Gender dysphoria and homosexuality: A patient series

PurposeTo present the clinical course of adolescents who presented to the child and adolescent psychiatry outpatient clinic due to gender dysphoria and homosexuality through a patient series.MethodsThe clinical features, comorbidities, and the treatment process of 10 patients who presented to the outpatient clinic and were followed up over a period were presented.ResultsThe average age of the 10 patients, 5 girls and 5 boys, was 14.3 years for the girls and 16 years for the boys. Nine patients were admitted by their families primarily with the desire for the elimination of gender dysphoria or homosexual orientation. Only one female patient was brought by her family because of her intense depressive symptoms and suicidal thoughts. All of the patients had comorbid psychiatric diseases, nine had depression, and one had bipolar affective disorder comorbidity. The anxiety levels of all patients were high. Psychiatric management in each patient focused on the emotional, cognitive and social difficulties of the case. The treatment of two girls was interrupted suddenly by the family because they saw that the homosexual orientation of the patients was continuing. Two male patients were not brought back for treatment after the evaluation process.ConclusionsGender dysphoria and homosexual orientation are situations that families still find it difficult to accept and that they think it can be eliminated by pressure, coercion or psychiatric treatment. Patients show a high rate of psychiatric comorbidity due to family pressure and social exclusion. Although psychiatric support can cure comorbid disorders in a relatively short time, strains of family and social relationships continue to affect patients.     

Utiliser les psychédéliques pour « guérir » des adolescents homosexuels ? Essai de thérapie de conversion,France, 1960

Between 1960 and 1962, a children's judge placed two French adolescents in a psychiatric hospital in Alsace. Described as “delinquent sexual perverts”, Michel, 15, and Bernard, 18, were in fact two young homosexuals. However, at the time, homosexuality was considered a psychiatric disorder that should be “cured”. With this in mind, psychiatrists set up shock or disgust therapies to push patients to become heterosexual. In this hospital, the chief doctor tested two new substances on them: mescaline and LSD. Injected in very high doses, the idea was to cause a powerful psychological shock in the hope of changing the adolescents’ sexual orientation. This type of placement as well as the treatment inflicted were then common (lobotomies or electroshocks were part of the “therapeutic” possibilities to “cure” homosexuality). Two aspects of these experiments are however particularly original: on the one hand, the use of substances such as mescaline and LSD, on the other hand, the very type of “therapy” implemented. It would thus seem, in the current state of knowledge on the use of LSD and mescaline in psychiatric therapy, that these experiences were isolated facts: the literature remains silent on the subject of the use of mescaline to “cure” homosexuality, and the few known therapies carried out using LSD were offered to adults and above all volunteers. Finally, these therapeutic methods were the opposite: psychotherapies in which particular attention was paid to patients and their well-being in the United States or in England and “psychic shocks” in Alsace. This hospital is the only French example of an attempt to “treat” homosexuality using psychedelics. The use of these substances by the French team therefore began in 1960; it involved administering mescaline or LSD in high doses (an exceptional characteristic in Europe where psychiatrists were in favor of therapy with low doses known as “psycholytic”) and in injections, ranging from 200 to 1200 mg for mescaline and for LSD from 100 to 800 micrograms. By way of comparison, a recreational dose is 300 to 500 mg for mescaline and 100 micrograms for LSD, administered orally. In order to create “psychic shock”, the effects of the substances were immediately stopped by the injection of chlorpromazine, a powerful neuroleptic. The authors noted that for all patients, “two modes of behavior are common: stupor and agitation”. They sometimes tore their sheets or pajamas or grabbed the examiner, asking for support. The sessions were linked: in 118 days, Bernard would undergo 16 of these sessions, one every 7 days on average. Michel, during one of the sessions, felt like he had been killed by his psychiatrists. Neither would subsequently become heterosexual. Elsewhere in the world, other forms of LSD conversion therapy have emerged. However, these were benevolent psychotherapies; the product was not injected but taken orally (therefore with more progressive effects), and the approach was not the same. Thus, acceptance of their homosexuality by patients was considered as desirable an option for therapists as was conversion to heterosexuality. For French practitioners, on the contrary, “healing” was the only objective. This article will highlight a double French specificity in the use of psychedelics: first, the refusal to introduce the new method of administering these substances, called “set and setting”, theorized from the late 1950s in Anglo-Saxon countries, and yet known and discussed by French experimenters. Then, it will show the use of these substances in shock therapy, particularly in the treatment of homosexuality.     

多形式健康教育提高青少年性知识的效果观察

目的:探讨多形式健康教育提高青少年性知识的效果。方法:选取本辖区青少年400例为观察组,另选400例青少年为对照组,观察组实施多形式健康教育,对照组接受常规健康教育,对两组青少年的性知识情况、紧急避孕知识进行观察。结果:教育前,两组青少年的性知识了解程度无明显差异(P0.05),观察组青少年经教育后的性知识了解程度明显高于对照组,差异有统计学意义(P0.05);两组青少年教育前的紧急避孕知识知晓率无明显差异(P0.05),观察组教育后的知晓率显著较对照组高,差异有统计学意义(P0.05)。结论:多形式健康教育能提高青少年的性知识了解程度,也能提高青少年对紧急避孕知识的知晓率,对降低青少年非意愿妊娠、性传播疾病发生率具有显著作用,值得临床推广。     

青少年慢性鼻窦炎的鼻内窥镜手术与CT对照研究

目的：探讨青少年慢性鼻窦炎CT检查的价值。方法：对150例青少年患者行冠状位CT扫描，并行功能性内窥镜手术，对其CT表现和手术观察情况进行对照研究。结果：150例中，146例冠状位CT显示鼻窦炎，50例解剖变异者，47例同时伴发鼻窦炎，均经手术证实，多数与手术所见相符，仅4例CT结果阴性，临床表现典型鼻窦炎症状，经手术证实为鼻窦炎。结论：冠状位CT扫描是青少年慢性鼻窦炎患者鼻内窥镜手术前必要的检查方法。CT检查阴性时不能除外鼻窦炎的可能。     

外伤性青少年腰椎间盘突出症

目的：分析外伤性青少年腰椎间盘突出症特点，提高诊治水平。方法：9例13－18岁腰椎间盘症患者，3例因就诊时腰腿痛有神经损害明显，未行保守治疗，其余6例曾经1月－1年保守治疗无效，其中5例神经损害加重。9例全部后路手术治疗。结果：7例经1年－8年，平均4．3年随记，全部神经功能恢复，5例无腰腿痛，1例运动后有少行腰腿痛，1例第1次手术症状消失后7年，腰腿痛症状复发。结论：本病有以下特点：明显腰部外伤后发病；临床症状体症常明显；突出多为破裂游离型；手术治疗是主要方法，疗效满意。     

青少年健康人群抗白喉杆菌抗体水平调查

目的 了解青少年人群抗白喉杆菌抗体水平，为预防控制白喉提供依据。方法 采用随机抽样方法抽取调查点和被测人群，用间接血凝试验（IHA）检测抗白喉毒素抗体，结果 分析采用x^2检验和F检验。结果 青少年健康人群白喉抗体阳性率为80．32％（151／188），平均抗体滴度（GMT）为1：12．2236，抗毒素平均含量（ATC）为0．0599 IU／ml。抗体水平比较分析，年龄组中最高者是9～11岁组，96．67％，最低者是12～14岁组，48．78％；城关（95．45％）高于农村（72．13％）；男女性别间无差异。结论 岳阳市健康青少年人群的抗白喉抗体水平较高，能够有效防止白喉流行。     

立体定向放射治疗青少年脑动静脉畸形的疗效

目的　回顾性分析X射线立体定向放射治疗 (SRT)青少年脑动静脉畸形 (AVM)的远期疗效、并发症及影响因素。方法　 6 6例青少年脑AVM采用X射线SRT治疗 ,病灶体积 0 .32～ 4 2 .88cm3 ,周边剂量 18～ 2 3Gy。结果　随访 3～ 5年 ,AVM闭塞率 6 5 .2 % ,疗后 2年再出血率 4 .6 %。多因素回归分析结果显示周边剂量在 18～ 2 3Gy范围时 ,病灶体积大小是影响AVM闭塞率的唯一因素 ,而周边剂量和年龄与其无关。AVM体积 <10cm3 的闭塞率 (87.1% )明显高于体积 >10cm3 的 (45 .7% )(χ2 =10 .6 4 4 ,P <0 .0 1)。平均闭塞恢复期与治疗体积及周边剂量均有关 ,体积 <10cm3 的 1.4 4 4年短于体积 >10cm3 的 1.813年 (t =2 .0 6 6 ,P <0 .0 5 ) ;周边剂量 >2 0Gy的 1.4 4 8年短于剂量 <2 0Gy的1.85 7年 (t=2 .2 4 7,P <0 .0 5 ) ;而与年龄无关 ,少年组与青年组的恢复期分别为 1.4 74年与 1.6 6 7年 (t=1.0 73,P >0 .0 5 )。结论　X射线SRT治疗体积 <10cm3 的脑AVM ,当周边剂量 >2 0Gy时 ,有较高的闭塞率且完全闭塞所需时间较短 ,是外科手术及血管内栓塞的补充治疗手段     

青少年精神分裂症患者个性特征与家庭环境的相关性

目的探讨青少年精神分裂症的个性特点、家庭环境模式,及其家庭环境因素对青少年个性的影响。方法以16~19岁首发精神分裂症60例为研究组,同年龄段在校就读学生60例为正常对照组;以艾森克个性(成人)问卷(EPQ),家庭环境量表中文版(FES-CV),为测评工具,测验结果全部输入心理测验软件系统,用SPSS11.0统计软件进行均数、2、t检验及相关性检验。结果青少年精神分裂症性格多为内向不稳定型(19例)、高精神质[(7.12±3.22)分]、高神经质[(14.38±5.85)分];其家庭环境亲密度[(5.55±2.19)分]、成功性[(5.22±2.18)分]、知识性[(4.08±1.82)分]、娱乐性[(4.37±2.16)分]、组织性[(5.13±2.23)分]、道德性[(5.23±1.79)分]得分显著低于对照组,而家庭环境中亲密度和组织性与个性有高度相关性(P<0.01)。结论家庭环境对青少年的个性有重要的影响,特别是家庭环境中的亲密度和组织性。     

湖南部分地区城乡青少年行为方式和生活态度的比较分析

目的　比较分析城市和乡村地区青少年之间的生活态度和行为方式。方法　对长沙地区 (城区 )及韶山地区 (乡村 )各一所中学的初一年级至高二年级学生进行统一问卷调查。答卷采用无记名方式 ,涵盖生活态度及行为方式的内容。结果　共 2 4项选题 ,城乡青少年行为方式比较有显著性差异 (P <0 .0 1)。生活态度比较 ,除对向往的生活方式、异性偶像两题外 ,对其余各题的选择 ,城乡学生间均有差异 (P <0 .0 1) ,但其中部分选题的某些选项 ,城乡学生看法较一致 ,无统计学意义 (P >0 .0 5 )。结论　社会因素是造成城乡学生间心理发育差异的决定性因素 ;当前城乡学生的性意识均有显著增强。     

对18岁以下心理问题者进行系统家庭治疗的研究

目的探讨对１８岁以下心理问题者进行系统家庭治疗的应用情况。方法运用规范的系统家庭治疗技术进行访谈、干预７３例家庭，随访５１例；用彩色摄像和高灵敏度录音系统记录每次治疗访谈和随访访谈的全部过程，用相应调查表进行反馈。结果随访治疗有效率８６３％；社会功能显著改善；６项家庭动力学指标中，有５个维度差异有显著性：１系统逻辑向多元宽容方向移动；２僵化的关系现实有所软化；３关系控制减弱；４疾病观念向“患者可以有所作为”转变；５个性化程度增高。结论系统家庭治疗技术适用于中国青少年儿童家庭，可逐渐推广、应用。