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Sinha S, Vasudeva P. Can apparently transient life events trigger long-term lower urinary tract symptoms? Neurourol Urodyn 2024; 43:1104-1108. [PMID: 38289333 DOI: 10.1002/nau.25303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 02/01/2024]
Abstract
INTRODUCTION One-time life events such as neurological injury can result in lifelong lower urinary tract symptoms (LUTS). However, it is unclear whether an apparently transient life event can also trigger long-term LUTS. This review examines the possibility of an association and hypothesizes the pathogenesis. METHODS A pubmed search was conducted using the MeSH words "life change events," "child abuse," or "stress disorders, Posttraumatic", and LUTS. Additional manuscripts were identified by a hand and citation search. RESULTS Long-term LUTS was noted following temporally remote childhood sexual abuse, adverse childhood experiences, and stressful experiences in adults. There was evidence for an association of childhood sexual abuse and adverse childhood events with both storage as well as voiding LUTS. There was limited evidence that the number of adverse childhood events might increase the risk and severity of LUTS. There was evidence of an association between post-traumatic stress disorder in adults and LUTS. The finding of mental health disorders in such patients could explain some but not all of the observed association suggesting that other factors might also be important. CONCLUSIONS There is an association noted between apparently transient lifetime events and the subsequent reporting of LUTS. The timing of these adverse experiences might be important in determining the propensity for clinical manifestation. There is a need to explore this association, establish causality, and determine the underlying etiopathogenesis.
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Affiliation(s)
- Sanjay Sinha
- Department of Urology, Apollo Hospital, Hyderabad, India
| | - Pawan Vasudeva
- Department of Urology and Renal Transplant, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Wang SJ, Chang JJ, Cao LL, Li YH, Yuan MY, Wang GF, Su PY. The Relationship Between Child Sexual Abuse and Sexual Dysfunction in Adults: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:2772-2788. [PMID: 35993405 DOI: 10.1177/15248380221113780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Child sexual abuse (CSA) has been recognized as a risk factor for sexual dysfunction and has attracted increasing attention. However, controversies remain regarding related research. The aim is to calculate the pooled effect size estimate for the correlation between CSA and sexual dysfunction in adults by meta-analysis. Five bibliographic databases (PubMed, Cochrane Library, Web of Science, Embase, and PsycINFO) were comprehensively searched to clarify the association between CSA and sexual dysfunction in adults. We used a fixed-effects model to determine the total pooled effect size estimate and reported odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Subgroup analysis, publication bias analysis, and sensitivity analysis were conducted. Adults who had a history of CSA experienced a higher proportion of sexual dysfunction than adults with no history of CSA (OR = 1.68, 95% CI [1.49, 1.87]). Subgroup analysis showed that women with a history of CSA reported a higher proportion of sexual dysfunction than men with a history of CSA (men: OR = 1.45, 95% CI [1.05, 1.84]; women: OR = 1.62, 95% CI [1.42, 1.83]). The estimates of the effect sizes differed substantially depending on the CSA and sexual dysfunction instruments that were used in each study and the region of each sample. This meta-analysis provides conclusive evidence of an association between CSA and sexual dysfunction in adults. Currently known interventions for the treatment of sexual dysfunction after CSA have only been evaluated in women, so specific interventions should be designed for men CSA survivors who experience sexual impairment.
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Affiliation(s)
- Shao-Jie Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Jun-Jie Chang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Lei-Lei Cao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yong-Han Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Meng-Yuan Yuan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Geng-Fu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Ministry of Education of the People's Republic of China, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Pu-Yu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Ministry of Education of the People's Republic of China, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
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Winterstein TB, Avieli H, Gichaz M. Recovering the Lost Soul: Older Women's Reflections on Past Intrafamilial Child Sexual Abuse. QUALITATIVE HEALTH RESEARCH 2023; 33:426-439. [PMID: 36882288 DOI: 10.1177/10497323231159802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Intrafamilial child sexual abuse (IFCSA) is a social problem with longstanding effects on victims' lives. While scholarly literature has focused on the adverse aftermath of sexual abuse, only a few studies have acknowledged older women's perspectives on their experience of IFCSA and their journey of healing and recovery. The aim of the present study was to explore how older survivors of IFCSA construct and shape their experience of healing in later life and the meaning they assign to this process. Narrative inquiry was selected to explore the narratives of 11 older women survivors of IFCSA. Participants were interviewed using a biographical narrative interviewing method. The narratives were then transcribed and analyzed using thematic, structural, and performance analyses. Four major themes emerged from the participants' narratives: Achieving closure; Spiritual framing of IFCSA as a platform for self-growth; Becoming whole in old age; and Looking to the future after IFCSA. During the aging years, IFCSA survivors may redefine their identity and their place in the world. Using life review processes, older women in this study were striving to heal and reconcile with their past.
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Affiliation(s)
| | - Hila Avieli
- Department of Criminology, Ariel University, Ariel, Israel
| | - Mili Gichaz
- Department of Gerontogy, University of Haifa, Ariel, Israel
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Jepsen D, Luck T, Bernard M, Moor I, Watzke S. Study protocol: Hypersexual and hyposexual behavior among adults diagnosed with alcohol- and substance use disorders-Associations between traumatic experiences and problematic sexual behavior. Front Psychiatry 2023; 14:1088747. [PMID: 37009122 PMCID: PMC10061101 DOI: 10.3389/fpsyt.2023.1088747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
Background Hypersexual and hyposexual behaviors are common concomitant of substance use disorders (SUD). On the one hand, the regular consumption of alcohol or illegal drugs can lead to hypersexual or hyposexual behavior due to its effects on the organism; on the other hand, the use of psychotropic substances is also used as a coping strategy concerning already existing sexual impairments. The aforementioned disorders show similarities in terms of their etiology, as traumatic experiences get special attention as potential risk factors for the development of addictions, hypersexual, and hyposexual behavior. Objectives The study aims to explore the association between SUD characteristics and hypersexual/hyposexual behavior, and a potential moderating effect of early traumatic life events by answering the following research questions: (1) Do people with SUD differ from a sample of people with other psychiatric disorders regarding hypersexual and hyposexual behavior? (2) What are the associations between the presence of sexual problems and different characteristics of the SUD (e.g., mono vs. polysubstance use, type of addictive substance, intensity of the disorder)? (3) What influence do traumatic experiences in childhood and adolescence have on the existence of sexual disorders among adults with a diagnosed SUD? Method The target group of this cross-sectional ex-post-facto study comprises adults diagnosed with an alcohol- and/or substance use disorder. Data will be collected with an online survey, which will be promoted via several support and networking services for people diagnosed with SUD. Two control groups will be surveyed, one consisting of people with other psychiatric disorders than SUD and traumatic experiences, and one healthy group. Relations between the dependent variables (hypersexual and hyposexual behavior) and independent variables (sociodemographic information, medical and psychiatric status, intensity of the prevalent SUD, traumatic experiences, and symptoms of posttraumatic stress disorder) will be initially calculated via correlations and linear regression. Risk factors will be identified via multivariate regression. Discussion Gaining relevant knowledge promises new perspectives for prevention, diagnosis, case conception, and therapy of SUDs as well as problematic sexual behaviors. The results can provide more information about the importance of psychosexual impairments regarding the development and maintenance of SUDs.
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Affiliation(s)
- Dennis Jepsen
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Tobias Luck
- Faculty of Applied Social Sciences, University of Applied Sciences Erfurt, Erfurt, Germany
| | - Marie Bernard
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Irene Moor
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Stefan Watzke
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital Halle, Halle (Saale), Germany
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Selai C, Elmalem MS, Chartier-Kastler E, Sassoon N, Hewitt S, Rocha MF, Klitsinari L, Panicker JN. Systematic review exploring the relationship between sexual abuse and lower urinary tract symptoms. Int Urogynecol J 2023; 34:635-653. [PMID: 35751671 PMCID: PMC9947020 DOI: 10.1007/s00192-022-05277-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/03/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Patients presenting with lower urinary tract symptoms (LUTS) may report a history of sexual abuse (SA), and survivors of SA may report LUTS; however, the nature of the relationship is poorly understood. The aim of this review is to systematically evaluate studies that explore LUT dysfunction in survivors of SA. METHODS A systematic literature search of six databases, Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO, was performed. The last search date was June 2021 (PROSPERO CRD42019122080). Studies reporting the prevalence and symptoms of LUTS in patients who have experienced SA were included. The literature was appraised according to the PRISMA statement. The quality of the studies was assessed. RESULTS Out of 272 papers retrieved, 18 publications met the inclusion criteria: studies exploring LUTS in SA survivors (n=2), SA in patients attending clinics for their LUTs (n=8), and cross-sectional studies (n=8). SA prevalence ranged between 1.3% and 49.6%. A history of SA was associated with psychosocial stressors, depression, and anxiety. LUTS included urinary storage symptoms, voiding difficulties, voluntary holding of urine and urinary tract infections. Most studies were of moderate quality. Assessment of SA and LUTS lacked standardisation. CONCLUSIONS The review highlights the need for a holistic assessment of patients presenting with LUTS. Although most of the studies were rated as being of 'moderate' quality, the evidence suggests the need to provide a "safe space" in clinic for patients to share sensitive information about trauma. Any such disclosure should be followed up with further assessment.
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Affiliation(s)
- Caroline Selai
- UCL Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
| | - Michael S Elmalem
- UCL Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- UCL Department of Brain Repair and Rehabilitation, Queen Square Institute of Neurology, Queen Square, London, UK
| | - Emmanuel Chartier-Kastler
- Department of Urology, Academic Hospital Pitié-Salpêtrière, Medical School, Sorbonne University, AP-HP, 47-83, Bd de l'Hôpital, 75651, Paris cedex 13, France
| | - Natalia Sassoon
- UCL Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Sam Hewitt
- UCL Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Maria Francisca Rocha
- UCL Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Larisa Klitsinari
- UCL Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Jalesh N Panicker
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- UCL Department of Brain Repair and Rehabilitation, Queen Square Institute of Neurology, Queen Square, London, UK
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Lake AM, Goleva SB, Samuels LR, Carpenter LM, Davis LK. Sex Differences in Health Conditions Associated with Sexual Assault in a Large Hospital Population. Complex Psychiatry 2023; 8:80-89. [PMID: 36660008 PMCID: PMC10288064 DOI: 10.1159/000527363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/25/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction Sexual assault is an urgent public health concern with both immediate and long-lasting health consequences, affecting 44% of women and 25% of men during their lifetimes. Large studies are needed to understand the unique healthcare needs of this patient population. Methods We mined clinical notes to identify patients with a history of sexual assault in the electronic health record (EHR) at Vanderbilt University Medical Center (VUMC), a large university hospital in the Southeastern USA, from 1989 to 2021 (N = 3,376,424). Using a phenome-wide case-control study, we identified diagnoses co-occurring with disclosures of sexual assault. We performed interaction tests to examine whether sex modified any of these associations. Association analyses were restricted to a subset of patients receiving regular care at VUMC (N = 833,185). Results The phenotyping approach identified 14,496 individuals (0.43%) across the VUMC-EHR with documentation of sexual assault and achieved a positive predictive value of 93.0% (95% confidence interval = 85.6-97.0%), determined by manual patient chart review. Out of 1,703 clinical diagnoses tested across all subgroup analyses, 465 were associated with sexual assault. Sex-by-trauma interaction analysis revealed 55 sex-differential associations and demonstrated increased odds of psychiatric diagnoses in male survivors. Discussion This case-control study identified associations between disclosures of sexual assault and hundreds of health conditions, many of which demonstrated sex-differential effects. The findings of this study suggest that patients who have experienced sexual assault are at risk for developing wide-ranging medical and psychiatric comorbidities and that male survivors may be particularly vulnerable to developing mental illness.
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Affiliation(s)
- Allison M. Lake
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Slavina B. Goleva
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Lauren R. Samuels
- Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, USA
| | - Laura M. Carpenter
- Department of Sociology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lea K. Davis
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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