejeira
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
B. Rodríguez Rodríguez
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
M. Fernández Lozano
Affiliation:
Hospital Clínico Universitario de Valladolid, Psiquiatría, VALLADOLID, Spain
M.J. Mateos Sexmero
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
N. Navarro Barriga
Affiliation:
Hospital Clínico Universitario de Valladolid, Psiquiatría, VALLADOLID, Spain
N. De Uribe Viloria
Affiliation:
Hospital Universitario Fundación de Alcorcón, Psychiatry, Madrid, Spain
G. Medina Ojeda
Affiliation:
Sacyl, Hospital Clínico Universitario Valladolid, Psiquiatría, Valladolid, Spain
L. Rodriguez Andrés
Affiliation:
Hospital Clinico Universitario de Valladolid, Psychiatry, Valladolid, Spain
*
*Corresponding author.

Abstract

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Introduction

We present the clinical case of a patient where the psychotic clinic coexists with gender dysphoria. This scenario can be the result of a change in gender identity derived from the psychotic process or appear independently of it.

Objectives

We want to explain the importance of knowing how to act with a patient in whom these two processes coexist.

Methods

20-year-old woman, with no history of mental health. She comes to the emergency department for behavioral alteration. The family observes strange behaviors, unmotivated laughter, soliloquies and aggressive episodes. Abandonment of studies, hobbies and radical physical change. Delusions of prejudice and self-referential delusions. Possible phenomena of echo and diffusion of the thought. Auditory hallucinations talking to her in male gender, since then she presents doubts about her sexual identity and manifests her desire to change sex. Altered judgment of reality.

Results

During admission, we started treatment with an antipsychotic with good tolerance and she was referred to mental health team, where psychopharmacological treatment was adjusted with good response. In the following medical appointments the psychotic clinic disappeared at the same time that sexual identification was completely restored and made a critique of the behavior and experiences.

Conclusions

This case highlights the importance of assessing the chronology of symptoms, the patient’s criticality, the response to antipsychotic treatment and the need to exclude the psychotic background of the desire for gender reassignment before making a therapeutic decision.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (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.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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