European Psychiatry - Volume 33 - March 2016

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S734 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
Methods MEDLINE, PsycINFO databases were searched for arti-
cles published between 2005–2015 containing the keywords
“gender dysphoria”, “gender-variant people” and “transgender
people”. Relevant policies, guidelines and legislations were also
reviewed.
Results Transgender people still face major health inequalities
and discrimination. National statistics show that 80% have expe-
rienced harassment, 62% suffered discrimination at work or home
and 54% reported being denied access to NHS care due to lack of
cultural competency from staff. Guidelines, research, policies and
equality legislation have begun to be implemented to protect trans-
gender people from discrimination and accord rights.
Conclusions Many areas need attention and improvement includ-
ing not only healthcare but also employment, education, housing
and media perception. Promotion of equality in the general popu-
lation with the aim of achieving cultural change and improvement
of cultural competency of health professionals is needed.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1205
Flibanserin: The first drug approved
for the treatment of hypoactive sexual
desire disorder in pre-menopausal
women
N. Couto ∗, R. Ribeiro Silva
1 Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Psychiatry and
Mental Health, Braga, Portugal
2 Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Psychiatry and
Mental Health, Vila Nova de Gaia, Portugal
∗ Corresponding author.
Introduction Hypoactive sexual desire disorder (HSDD) is char-
acterized by persistent or recurrent deficiency or absence of sexual
fantasies and desire for sexual activity, causing marked biopsy-
chosocial dysfunction. The etiology of HSDD involves a wide range
of biological and psychosocial factors. One of the biological factors
is the balance between excitatory and inhibitory neurotransmitter
pathways that regulate the sexual response in the central nervous
system. Flibanserin is a compound discovered in 1995, agonist of
the 5-HT1A antagonist and the 5-HT2A receptors, which became
August 2015 in the first drug approved for the treatment of HSDD.
Objectives Describe the main pharmacokinetic and pharmaco-
dynamic characteristics of flibanserin, as well as the results and
conclusions of the phase three clinical trials that led to its approval
by the US regulatory authority.
Aims To understand the potential benefits and risks of the clinical
use of flibanserin.
Methods Search online titles and abstracts related to flibanserin.
Results Flibanserin is a multifunctional serotonin agent who is
both a serotonin 1A agonist and a serotonin 2A antagonist. Theoret-
ically, flibanserin improves sexual activity by increasing dopamine
and norepinephrine release as it reduces serotonin release in
brain circuits that mediate the symptoms of interest/female sex-
ual arousal. Flibanserin showed a statistically significant increase in
the number of improvements and satisfactory sexual events in sev-
eral other validated scales. The main side effects include dizziness,
sleepiness, nausea and (rarely) syncope.
Conclusions Despite the efficacy of flibanserin not produce statis-
tically powerful results, although statistically significant, this may
be important for a particular woman’s profile, including those in
which other psychotherapeutic approaches have failed.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1206
Personality traits and personality
disorders in gender dysphoria
V. Deiana ∗, E. Corda , C. Bandecchi , S. Pintore , F. Pinna ,
R. Pusceddu , A. Oppo , S. Mariotti , A. Argiolas ,
B. Carpiniello
1 University of Cagliari, Clinica Psichiatrica, Cagliari, Italy
2 AOU Cagliari, Unità Operativa di Endocrinologia, Monserrato, Italy
∗ Corresponding author.
Investigations in the field of gender dysphoria (GD) have been
mostly related to psychiatric comorbidity and severe psychiatric
disorders, but have focused less on personality traits and personal-
ity disorders (PDs).
We aimed to assess personality and the presence of PDs in a sam-
ple of 25 persons with GD attending the Psychiatric Clinic or the
Department of Endocrinology of the University of Cagliari request-
ing sex reassignment therapy. They were assessed through the
Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the
Structured Clinical Interview for DSM-IV Axis II (SCID-II).
The sample consisted of 14 MtF and 11 FtM, with a mean age of
29.6 ±9.5. Overall, 39.1% of the sample met the criteria for at least
one PD, more frequently cluster-B PD (21.7%). MtF met a higher
number of SCID-II criteria than FtM, especially regarding histrionic
personality traits ( P= 0.001). A total of 20 persons (9 MtF and 11
FtM) completed the MMPI-2. Mean T scores did not differ from the
general population, except for the Psychopathic Deviate (Pd) scale
(mean T = 66.2 ± 11.2). The Masculinity-Femininity (Mf) scale was
slightly increased, and its score reduced after correction for per-
ceived sex (P = 0.037). MtF scored significantly higher at the Family
Problems (FAM) scale (P= 0.052) and lower at the Social Discomfort
(SOD) scale (P = 0.005) compared to FtM.
The high prevalence of PDs confirms that this kind of assessment in
GD is of great importance, as a key part of personalized treatment
plan tailoring. The high scores on the Pd scale suggest misidentifi-
cation with societal standards.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1207
Body image and gender role perceived
in gender dysphoria: Cross-sex
hormone therapy effects
E. Corda , C. Bandecchi , V. Deiana ∗, S. Pintore , F. Pinna ,
R. Pusceddu , A. Oppo , S. Mariotti , A. Argiolas ,
B. Carpiniello
1 University of Cagliari, Clinica Psichiatrica, Cagliari, Italy
2 AOU Cagliari, Unità Operativa di Endocrinologia, Monserrato, Italy
∗ Corresponding author.
The gender dysphoria (GD) refers to the distress caused by the
incongruence between gender identity and biological sex. This
occurs, especially in pre-treatment cross-sex hormone therapy
(CHT), with a marked dissatisfaction with their body image.
The purpose of this study is to evaluate the role of perceived gender
in a total of 20 subjects (9 MtFs and 11 FtMs), presented for initia-
tion of CHT at the Psychiatric Clinic or Department of Endocrinology
of University Hospital of Cagliari and deemed appropriate to take
the transition path aimed at sex reassignment. On a subsample of
7 patients (2 MtFs and 5 FtMs) were then evaluated changes, in
terms of improving the acceptance of body image, at 2 months
after initiation of CHT, using the Minnesota Multiphasic Person-
ality Inventory-2 (MMPI-2) (focusing on MF, Gm and Gf scale), the
BemSex Role Inventory (BSRI), and the Body Uneasiness Test (BUT).
The MF scale shows a moderate elevation, which is reduced signif-
icantly as a result of correction for perceived gender rather than
biological sex. MtFs get higher scores on the Gf scale and lower