[性同一性障害の診断と性的割り当て手術の適格性の評価におけるRorschachテストを利用]

はじめに：性同一性障害（GID）は、明確で定義された遺伝的または生物学的変化がない場合、性同一性が解剖学的性別と一致しない精神障害です。GIDの診断と、性的割り当て手術（SRS）の患者の適格性の評価は、法的認識手順の前提条件です。この研究の目的は、鑑別診断の決定におけるロールシャッハテストの有用性を評価し、主にSRSの患者の適格性に関する情報を提供し、臨床、治療、および法医学的心理測定および精神診断評価の枠組みにおいて、そして世界の専門家協会（WATH）の基準によると 材料と方法：この目的のために、47人の患者（33人のGIDおよび14 GID NAS）のRorschachテストを分析しました。 結果：GID NAS患者はストレス制御に大きな困難を抱え、適応性が低下し、混乱、衝動性、行動障害、およびより高いレベルの状況および慢性ストレスにつながる可能性があります。 結論：この研究は、特に主要な精神病理学的障害の有病率に有意差を示さないグループを比較しない場合、SRSの患者の適格性の診断と評価において、GIDとGID NASの間の鑑別診断の決定においてロールシャッハ検査を単独で使用できないことを示しています。

INTRODUCTION: Gender identity disorder (GID) is a mental disorder in which gender identity is incongruent with the anatomical sex, in the absence of any clear and defined genetic or biological alteration. The diagnosis of GID as well as the assessment of patient eligibility for sex reassignment surgery (SRS) are prerequisite to the legal recognition procedure. The aim of this study was to evaluate the usefulness of the Rorschach test in differential diagnosis determination and primarily in providing information on patient eligibility for SRS, in the framework of the clinical, therapeutic and forensic psychometric and psychodiagnostic assessment, and according to the World Professional Association for Transgender Health (WPATH) criteria. MATERIALS AND METHODS: For this purpose we analysed the Rorschach test of 47 patients (33 GID and 14 GID NAS). RESULTS: Results show that GID NAS patients have greater difficulties in stress control and less adaptability, which could lead to disorganisation, impulsiveness, behavioural disorders, as well as higher levels of situational and chronic stress, with altered thought patterns and uncontrolled ideation, a higher frequency of thought disorders and disturbed relations, with lower quality and less adaptive interpersonal relationships, which are characterized by dependency and aggressive behaviours. CONCLUSIONS: This research shows that the Rorschach test cannot be used alone in the determination of the differential diagnosis between GID and GID NAS in the diagnosis and evaluation of patient eligibility for SRS, especially when comparing groups which do not shows significant differences in the prevalence of the main psychopathological disorders.