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      A Case of Mania Presenting with Hypersexual Behavior and Gender Dysphoria that Resolved with Valproic Acid

      case-report

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          Abstract

          Hypersexuality and gender dysphoria have both been described in the literature as symptoms of mania. Hypersexuality is listed in the Diagnostic and Statistical Manual of Mental Disorders 5 as part of the diagnostic criteria for bipolar disorder. Gender dysphoria is less often described and its relation to mania remains unclear. This case report describes a young homosexual man presenting in a manic episode with co-morbid amphetamine abuse whose mania was marked by hypersexuality and the new onset desire to be a woman. Both of these symptoms resolved with the addition of valproic acid to antipsychotics. This case report presents the existing literature on hypersexuality and gender dysphoria in mania and describes a treatment option that has not been previously reported.

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          HIV risk behavior among patients with co-occurring bipolar and substance use disorders: associations with mania and drug abuse.

          Christina S Meade, Fiona S Graff, Margaret L Griffin … (2008)
          Bipolar and substance use disorders frequently co-occur, and both are associated with impulsivity, impaired judgment, and risk-taking. This study aimed to: (1) describe the rates of HIV sexual and drug risk behaviors among patients with co-occurring bipolar and substance use disorders, (2) test whether acute mania, psychiatric severity, and drug severity independently predict HIV risk, and (3) examine the relationship between specific substance dependencies and sexual risk behaviors. Participants (N=101) were assessed for psychiatric diagnoses, substance abuse, and HIV risk behavior using structured clinical interviews and self-report questionnaires. The majority (75%) were sexually active in the past 6 months and reported high rates of sexual risk behaviors, including unprotected intercourse (69%), multiple partners (39%), sex with prostitutes (24%, men only), and sex trading (10%). In a multivariate linear regression model, recent manic episode, lower psychiatric severity, and greater drug severity were independent predictors of total HIV risk. Cocaine dependence was associated with increased risk of sex trading. Results underscore the importance of HIV prevention for this population.
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            A cross-national epidemiological study of mania.

            Julian Leff, C Bertelsen, Sarah Fischer (1976)
            An epidemiological study of the first admission rate for mania was carried out in London and Aarhus. The case registers in these two centres were used to conduct a retrospective study of case notes covering several years, and a screening procedure was used for the prospective collection of new cases over the course of one year. The annual incidence of mania was found to be virtually identical in both centres. The retrospective study gave a figure of 2-6 per 100,000 population in both Aarhus and London. But the London sample was found to contain 45 per cent of immigrants in contrast to the Aarhus sample in which only a negligible proportion were born outside Denmark. Male West Indians, in particular, were over-represented in the London sample.
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              The stages of mania. A longitudinal analysis of the manic episode.

              Alice Goodwin, Noel Carlson (1973)
              Article 0 comments Cited 18 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ment Illn
                Journal ID (iso-abbrev): Ment Illn
                Journal ID (publisher-id): MI
                Title: Mental Illness
                Publisher: PAGEPress Publications, Pavia, Italy
                ISSN (Print): 2036-7457
                ISSN (Electronic): 2036-7465
                Publication date (Electronic): 23 November 2016
                Publication date Collection: 23 November 2016
                Volume: 8
                Issue: 2
                Electronic Location Identifier: 6546
                Affiliations
                [1 ]University of California , Irvine
                [2 ]Department of Psychiatry and Human Behavior, University of California , Irvine, CA, USA
                Author notes
                University of California, Irvine CA 92697, USA. +1.530.902.7573. mrabowsk@ 123456uci.edu.

                Contributions: MRH, data collecting, manuscript writing, references search; MB, manuscript writing and references search; LRF, manuscript reviewing and writing.

                Conflict of interest: the authors declare no potential conflict of interest.

                Article
                DOI: 10.4081/mi.2016.6546
                PMC ID: 5136748
                PubMed ID: 27994833
                SO-VID: 187747cb-595a-49bd-8d05-c022e75c0445
                Copyright © ©Copyright M.R. Heare et al.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 16 April 2016
                Date revision received : 02 June 2016
                Date accepted : 02 June 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 2
                Categories
                Subject: Case Report

                Keywords: psychiatry,mania,hypersexual,gender dysphoria
                Data availability:
                Keywords: psychiatry, mania, hypersexual, gender dysphoria

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