ABSTRACT
Objective: Present a case of a transgender and gender diverse (TGD) individual receiving gender affirming hormone therapy (GAHT) who presented with first episode bipolar mania and received electroconvulsive therapy (ECT). To understand the safety and efficacy of ECT in the TGD population including those receiving GAHT through literature review. Materials and Methods: Case report using informed consent from an individual TGD patient who received ECT. A review of the literature was conducted using PubMed, Embase, and Medline. Results: The case illustrated safe and effective ECT use in a TGD individual receiving GAHT. Eight studies were reviewed. GAHT has been reported to interfere with certain anaesthetic agents used in ECT. ECT appeared to be a safe and effective treatment in the TGD samples in those studies. Conclusion: There is limited literature on the safety and efficacy of ECT for TGD individuals receiving GAHT. More research is required to address mental health inequalities in this population and to support safe and effective gender affirming treatment modalities.
ABSTRACT
BACKGROUND: Little empirical research has been done to assess the impact of obsessive-compulsive disorder (OCD) on patients and their caregivers. OBJECTIVE: To assess the psychosocial impact of OCD on patients and their caregivers and compare it with depressed controls. METHOD: Thirty two patients with OCD and their caregivers and 30 patients of depression and their caregivers were assessed on sociodemographic and clinical variables and the following scales: World Health Organization Quality of Life Questionnaire-BREF version (WHOQOL-BREF); Schedule for Assessment of Psychiatric Disability; Family Burden Interview Schedule; and Family Accommodation Scale. Yale Brown Obsessive-Compulsive Disorder Scale (YBOCS) and Hamilton Depression Rating Scale (HDRS) were applied to rate the severity of obsessive-compulsive and depressive symptoms. RESULTS: Patients with OCD had the lowest scores in the psychological health domain of the WHOQOL-BREF. They were also disabled due to their illness with maximum disability being experienced in the overall behaviour domain. Caregivers of OCD patients experienced burden in several areas and had to accommodate to the patient's behaviour. Patients with OCD had a better quality of life (QOL) and were less disabled compared with depressed patients, but their caregivers were more burdened and had to accommodate to a greater degree in comparison to caregivers of depressed patients. The OCD patients' QOL and disability scores and their caregivers' burden and accommodation scores correlated significantly with several sociodemographic, clinical and psychological variables. CONCLUSION: OCD patients, when compared with depressed subjects, have a better QOL and are less disabled, but their caregivers are more burdened and have to accommodate more.
