[Questions and challenges in the diagnostics of gender identity disorder. Review and case vignettes].

Professionals working in the field of psychiatry have recently been increasingly encountering patients seeking help who define themselves as transsexual. Gender identity and gender self-expression of transsexual people do not match their biological sex, and they also feel an intense desire and urge to change their officially registered gender at birth and their physical appearance - even by using hormone therapy or surgery. In their case, the diagnosis of gender identity disorder as a disease category enables the use of medical interventions and health services necessary for transition. At the same time, the diagnosis is complicated by the fact that there is currently no specific psychodiagnostic procedure suitable for the clear identification of gender identity disorder, and gender incongruence can also appear as a symptom of many other mental disorders. Therefore, careful differential diagnosis is essential to establish a well-founded diagnosis, with the help of this literature review that summarizes other mental illnesses with similar symptoms as well as the more common comorbid pathologies.

[The psychotherapy of male patient with sex addiction].

No abstract available.

Altered Neural Activity during Irony Comprehension in Unaffected First-Degree Relatives of Schizophrenia Patients-An fMRI Study.

Irony is a type of figurative language in which the literal meaning of the expression is the opposite of what the speaker intends to communicate. Even though schizophrenic patients are known as typically impaired in irony comprehension and in the underlying neural functions, to date no one has explored the neural correlates of figurative language comprehension in first-degree relatives of schizophrenic patients. In the present study, we examined the neural correlates of irony understanding in schizophrenic patients and in unaffected first-degree relatives of patients compared to healthy adults with functional MRI. Our aim was to investigate if possible alterations of the neural circuits supporting irony comprehension in first-degree relatives of patients with schizophrenia would fulfill the familiality criterion of an endophenotype. We examined 12 schizophrenic patients, 12 first-degree relatives of schizophrenia patients and 12 healthy controls with functional MRI while they were performing irony and control tasks. Different phases of irony processing were examined, such as context processing and ironic statement comprehension. Patients had significantly more difficulty understanding irony than controls or relatives. Patients also showed markedly different neural activation pattern compared to controls in both stages of irony processing. Although no significant differences were found in the performance of the irony tasks between the control group and the relative group, during the fMRI analysis, the relatives showed stronger brain activity in the left dorsolateral prefrontal cortex during the context processing phase of irony tasks than the control group. However, the controls demonstrated higher activations in the left dorsomedial prefrontal cortex and in the right inferior frontal gyrus during the ironic statement phase of the irony tasks than the relative group. Our results show that despite good task performance, first-degree relatives of schizophrenia patients had alterations in the neural circuits during irony processing. Thus, we suggest that neural alteration of irony comprehension could be a potential endophenotypic marker of schizophrenia.

The decoding of the flouting of the Gricean relevance maxim is impaired in mental retardation caused by perinatal hypoxia. A brief report.

The authors examined the decoding of the flouting of the Gricean relevance maxim among children with mental retardation compared to a mental age matched control group with average intellectual capacities, where the cause of mental retardation was perinatal hypoxia. They have investigated the decoding deficit by five short "question and answer" conversation vignettes, where the flouting of the relevance maxim was presented. They have found significant deficit in the mental retardation group in their capacity to decode properly the flouting of the Gricean relevance maxim. These data are the first that point at a pragmatic language use deficit in mental retardation caused by perinatal hypoxia.

Coexistence of folie communiquée and folie simultanée.

Objective. The authors report a case during which they observed serious subtypes of induced delusional psychosis (folie communiquée and folie simultanée) without any common genetic background or premorbid psychosis in the case of the secondary patient. Method. The clinical phenomenology of the case is described. Results. Mild intellectual disability and environmental-psychological factors (social isolation and the symbiotic-like interpersonal relatedness) play an essential aetiological role in the case of the secondary recipient patient. Conclusion. The authors emphasize the importance of subclassification of induced delusional psychosis for further aetiological and clinical research.