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1.
Trends psychiatry psychother. (Impr.) ; 41(3): 247-253, July-Sept. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1043531

RESUMO

Abstract Introduction Sexual dysfunction is common in individuals with psychiatric disorders and under psychotropic medication such as antidepressants and antipsychotics. Several scales have been developed to assess sexual function in these patients. The Arizona Sexual Scale (ASEX) is a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. We describe the translation and cross-cultural adaptation of the ASEX into the Portuguese language, with the goal of contributing to the assessment of sexual function in Portuguese-speaking psychiatric patients under treatment with psychotropic drugs. Methods The translation and cross-cultural adaptation process thoroughly followed the steps recommended by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), namely: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing, finalization, proofreading, and final version. Results The process was successfully completed and no major differences were found between the translation, reconciliation and back-translation phases, with only small adjustments being made. Conclusion The translation of the ASEX was completed successfully, following international reference guidelines. The use of these guidelines is a guarantee of a Portuguese version that is qualitatively and semantically equivalent to the original scale. This availability of this new scale version will enable studies evaluating the sexual function of Portuguese-speaking psychiatric patients. Future studies may assess the validity of the scale for Portuguese-speaking populations.


Resumo Introdução A disfunção sexual é comum em indivíduos com doenças psiquiátricas e sob o uso de medicações como antidepressivos e antipsicóticos. Várias escalas foram desenvolvidas para avaliar a função sexual desses doentes. A Arizona Sexual Scale (ASEX) é uma escala de cinco itens de avaliação que quantifica desejo sexual, excitação, lubrificação vaginal/ereção peniana, capacidade para atingir o orgasmo e satisfação com o orgasmo. Este artigo descreve o processo de tradução e adaptação transcultural da escala ASEX para a língua portuguesa, com o objetivo de contribuir para a avaliação da função sexual dos doentes medicados com fármacos psicotrópicos nos vários países onde se utiliza essa língua. Métodos A tradução e a adaptação transcultural seguiram de forma detalhada os passos recomendados pelo grupo de trabalho da International Society for Pharmacoeconomics and Outcomes Research (ISPOR), nomeadamente: preparação, tradução inicial, reconciliação, retroversão, revisão da retroversão, harmonização, teste cognitivo, revisão do teste cognitivo, finalização, leitura final e versão final. Resultados O processo foi completado com sucesso, e não foram observadas diferenças grandes entre as fases de tradução, reconciliação e retroversão, tendo sido feitos apenas pequenos ajustes. Conclusão A tradução da escala ASEX foi bem-sucedida, seguindo orientações internacionais de referência. A aplicação dessas orientações é a garantia de uma versão em língua portuguesa que é qualitativa e semanticamente equivalente à versão original da escala. A existência desta nova versão da escala permitirá estudos que avaliem a função sexual dos doentes em países nos quais se fale a língua portuguesa. Estudos futuros poderão atestar a validade da escala para essas populações.


Assuntos
Humanos , Masculino , Feminino , Psicotrópicos/efeitos adversos , Disfunções Sexuais Fisiológicas/diagnóstico , Traduções , Disfunções Sexuais Psicogênicas/diagnóstico , Transtornos Mentais/psicologia , Orgasmo/fisiologia , Satisfação Pessoal , Nível de Alerta/fisiologia , Portugal , Escalas de Graduação Psiquiátrica , Disfunções Sexuais Fisiológicas/induzido quimicamente , Vagina/fisiologia , Ereção Peniana/psicologia , Arizona , Comparação Transcultural , Inquéritos e Questionários , Disfunções Sexuais Psicogênicas/induzido quimicamente , Libido/fisiologia , Transtornos Mentais/tratamento farmacológico
2.
Turk Psikiyatri Derg ; 30(1): 67-70, 2019.
Artigo em Turco | MEDLINE | ID: mdl-31170309

RESUMO

Persistent Genital Arousal Disorder is characterized with unwanted, uncontrollable and persistent genital arousal symptoms that occur spontaneously in the absence of simultaneous sexual fantasy, sexual desire or sexual stimulation. The condition may last for hours or days. Patients often find it difficult to share this condition with their health care providers because they are afraid of being diagnosed with hypersexuality and they often get different psychiatric diagnoses such as Obsessive Compulsive Disorder and Major Depressive Disorder. Therefore, little is known about the real prevalence, pathophysiology or etiology of Persistent Genital Arousal Disorder. In addition, since there is no study conducted in this field, our information in this area is limited to case reports. Although there is no consensus about the treatment of Persistent Genital Arousal Disorder in the psychiatric literature, there are some case reports about the use of pregabaline, clomipramine, duloxetine, clonazepam, varenicline, olanzapine, risperidone in addition to the case reports on treatment with hypnotherapy, pelvic floor physiotherapy and electroconvulsive therapy (ECT). In this case report, we aimed to present the detailed description of a successful treatment procedure with duloxetine in a forty two years old female patient diagnosed with Persistent Genital Arousal Disorder. She had been using various antidepressants, antipsychotics, anxiolytics and mood stabilizers for sixteen years with different psychiatric misdiagnoses like Bipolar Disorder, Obsessive Compulsive Disorder, Anxiety Disorder and Major Depressive Disorder and yet, had not shared her symptoms of genital arousal with any psychiatrist previously.


Assuntos
Cloridrato de Duloxetina/uso terapêutico , Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico , Disfunções Sexuais Psicogênicas/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Escalas de Graduação Psiquiátrica , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Disfunções Sexuais Psicogênicas/psicologia
3.
Ther Umsch ; 73(9): 565-571, 2019.
Artigo em Alemão | MEDLINE | ID: mdl-31113317

RESUMO

Vulvar Pain Abstract. During their lifetime, many women experience vulvar and / or vaginal pain. The reasons of those pains or discomforts can be multiple and sometimes hard to identify and therefore difficult to treat. Besides organic causes such as infections, inflammations, changes after operations and others we can find complex conditions such as vulvodynia and dyspareunia. Vulvodynia is a vulvar pain of at least 3 months duration without clear identifiable cause, which may have potential associated factors. It is important for a successful therapy to identify these factors. It will need an individual access to every woman and there is no single therapy that fits all women. Dyspareunia is also a less common but also complex problem that needs accurate approach and therapy. With this article, we would like to give you insights in these disorders in a practical way in order to make them find their place in our daily practice.


Assuntos
Dispareunia , Doenças da Vulva/diagnóstico , Vulvodinia , Dispareunia/diagnóstico , Feminino , Humanos , Dor/diagnóstico , Dor/etiologia , Disfunções Sexuais Psicogênicas/diagnóstico , Doenças da Vulva/complicações , Vulvodinia/diagnóstico
4.
Med Clin North Am ; 103(4): 681-698, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31078200

RESUMO

Female sexual dysfunction can drastically diminish quality of life for many women. It is estimated that in the United States 40% of women have sexual complaints. These conditions are frequently underdiagnosed and undertreated. Terminology and classification systems of female sexual dysfunction can be confusing and complicated, which hampers the process of clinical diagnosis, making accurate diagnosis difficult. There are few treatment options available for female sexual dysfunctions, however, some interventions may be of benefit and are described. Additional treatments are in development. The development of clear clinical categories and diagnostic guidelines for female sexual dysfunction are of utmost importance and can be of great benefit for clinical and public health uses and disease-related research.


Assuntos
Qualidade de Vida , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Saúde da Mulher , Feminino , Humanos , Comportamento Sexual , Disfunções Sexuais Fisiológicas/classificação , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/classificação , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/terapia , Estados Unidos
5.
Mayo Clin Proc ; 94(5): 842-856, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30954288

RESUMO

Sexual problems are common in women of all ages. Despite their frequency and impact, female sexual dysfunctions (FSDs) are often unrecognized and untreated in clinical settings. In response, the International Society for the Study of Women's Sexual Health convened a multidisciplinary, international expert panel to develop a process of care (POC) that outlines recommendations for identification of sexual problems in women. This POC describes core and advanced competencies in FSD for clinicians who are not sexual medicine specialists and serve as caregivers of women and, therefore, is useful for clinicians with any level of competence in sexual medicine. The POC begins with the expectation of universal screening for sexual concerns, proceeds with a 4-step model (eliciting the story, naming/reframing attention to the problem, empathic witnessing of the patient's distress and the problem's impact, and referral or assessment and treatment) that accommodates all levels of engagement, and delineates a process for referral when patients' needs exceed clinician expertise. Distressing problems related to desire, arousal, and orgasm affect 12% of women across the lifespan. Low desire is the most common sexual problem, but sexual pain and other less common disorders of arousal and orgasm are also seen in clinical practice. Screening is best initiated by a ubiquity statement that assures the patient that sexual concerns are common and can be revealed. Patient-centered communication skills facilitate and optimize the discussion. The goal of the POC is to provide guidance to clinicians regarding screening, education, management, and referral for women with sexual problems.


Assuntos
Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Saúde Sexual/normas , Saúde da Mulher/normas , Competência Clínica , Empatia , Feminino , Humanos , Assistência Centrada no Paciente/métodos , Relações Médico-Paciente , Guias de Prática Clínica como Assunto , Encaminhamento e Consulta/normas , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/terapia , Sociedades Médicas
6.
J Sex Marital Ther ; 45(4): 283-302, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30657020

RESUMO

Hypersexuality is a problematic behavior characterized by the combination of an excessive sexual desire and the pathological inability to control it. This study presents the psychometric properties of the Spanish paper-and-pencil and online versions of the Hypersexual Behavior Inventory (HBI), one of the most popular scales to assess this issue. A total of 2,250 participants (1,070 men) completed a translated version of the HBI (1,450 in paper-and-pencil; 800 online). The exploratory factor analysis yielded three factors that explained 67.53% of total variance for the HBI paper-and-pencil version. This factor structure was confirmed in the HBI online version through confirmatory factor analysis (CFA). Factorial, structural, scalar and error variance-invariance according to gender was also confirmed through multigroup CFA. Reliability of the total score and subscales ranged between .89 and .96. Likewise, correlations with other related scales were positive and significant (r between .511 and .743). Temporal stability one year after the first application was .77 (paper-and-pencil format) and .68 (online version). These results support the reliability and validity of the HBI and justify its use in the assessment of hypersexuality in Spanish-speaking countries.


Assuntos
Hispano-Americanos/estatística & dados numéricos , Transtornos Parafílicos/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Inquéritos e Questionários/normas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Parafílicos/diagnóstico , Psicometria , Reprodutibilidade dos Testes , Disfunções Sexuais Psicogênicas/psicologia , Adulto Jovem
7.
J Pediatr Adolesc Gynecol ; 32(2): 186-188, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30513343

RESUMO

BACKGROUND: After several visits with unrelated complaints, a 16-year-old female patient disclosed symptoms of unwanted genital arousal and was diagnosed with persistent genital arousal disorder (PGAD). CASE: A 16-year-old female patient with history of depression, sexual abuse, and dysmenorrhea insistently requested etonogestrel rod removal. At 2 visits after implant removal, the patient disclosed the reason for her insistence: PGAD symptoms developed after implant insertion, although they worsened with removal. Chart review revealed selective serotonin reuptake inhibitor discontinuation before symptom onset. Normalization of sexual arousal occurred with counseling, selective serotonin reuptake inhibitor treatment, and hormonal contraception. SUMMARY AND CONCLUSION: This case highlights the importance of clinician recognition of PGAD symptoms, which adolescents might not openly disclose. Clinicians must nonjudgmentally collect medication history and sexual history, including sexual arousal and satisfaction, to make this diagnosis.


Assuntos
Depressão/tratamento farmacológico , Inibidores de Captação de Serotonina/administração & dosagem , Disfunções Sexuais Psicogênicas/diagnóstico , Adolescente , Anticoncepcionais Orais Hormonais/uso terapêutico , Diagnóstico Diferencial , Feminino , Genitália , Humanos , Inibidores de Captação de Serotonina/efeitos adversos , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/terapia
8.
Sex Med Rev ; 7(1): 2-12, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30301706

RESUMO

INTRODUCTION: Persistent genital arousal disorder (PGAD) is a highly distressing and poorly understood condition characterized by unwanted sensations of genital arousal in the absence of subjective sexual desire. Research has shown that some individuals with PGAD also report orgasm, urinary, and pain symptoms, with 1 recent study specifically comparing a "painful persistent genital arousal symptom" group to a "non-painful persistent genital arousal symptom" group on various indicators given the highly frequent report of comorbid genitopelvic pain in their sample. AIM: To review literature on PGAD focusing on the presence of pain symptoms. METHODS: A literature review through May 2018 was undertaken to identify articles that discuss pain characteristics in individuals with persistent sexual arousal syndrome, persistent genital arousal disorder, symptoms of persistent genital arousal, and restless genital syndrome. MAIN OUTCOME MEASURE: A review of pain/discomfort associated with persistent genital arousal, and the proposal of a new theoretical framework of genitopelvic dysesthesias. RESULTS: PGAD is a distressing condition that is associated with a significant, negative impacts on psychosocial and daily functioning. Although it is clear that unwanted and persistent genital arousal is the hallmark symptom of PGAD, symptoms of pain and discomfort are also frequently reported. Based on the results of this review, a model of genitopelvic dysesthesias is proposed, with subcategories of unpleasant sensations that are based on patients' primary complaint: arousal, arousal and pain, or pain (and other sensations). CONCLUSION: The proposed model can provide an important framework for conceptualizing conditions characterized by unpleasant genitopelvic sensations. A model such as this one can benefit highly misunderstood conditions that are questioned in terms of their legitimacy and severity-such as PGAD-by conceptualizing them as sensory disorders, which in turn can reduce stigma, unify research efforts, and potentially improve access to care. Pukall CF, Jackowich R, Mooney K, et al. Genital Sensations in Persistent Genital Arousal Disorder: A Case for an Overarching Nosology of Genitopelvic Dysesthesias? Sex Med Rev 2019;7:2-12.


Assuntos
Doenças dos Genitais Femininos/fisiopatologia , Doenças dos Genitais Masculinos/fisiopatologia , Genitália/inervação , Parestesia/fisiopatologia , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Psicogênicas/fisiopatologia , Ansiedade , Nível de Alerta/fisiologia , Feminino , Doenças dos Genitais Femininos/diagnóstico , Doenças dos Genitais Femininos/psicologia , Doenças dos Genitais Masculinos/diagnóstico , Doenças dos Genitais Masculinos/psicologia , Humanos , Masculino , Parestesia/complicações , Parestesia/psicologia , Qualidade de Vida , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/psicologia
9.
J Sex Marital Ther ; 45(2): 141-147, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30040591

RESUMO

Despite the wide use of the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) in several populations, the instrument has yet to be validated among patients with type 2 diabetes. The aim of this study was to evaluate the validity and reliability of the GRISS for the estimation of clinically relevant sexual dysfunction among type 2 diabetes patients under clinical management. This cross-sectional study was conducted among a total of 136 and 126 type 2 diabetic males and females, respectively, using GRISS for male and female. Internal consistency, test-retest reliability, and scores of discriminant validity were calculated. Cronbach's alpha coefficient ranged from 0.71 to 0.90 in total samples of males and females. The values obtained were similar between the chronic diabetic patients with self-reported sexual problems and normal samples. Test-retest reliability gave fair scaling results of 0.94 overall for males and 0.97 for females using Pearson's correlation coefficient. GRISS subscales differentiated multivariately between men (F7,122 = 19.308; p = 0.000; eta2 = 0.721; power = 0.993) and women (F7,118 = 18.705; p = 0.000; eta2 = 0.526; power = 0.928) with and without sexual problems. GRISS appears to be valuable and reliable for use among the Ghanaian population. Regular use of the GRISS for the screening of sexual problems among diabetic patients appears warranted.


Assuntos
Diabetes Mellitus Tipo 2/psicologia , Satisfação Pessoal , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/psicologia , Adulto , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes
10.
Arch Med Res ; 50(8): 567-576, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-32062429

RESUMO

BACKGROUND: Women's experiences of female sexual difficulties are shaped by cultural expectations. AIM OF THE STUDY: To investigate the cultural validity and clinical utility of the classification of female sexual dysfunctions (FSD) in the International Classification of Diseases - 11th Revision (ICD-11) among Indian Women. METHODS: A purposive sample of 22 married women with probable sexual problems underwent cognitive interviews that were conducted using a semi-structured guide. The interviews were transcribed and analyzed qualitatively to help establish the content and cultural validity of the ICD-11 classification of FSD. RESULTS: Most participants had limited knowledge of the sexual act, felt unskilled in sex, and were led by their husbands in sexual matters. Many participants reported problems related to sexual dysfunction and sexual pain-penetration. Many participants with sexual pain-penetration issues and some with low sexual desire considered these symptoms to be problematic; however, this was rarely the case with the absence or lack of sexual arousal and orgasm. The application of the 'independent focus of clinical attention' requirement for diagnosis reduced cases by half for Hypoactive Sexual Desire Disorder (HSDD) and almost eliminated all cases of Female Sexual Arousal Dysfunction (FSAD) and Anorgasmia. Hence, this requirement was moved from essential (required) features to 'additional features' of the final ICD-11 sexual dysfunction guidelines. CONCLUSION: Advancement toward a more precise nomenclature and classification system of FSD will facilitate better diagnosis which will ultimately lead to improved care for women with sexual dysfunction.


Assuntos
Classificação Internacional de Doenças , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Adulto , Idoso , Nível de Alerta/fisiologia , Grupo com Ancestrais do Continente Asiático , Cognição , Feminino , Humanos , Índia , Libido/fisiologia , Pessoa de Meia-Idade , Orgasmo/fisiologia , Saúde da Mulher
11.
Urologiia ; (6): 150-155, 2019 12 31.
Artigo em Russo | MEDLINE | ID: mdl-32003187

RESUMO

Delayed ejaculation is a form of sexual disorders, which is characterized by constant or intermittent delays or absence of ejaculation and orgasm, despite normal sexual arousal and erectile function. Delayed ejaculation is one of the most studied and rare types of male sexual dysfunctions, which leads to depression, anxiety, and often is a reason of low self-esteem, reduced satisfaction of a man with his partner, and worsening of relationships between partners. In some cases, delayed ejaculation and anejaculation cause infertility. Current views on epidemiology, diagnostics and treatment strategy of delayed ejaculation are presented in the article.


Assuntos
Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Ejaculação , Humanos , Masculino , Orgasmo , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/terapia
12.
BMC Womens Health ; 18(1): 204, 2018 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-30572853

RESUMO

BACKGROUND: Most studies on female sexual dysfunction are performed in population inventories and under specific clinical conditions. These approaches are performed using validated psychometric scales. Different scales to assess sexual function use different numbers of questions to characterize their domains. They also may or may not include domains of interaction between sexual partners. The objective of this study was to compare the precision between scales to be able to analyze their accuracy for better diagnosis of sexual dysfunction. METHODS: Fifty (50) healthy young women were enrolled in this study. Three questionnaires (FSFI, SQ-F, and GRISS) were applied to assess sexual function (n = 44). The accuracy measured by the area under the ROC curve (AUC) for individual domains and to cross-validated pairwise comparison of the three analyzed instruments was used. Kruskall-Wallis test to analyze individual domains of the scales was also used.The P-value was established as 0.05. RESULTS: The results showed that all domains and total FSFI and GRISS scores were significantly different between normal and dysfunctional women, but not for SQ-F domains. Indeed, AUC accuracy varied from excellent-good domain discrimination for FSFI and GRISS, but fair-poor for SQ-F. For the paired comparison between the three questionnaires a fair accuracy was detected. The specificity percentage was around 84% whereas that for sensibility was low, around 30%. CONCLUSIONS: The best agreement was between FSFI and SQ-F, probably being related to high similar shared questions when compared to GRISS. The agreement between SQ-F and GRISS was low possible due to low number of questions in SQ-F to characterize similar domains. This study evidenced high agreement between scales to sensitivity and low agreement for specificity, thereby conferring fair accuracy between them. Thus, the limited grade for discriminatory capacity (AUC) for sexual response should be considered when comparing results from these three different questionnaires and also when comparing with other different scales. In addition, despite the diversity of scales, the high reliability and fit for their desire domain suggest that the FSFI scale has good accuracy for the current clinical assessment of women's sexual health. CLINICAL TRIAL REGISTRATION: NCT03241524 . Retrospectively registered on 08/02/2017.


Assuntos
Libido , Comportamento Sexual/psicologia , Inquéritos e Questionários/normas , Saúde da Mulher , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Parceiros Sexuais
13.
Rev Int Androl ; 16(3): 102-106, 2018.
Artigo em Português | MEDLINE | ID: mdl-30300130

RESUMO

INTRODUCTION: Sexual dysfunctions are a high prevalence health problem, making it necessary to provide assessment instruments adapted to the Portuguese population. METHODS: The purpose of this study was to validate the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) for the Portuguese population. Participants in this study were 1079 Portuguese adults who completed a sociodemographic questionnaire and the MGH-SFQ. The participants' ages varied between 18 and 89 years of age (M = 29.66; SD = 13.05), and 32.6% (n = 352) were men and 67.4% (n = 727) were women. RESULTS: The Cronbach's alpha obtained was .91 and the psychometric properties of the scale were adequate. The validation of the construct was evaluated through Confirmatory Factor Analysis, setting up a suitable one-dimensional model (RMSEA = .041, CFI = .974). DISCUSSION: Taking into account the results of the psychometric validation, the sample size and the applicability of this instrument in clinical and sexological practice, we can confirm that this is a valid and reliable instrument to evaluate the sexual functioning of both Portuguese men and women.


Assuntos
Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Portugal , Psicometria , Reprodutibilidade dos Testes , Adulto Jovem
14.
Medicine (Baltimore) ; 97(42): e12807, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30334975

RESUMO

Psoriasis and psoriatic arthritis impact sexuality and intimate relationships in both men and women, and can be associated with sexual dysfunctions.The aim of this study was to develop and validate a specific questionnaire assessing the impact of psoriasis and psoriatic arthritis on patients' sexuality. Two focus groups of patients, concerned by sexuality, were conducted in February 2015. Based on the verbatim transcripts, a content analysis was performed by a psychologist trained in qualitative procedures.After analysis of the verbatim reports by the research group, a preliminary questionnaire comprising 22 questions was drawn up. The areas covered by the questions concerned: the quality of daily life, tolerance of the cutaneous state by the patient, tiredness, mobility and flexibility of the joints, outside activities involving movement of all or part of the body. In the following step the questions were then submitted to a panel of experts for selection using a Delphi method. The experts were questioned about item relevance and content. After expert consensus had been reached, the instructions to participants completing the questionnaire, the wording of items, and the possible answers were finalized.The final questionnaire (comprising 14 questions) is entitled "Questionnaire of sexual quality of life perceived by patients with cutaneous and/or articular psoriasis" (short denomination: Qualipsosex). The quantitative step has not yet been conducted. This step will aim to evaluate the metrologic qualities (reliability, validity, and responsiveness) of the questionnaire and will need to be validated according to the consensus-based standards for the selection of health measurement instrument checklist.


Assuntos
Artrite Psoriásica/psicologia , Psoríase/psicologia , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Inquéritos e Questionários/normas , Adulto , Técnica Delfos , Análise Fatorial , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Pesquisa Qualitativa , Qualidade de Vida/psicologia , Reprodutibilidade dos Testes , Disfunções Sexuais Psicogênicas/psicologia
15.
Expert Opin Emerg Drugs ; 23(3): 223-230, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30251897

RESUMO

INTRODUCTION: Female sexual dysfunction (FSD) is a highly prevalent, yet commonly underdiagnosed and undertreated condition. This paper reviews the diagnostic terminology for FSD, and basic sexual physiology in women. The Food and Drug Administration (FDA) approved drugs for FSD are discussed, followed by investigational drugs for FSD currently in phase 2 or 3 clinical trials, reasons for failure of drug development, and potential future drug targets. Areas covered: A literature review was conducted for available treatments for FSD: flibanserin, estrogen, ospemifene and prasterone. Potential treatments are assessed, as was the Pharmaprojects database which includes clinical trial information. Testosterone, bremelanotide, bupropion-trazodone, PDE-5 inhibitors, prostaglandins, tibolone and combination therapies, and the theoretical basis of potential drug targets are discussed. Expert opinion: The lack of established endpoints for phase 3 studies of FSD has impeded approval of new treatments, and required additional studies for validation, resulting in proposed changes to the FDA draft guidance for FSD clinical trials in October 2016. Current DSM-5 diagnostic nosology also fails to capture the full range of symptomology. Several promising compounds have shown no movement for several years limiting women's options. Overcoming socio-cultural bias against women's sexual and reproductive health will be critical in the approval of new treatments for FSD.


Assuntos
Drogas em Investigação/uso terapêutico , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Animais , Aprovação de Drogas , Desenho de Fármacos , Drogas em Investigação/farmacologia , Feminino , Humanos , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/fisiopatologia , Estados Unidos , United States Food and Drug Administration
16.
Rheumatol Int ; 38(11): 2103-2109, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30167765

RESUMO

The Qualisex questionnaire was developed and validated to assess sexuality in patients with rheumatoid arthritis. To the best of our knowledge, there is no instrument to evaluate sexuality in axial spondyloarthritis (axSpA). For this reason, the objective of this study was to validate and adapt the Qualisex questionnaire in axSpA and evaluate the impact of the disease on patients' sexuality. Cross sectional study. Consecutive patients, with ≥ 21 years of age, diagnosed with axSpA according to ASAS'09 criteria were included. Sexual health was assessed using the Qualisex questionnaire. The original version was translated to Spanish and adapted to axSpA. Internal consistency, and test re-test reliability was calculated. Criterion and construct validity were assessed by comparing the Qualisex with parameters of disease activity functional capacity and quality of life. 61 patients were invited to participate in the study, 11 of whom refused. 50 patients were included; 40 (80%) were males, with a median age of 47 years (IQR 21-72) and a median disease duration of 13 years (IQR 1-46). Reproducibility was excellent with an ICC of 0.99 (95% CI 0.65-1). The Qualisex had a good correlation with different disease evaluation parameters. The Qualisex was significantly higher among women (5.4 in women vs. 2.5 in men, p = 0.02), unemployed (4.7 in unemployed vs. 2.3 in employed, p = 0.01), in patients with higher disease activity (4.2 in active patients vs. 1.6 in inactive patients, p = 0.01), and it was lower in patients receiving biologic therapy (BT) (1.9 with BT vs. 3.8 without BT, p = 0.01). Multivariable analysis showed that female sex, longer disease duration and higher disease activity were independently associated with a greater impact on sexuality. The Qualisex adapted to axSpA is a valid and reliable questionnaire. Female axSpA patients, those with longer disease duration and higher disease activity presented a worse sexual life.


Assuntos
Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Sexualidade , Espondilartrite/diagnóstico , Inquéritos e Questionários , Adulto , Idoso , Antirreumáticos/efeitos adversos , Argentina , Produtos Biológicos/efeitos adversos , Estudos Transversais , Características Culturais , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Qualidade de Vida , Reprodutibilidade dos Testes , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/fisiopatologia , Disfunções Sexuais Psicogênicas/psicologia , Sexualidade/efeitos dos fármacos , Espondilartrite/tratamento farmacológico , Espondilartrite/fisiopatologia , Espondilartrite/psicologia , Fatores de Tempo , Tradução , Adulto Jovem
17.
Rev. int. androl. (Internet) ; 16(3): 102-106, jul.-sept. 2018. tab
Artigo em Português | IBECS | ID: ibc-178035

RESUMO

Introdução: As disfunções sexuais constituem um problema de saúde de elevada prevalência, tornam‐se necessários instrumentos de avaliação adaptados para a população portuguesa. Método: O objetivo deste estudo foi validar o Massachusetts General Hospital - Sexual Functioning Questionnaire (MGH‐SFQ) para a população portuguesa. Participaram 1.079 adultos portugueses que preencheram um questionário sociodemográfico e o MGH‐SFQ. A idade dos participantes variou de 18 a 89 anos (M = 29,66; SD = 13,05), 32,6% (n = 352) foram homens e 67,4% (n = 727) mulheres. Resultados: O alfa de Cronbach obtido foi de 0,91 e as propriedades psicométricas da escala foram adequadas. A validação do constructo foi avaliada através da Análise Fatorial Confirmatória, configurou um modelo unidimensional adequado (RMSEA = 0,041, CFI = 0,974). Discussão: Tendo em conta os resultados da validação psicométrica, a dimensão da amostra e a aplicabilidade desse instrumento na prática clínica e sexológica, somos levados a afirmar que se trata de instrumento válido e confiável para avaliar o funcionamento sexual, quer de homens quer de mulheres portugueses


Introduction: Sexual dysfunctions are a high prevalence health problem, making it necessary to provide assessment instruments adapted to the Portuguese population. Methods: The purpose of this study was to validate the Massachusetts General Hospital‐Sexual Functioning Questionnaire (MGH‐SFQ) for the Portuguese population. Participants in this study were 1079 Portuguese adults who completed a sociodemographic questionnaire and the MGH‐SFQ. The participants' ages varied between 18 and 89 years of age (M = 29.66; SD = 13.05), and 32.6% (n = 352) were men and 67.4% (n = 727) were women. Results: The Cronbach's alpha obtained was .91 and the psychometric properties of the scale were adequate. The validation of the construct was evaluated through Confirmatory Factor Analysis, setting up a suitable one‐dimensional model (RMSEA = .041, CFI = .974). Discussion: Taking into account the results of the psychometric validation, the sample size and the applicability of this instrument in clinical and sexological practice, we can confirm that this is a valid and reliable instrument to evaluate the sexual functioning of both Portuguese men and women


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Psicometria/instrumentação , Sexualidade/psicologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Reprodutibilidade dos Testes , Reprodutibilidade dos Testes
18.
Rev Int Androl ; 16(1): 42-44, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30063023

RESUMO

Postorgasmic illness syndrome (POIS) is a rarely described syndrome characterized by transient flu-like symptoms and cognition disorders. Recent studies suggest that immunogenic reactivity to autologous semen is the underlying mechanism in POIS. Our study is regarding a 30-year-old that visited our unit for an allergy consultation because he experienced malaise after ejaculations. Skin prick tests and intracutaneous tests with autologous diluted semen with negative results were performed. Immunoblotting and western blot of the patient's autologous semen showed negative results. To complete the study, we intended to rule out other possible causes such as urological, hormonal, or neuropsychiatric disorders. We present a case of POIS based on the clinical criteria that did not show an IgE mediated cause. In the case of our patient, we could not identify the underlying cause; however, we believe that the possible involvement of neurobiochemical mediators should be studied.


Assuntos
Fadiga/etiologia , Sêmen/imunologia , Disfunções Sexuais Psicogênicas/diagnóstico , Adulto , Ejaculação/fisiologia , Humanos , Imunoglobulina E/imunologia , Masculino , Disfunções Sexuais Psicogênicas/imunologia , Síndrome
19.
Inflamm Bowel Dis ; 24(11): 2350-2359, 2018 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-30165525

RESUMO

Background: Women with inflammatory bowel disease (IBD) may have decreased sexual function. To understand how common this condition is in our female patients, we developed a new IBD-specific Female Sexual Dysfunction Scale (the IBD-FSDS). Methods: We performed a prospective cross-sectional study of 454 female IBD patients ≥18 years of age attending 1 of 3 IBD clinics in the United States or Denmark. We gathered information on sexual function via a de novo 23-item scale. General sexual functioning was measured with the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R). Depressive symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9). Medical history and sociodemographic data were collected via chart review. Exploratory factor analyses (EFAs) of the English language version of IBD-FSDS assessed unidimensionality, factor structure, reliability, criterion validity, and construct validity. Results: EFAs suggested retaining 15-items creating a unidimensional scale with strong internal consistency reliability (α = 0.93). Validity of the English language IBD-FSDS was measured using Spearman's coefficient, demonstrating significant criterion validity with the FSDS-R (P < 0.05) and the FSFI (P < 0.05) and significant construct validity with the composite for cases of active IBD (P < 0.05) and PHQ-9 (P < 0.05). Sexual dysfunction in women with IBD was significantly associated with depression (P = 0.042), active IBD (P = 0.002), and no history of surgery (P = 0.044). Conclusions: We have developed and validated an IBD-specific scale to assess the psychosexual impact of IBD in women. This novel screening questionnaire may help health care providers recognize factors contributing to impaired sexual function in their female patients.


Assuntos
Doenças Inflamatórias Intestinais/complicações , Psicometria/métodos , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Adulto , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Índice de Gravidade de Doença , Comportamento Sexual , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Inquéritos e Questionários , Saúde da Mulher
20.
PLoS One ; 13(8): e0202076, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30157203

RESUMO

The female orgasm represents one of the most complex functions in the field of human sexuality. The conjunction of the anatomical, physiological, psycho-relational and socio-cultural components contributes to make the female orgasm still partly unclear. The female orgasmic experience, its correlates and the relation with sexual desire, arousal and lubrication as predictors are highly debated in scientific community. In this context, little is known about the impact of female sexual dysfunction (SD) on sexual pleasure expressed by subjective orgasmic intensity, and there are no suitable psychometric tools suited to investigate this dimension. Thus, we validate, in female subjects, a Visual Analogue Scale (VAS) that we named Orgasmometer-F, to verify if SD is accompanied by a lower perceived orgasmic intensity. A total of 526 women, recruited through a web-based platform and from sexological outpatient clinic, were enrolled in the study. They were divided into, on the basis of the Female Sexual Function Index (FSFI) score in two groups: 1) 112women suffering from SD, (SD Group); and 2) 414 sexually healthy women (Control Group). The participants were requested to fill out the Orgasmometer-F, recording orgasmic intensity on a Likert scale from 0 (absence of orgasmic intensity) to 10 (maximum orgasmic intensity experienced). Women with SD experienced significantly lower orgasmic intensity than controls, as measured by the Orgasmometer-F (p < 0.0001). Interestingly, masturbatory frequency was positively correlated with orgasmic intensity, as were the lubrication, orgasm and sexual satisfaction domains of the FSFI. The Orgasmometer-F was well understood, had a good test-retest reliability (ICC = 0.93) and a high AUC in differentiating between women with and without sexual dysfunction (AUC = 0.9; p < 0.0001). The ROC curve analysis showed that a cut-off <5 had 86.5% sensitivity (95% CI 82,8-89,6), 80.4% specificity (95% CI 71.8-87.3), 75.4% positive predictive value (PPV) and 89.5% negative predictive value (NPV). In conclusion, the Orgasmometer-F, a new psychometrically sound tool for measuring orgasmic intensity in female population, demonstrated that SD impair orgasmic intensity.


Assuntos
Orgasmo , Percepção , Disfunções Sexuais Psicogênicas/diagnóstico , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Psicometria/métodos , Psicometria/normas , Disfunções Sexuais Psicogênicas/psicologia
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