자살사고와 중증 기분조절 장애를 가진 성 불쾌감 환자에서의 전기경련치료 1예
Electroconvulsive Therapy in a Case of Gender Dysphoria Patient with Severe Mood Dysregulation and Suicidal Ideation
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초록
어려서부터 지속된 성 불쾌감이 있는 25세 남자는 중증기분조절 장애, 만성적인 자살사고를 보였으며 전기경련치료에 증상의 호전을 보였다. 성 불쾌감을 가진 환자의 경우,우울증과 자살사고의 위험성 등 정신과적 공존질환을 가지는 경우가 많아 이에 대한 적극적인 정신과적 개입이 필요하다. 상기 증례의 경우처럼 약물에 지속적인 저항성을 가진경우나 응급적인 상황인 경우 전기경련치료를 고려해 볼 수있다. 아직까지 우리나라는 소아나 청소년, 또한 성인에 있어서의 성 불쾌감 환자에 대한 조사가 전무한 실정이다. 향후 조사를 통해 우리나라 성 불쾌감 환자의 유병률 및 동반된 정신병리 등에 대한 면밀한 평가가 이루어져야 한다, 또한 성전환수술시 정신과적 적극적인 개입을 통한 정동 문제,자살사고 등에 대한 법적 보호 장치의 마련이 필요할 것으로여겨진다.
Abstract
Gender dysphoria is very rare, but has frequent psychiatric comorbidity. In addition, risk of suicideis higher in patients with gender dysphoria than for the general population. Treatment ofgender dysphoria is not determined, and more aggressive treatment is required for patients withsuicidal ideation. No case involving electroconvulsive therapy of a gender dysphoria patient hasbeen reported in South Korea. We discuss a 24 year-old man given electroconvulsive therapy forgender dysphoria with severe mood dysregulation and suicidal ideation.
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