European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S53–S68 S57
Workshop: love, sex and psychiatry: the case of
gender dysphoria
W014
A Dimensional perspective on sexual
orientation and gender
G. Castellini
Universisty of Florence, department of neuroscience- psychology-
drug research and child health, Florence, Italy
Gender identity - the subjective experience of membership to a
gender - is generally taken for granted by most of the persons.
It is part of our general identity, and provides a sense of conti-
nuity of the self, and interrogative on this aspect of our life are
barely present in our consciousness. Exceptions are represented
by stages of development such as adolescence or some categories
of persons who do not identify themselves into the dichotomous
world of men/female. The debate on gender identity recently has
broken into the consciousness for Psychopathology, rising interrog-
atives from different perspectives, including Medicine, Phycology,
Anthropology, and Ethic.
In the present symposium we resume the historical trajectory
of gender definition, emphasizing the importance of a different
perspective on gender than the common definition provided by
western culture. We propose a phenomenological perspective on
the components of sexual identity, which includes anatomical sex,
gender identity, sexual orientation, and gender role. The pheno-
menological approach is coherent with the dimensional view on
sexual identity proposed by the DSM board, as well as by LGBT
movements. This position considers Gender Dysphoria and trans-
sexualism as a pole of gender variants continuum. Phenomenology
looks at the comprehension of subjective gender heterogeneity,
and the subjective world of gender dysphoric persons as the only
way to take care of them; every psychological medical or surgical
treatment should come as consequences. The phenomenological
perspective on gender dysphoria may be useful to understand and
partially explain the different subjective satisfaction to common
hormonal and surgical treatment.
Disclosure of interest The author has not supplied his declaration
of competing interest.
W015
Gender identity issues in children and
adolescents
T.D. Steensma
VU university medical center, center of expertise on gender
dysphoria- medical psychology, Amsterdam, The Netherlands
Gender identity issues in children and adolescents.
Gender dysphoria (GD) refers to the significant distress due to the
incongruence between assigned gender at birth and experienced
gender. Over the last decade, the care for prepubescent children
and adolescents with GD is rapidly changing and there is a grow-
ing number of specialized gender clinics for youth. However, the
offered care between countries is very different and the best clini-
cal practice in this population is still controversial and under debate
among dedicated professionals.
The current presentation will focus on providing a clinical picture
of children and adolescents referred to gender identity clinics. For
prepubescent children the focus will be on the present knowl-
edge about the psychosexual development of these children and
treatment & counseling approaches are presented and discussed.
With regard to the adolescents, medical treatment approaches are
presented and discussed, followed by the results from the only
follow-up study on medical treatment in adolescents with GD.
Disclosure of interest The author has not supplied his declaration
of competing interest.
Workshop: reward circuits, anhedonia and
avolition: brain imaging contribution to their
understanding in schizophrenia
W016
VTA-insula connectivity and avolition
in subjects with schizophrenia
A. Mucci ∗, G.M. Giordano , M. Stanziano , M. Papa ,
S. Galderisi
1 University of Campania “Luigi Vanvitelli”, department of psychiatry,
Naples, Italy
2 University of Campania “Luigi Vanvitelli”, laboratory of neuronal
networks- department of mental and physical health and preventive
medicine, Naples, Italy
∗ Corresponding author.
Introduction Avolition represents an important domain of nega-
tive symptoms in schizophrenia with a strong impact on functional
outcome. Primary and persistent avolition is refractory to available
pharmacological and psychological treatments. A better under-
standing of its pathophysiological mechanisms is fundamental to
promote development of new treatments. Recent models of avoli-
tion converge on dopaminergic circuits involved in motivation and
its translation in goal-directed behavior. Deficits in task-related
activation or connectivity within mesolimbic and mesocortical
dopamine circuits were reported in schizophrenia but the relation-
ship with avolition was not fully established.
Aims The present study aimed to investigate resting-state func-
tional connectivity (RS-FC) within the motivation circuits in
schizophrenia patients and its relationships with primary and per-
sistent avolition.
Methods RS-FC, using VTA as a seed region, was investigated in
22 healthy controls (HC) and in 26 schizophrenia patients (SCZ)
divided in high (HA) and low avolition (LA) subgroups. Avolition
was assessed using the Schedule for the Deficit Syndrome.
Results HA, in comparison to LA and HC, showed significantly
reduced RS-FC with the right ventrolateral prefrontal cortex (R-
VLPFC), right insula (R-INS) and right lateral occipital cortex
(R-LOC). The RS-FC of these regions was negatively correlated to
avolition.
Conclusions Our findings demonstrate that avolition in
schizophrenia is linked to dysconnection of VTA from key cortical
regions involved in retrieval of outcome values of instrumental
actions to motivate behavior.
Disclosure of interest AM received honoraria or advisory
board/consulting fees from the following companies: Janssen
Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre. SG received
honoraria or advisory board/consulting fees from the follow-
ing companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La
Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter. All
other Authors declare no potential conflict of interest.