Low prevalence of contraceptive use among Brazilian women of reproductive age with systemic lupus erythematosus.

This was a cross-sectional study of women of reproductive age with systemic lupus erythematosus (SLE) being treated at Bahiana School Rheumatology Service in Brazil. The study aimed to assess the prevalence of contraceptive counselling and use. An interview was performed, and the results were analysed before and after the SLE diagnosis. Eighty-five women were included; the mean age of the group was 32.98 ± 8.39 years. Before SLE diagnosis, most of the patients had used some contraceptive method; mainly oral contraceptives (54%) or hormone injections (21%). After SLE diagnosis, 53% of patients did not use any contraceptive method. Among the remaining patients who continued using contraceptives, 22% used condoms, 11% used combined oral contraceptives and 7% used hormone injections. Although 62% of the patients regularly visited the gynaecologist, 56% were unaware of which contraceptive method could be used safely. Thus, a better contraceptive counselling of women of a reproductive age should be performed after SLE diagnosis. Impact Statement What is already known on this subject? Women diagnosed with SLE have inadequate counselling about family planning. What the results of this study add? Brazilian women with SLE have a low prevalence of contraceptive use after their diagnosis and are exposed to having high-risk pregnancies. What the implications are of these findings for clinical practice and/or further research? The results we found highlight the importance of continued medical educational programmes and establish questions for further studies in order to investigate the interventions used to improve the contraceptive use for women diagnosed with SLE.

Sexual function in patients with bipolar disorder type I evaluated in symptomatic remission: a cross-sectional study.

INTRODUCTION: Bipolar disorder (BD) is a chronic pathology that is associated with several impairments throughout a patient's life, including decreased sexual function. Despite the importance in quality of life (QoL), functionality and medication adherence, it is still little investigated in these patients. OBJECTIVE: To compare the sexual function of patients with Bipolar Disorder type I (BD-I), in remission, with healthy controls (HC) and to investigate the clinical and socio-demographic characteristics associated with sexual function in these individuals. Also, to assess the QoL in patients with and without sexual dysfunction (SD). METHODS: Cross-sectional study with 132 patients with BD-I in euthymic phase and 61 HCs from an outpatient clinic. All the participants were evaluated through the Arizona Sexual Scale (ASEX) and the brief version of the World Health Organization Quality of Life Assessment (WHOQoL-BREF). The patients with BD-I were compared with the HCs. The patients were divided into two groups: the ones diagnosed with SD and the ones without it. RESULTS: The patients with BD-I had higher rates of SD (42.4%) compared to the HCs (16.4%) (OR 3.67, 95% CI 1.55 - 8.67; p=0.003). SD in patients was associated with being women (p=0.001), older age (p=0.003) and having a longer duration of untreated illness (p=0.010). Patients with SD had worse QoL scores compared to those without SD. CONCLUSION: Patients with BD-I have a high prevalence of SD and this was associated with worse QoL scores in all domains.

Lifetime prevalence of psychiatric comorbidities in patients with bipolar disorder: A systematic review and meta-analysis.

BACKGROUND: Bipolar disorder (BD) is a severe psychiatric disease and part of its burden is related to the high rates of lifetime psychiatric comorbidity (PC), with diagnostic, therapeutic, and prognostic implications. METHODS: Registered in PROSPERO (CRD42021282356). Meta-analyses were performed, searching for relevant papers published from 1993 to 2022 in Medline/PubMed (including E-Pub Ahead of Print), Embase, Cochrane Library (Central), PsycINFO, Scopus, Web of Science and via hand-searching, without language restrictions. 12.698 studies were initially identified, 114 of which were ultimately chosen based on the eligibility criteria. We performed two meta-analyses (prevalence and risk ratio) of mental health conditions among subjects with BD and then conducted a comprehensive examination of moderator effects using multivariable meta-regression models for moderators identified as significant in the univariable analysis. FINDINGS: Overall PC prevalence of at least one disorder was 38.91 % (95 % CI 35.24-42.70) and the most frequent disorders were: anxiety (40.4 % [34.97-46.06]), SUD (30.7 % [23.73-38.73]), ADHD (18.6 % [10.66-30.33]) and Disruptive, impulse-control and conduct disorder (15 % [6.21-31.84). The moderators with higher association with individual prevalences were UN's Human Development Index (HDI), female gender, age, suicide attempt, and age at onset (AAO). INTERPRETATION: It becomes evident that the prevalence of PC among individuals with BD is notably high, surpassing rates observed in the general population. This heightened prevalence persists despite significant heterogeneity across studies. Consequently, it is imperative to redirect clinical focus towards comprehensive mental health assessments, emphasizing personalized and routine screening. Additionally, there is a pressing need for the enhancement of public policies to create a supportive environment for individuals with BD, ensuring better therapeutic conditions and sustained assistance. By addressing these aspects, we can collectively strive towards fostering improved mental health outcomes for individuals with BD.