Psychosexual disorders and dermatologists

Incorporating and Emphasizing Sexual Health in Medical Curriculum of Nepal: Need of the Hour

Sexual health requires a positive and respectful approach to sexuality and sexual relationships. It is one of the most neglected parts of an individual's health. Sexual health is not adequately covered in the medical education curriculum of Nepal. There is a lack of clinicians practising sexual medicine, which provides a fertile field for quacks in this arena. Sexual health needs to be included and incorporated into medical education. The policymakers and stakeholders need to address this need in sexual health urgently and effeciently. Comprehensive sexual education should be included for children, adolescents and young adults.

Keywords

medical education; Nepal; sexual health.

The Pattern of Help-Seeking Behavior Among Patients With Sexual Dysfunctions Attending in Psychiatry Outpatient Department in a Tertiary Care Hospital of Bangladesh

INTRODUCTION

Identifying the possible pattern of help-seeking can explain the gap between care need and actual use of care.

AIM

To know the patterns of help-seeking behavior among patients with sexual dysfunction in the context of a developing country.

METHODS

This was a cross-sectional, qualitative study using criterion sampling among the diagnosed patients of sexual dysfunction attending the psychiatry outpatient department. Based on data saturation, 18 in-depth interviews were done. For method triangulation, 1 key informant interview, 1 informal interview, and 1 focus group discussion were performed. Data were analyzed manually using the thematic analysis method.

MAIN OUTCOME MEASURE

Using an interview guideline, face to face interview was performed and the participants reported their pattern of help-seeking regarding their sexual problems.

RESULTS

The majority of the participants were male, within 20-35 years of age range, literate, and from an urban background. Premature ejaculation and female sexual interest/arousal disorder were the most common disorders. After the identification of the problems, help-seeking was done mostly from close and intimate relationships, although a few of the participants choose a self-search strategy. The complementary and alternative medicine approach was mostly used where traditional healers played a major role. The biomedical approach was the last to seek help and most of the participants visited the dermatology and venereology department. Self-help techniques and internet use were found as emerging ways to seek help.

CONCLUSION

Sex education is necessary to improve general awareness because surrounding people were found as the primary source of information. Acharjee P, Mullick MSI. The Pattern of Help-Seeking Behavior Among Patients With Sexual Dysfunctions Attending in Psychiatry Outpatient Department in a Tertiary Care Hospital of Bangladesh. Sex Med 2021;9:100381.

Sexuality in Persons With Hidradenitis Suppurativa: Factors Associated With Sexual Desire and Functioning Impairment

Hidradenitis Suppurativa (HS) is a chronic skin disease involving intimate and sensitive areas and affecting physical and mental health. We investigated the prevalence of sexual desire and functioning impairment, and their associations with quality of life, anxiety, depression, minor psychiatric disorders (MPD), and clinical features (e.g., disease severity) in 77 patients with HS who completed self-report measures and answered to questions assessing socio-demographic characteristics, lifestyle habits, and hindered sexuality due to HS. The majority of patients reported hindered sexuality, and poor sexual functioning, while showing good levels of dyadic and solitary sexual desire. No associations were found between clinical severity and sexuality measures. Multivariate analyses showed significant associations of sexual outcome measures with alcohol consumption, low Body Mass Index, family history of HS, and severe skin symptoms. Moreover, we found that the presence of negative psychological factors (i.e., MPD, anxiety, poor mental status) increased the risk of sexual impairment. These findings underline the important role of psychological and sexual aspects in HS patients and suggest that physicians should consider the effect of disease burden on patients' sexual health.

Analysis of allergen profile in patients sensitized to canine allergen and potential Can f 5 cross-reactivity with human PSA

Can f 5 allergy and possible cross-reactivity with human semen in which there are significant amounts of prostate-specific antigen (PSA) are particularly interesting aspects of allergy to dog. The objective of the study was to confirm cross-reactivity between human PSA and Can f 5 in a study of canine sensitised women. A total of 100 women (aged 18-73, 41 on average) with a positive history of animal fur allergy or positive skin prick tests to canine allergens were selected. Levels of Immunoglobulin E (IgE) specific to Can f 1, Can f 2, Can f 3, Can f 5 were determined. Patients with increased concentration of sIgE Can f 5 were selected for further inhibition testing using polystyrene microplate ELISA test coated with human PSA. In the studied population, allergy to Can f 5 dominated (52.3% of patients with increased concentration of canine-specific IgE were allergic to this allergenic component). In all analyzed cases, the concentration of IgE Can f 5 decreased after incubation on the ELISA plate coated with human PSA. The minimum decrease in concentration was 10.44%, the maximum was 37.73%, the average decrease was 21.6%. No statistically significant influence of the presence or absence of allergenic sIgE Can f 5 in blood serum on the occurrence of symptoms after intercourse was found. The study confirmed the moderate ability of Can f 5 to cross-react with human PSA sIgE, which may be clinically significant in some women. At the same time, symptoms of an allergy to male semen do not constitute a typical clinical presentation of allergy to Can f 5.

Dermatological diseases, sexuality and intimate relationships: A qualitative meta-synthesis

AIMS AND OBJECTIVES

To conduct a systematic review and meta-synthesis of findings from qualitative research about sexuality and intimate relationship among patients with dermatological diseases.

BACKGROUND

Over the last few decades, there has been an increase in clinical research investigating aspects related to sex and sexuality in patients living with dermatological diseases. In fact, studies recognise a negative impact on various aspects of intimacy, such as sexual function, self-esteem and romantic relationships. The body of qualitative literature about sexuality in the context of dermatological diseases is emerging but consists mainly of small studies that would benefit from aggregation, synthesis and interpretation to highlight and summarise the overarching dimensions to this clinical issue.

DESIGN

A systematic review and meta-synthesis of qualitative studies.

METHODS

BioMed Central, Cochrane Library, MEDLINE, CINAHL, PsycINFO, PsycARTICLES, ERIC, Scopus, and Web of Science were searched between June-November 2017 with no publication date limits. Screening and selection of studies was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). After retrieval, the qualitative data were subject to meta-synthesis to identify overarching themes.

RESULTS

Ten qualitative studies were found. We identified four themes: (a) Embarrassment and shame; (b) Impaired sense of attractiveness and sexual avoidance; (c) Relationship issues; and (d) Lack of professional support. The patients in these studies adopted negative coping styles, such as avoidance and hiding their bodies.

CONCLUSION

When assessing and evaluating patient care in dermatology, it is important that sexuality and the impact the disease could have on relationships is included.

RELEVANCE TO CLINICAL PRACTICE

An important part of nursing care is ensuring that patients are helped to develop positive coping strategies rather than negative ones. Patients with dermatological conditions also need advice and treatment to address any physically related sexual problems. Nurses need to be the initiators of these sensitive conversations to put patients at ease and work together to implement positive measures to reduce the sexuality-related issues patients face.

Risk of Psychiatric Morbidity in Psychosexual Disorders in Male Patients: A Nationwide, Cohort Study in Taiwan

This study aimed to investigate the association between males with psychosexual disorders (PSDs) and the risk of developing psychiatric disorders. A total of 34,972 enrolled patients, with 8,743 subjects who had suffered from PSD and 26,229 controls (1:3) matched for age and index year, from Taiwan’s Longitudinal Health Insurance Database (LHID) from 2000 to 2015, selected from the National Health Insurance Research Database (NHIRD). After adjusting all the confounding factors, the multivariate Cox regression model was used to compare the risk of developing psychiatric disorders, between the PSD and non-PSD groups, during the 15 years of follow-up. Of the all enrollees, 1,113 in the PSD cohort and 2,611 in the non-PSD cohort (1,180.96 vs. 954.68 per 100,000 person-year) developed psychiatric disorders. Multivariate Cox regression model survival analysis revealed that, after adjusting for gender, age, monthly income, urbanization level, geographic region, and comorbidities, the adjusted hazard ratio (HR) was 2.448 (95% CI [2.227, 2.633], p < .001). PSD has been associated with the increased risk in anxiety disorders, depressive disorders, bipolar disorders, sleep disorders, and psychotic disorders, respectively. Sexual dysfunctions, paraphilia, and gender identity disorders were associated with the overall psychiatric disorders with adjusted HRs as 1.990 (p < .001), 11.622 (p < .001), and 5.472 (p < .001), respectively. Male patients who suffered from PSD have a higher risk of developing psychiatric disorders, and this finding should be considered as a timely reminder for the clinicians to provide much more attention for these patients because of their mental health issues.