Special Issue "Novel Research in Sexuality and Mental Health"
Deadline for manuscript submissions: 31 May 2019
Sexuality is considered as a great human value related to happiness and satisfaction, but unfortunately, when affecting mental disorders, they tend to be associated with second level human functions. Nevertheless, sexual dysfunction often accompanies psychiatric disorder, intensely influencing compliance, quality of life and human relationships. Sexuality could be influenced either by a mental disorder itself, difficulties to get and maintain couple relationships or by the use of psychotropic treatments. Treatment-related adverse events are unfortunately under-recognized by clinicians, scarcely spontaneously communicated by patients, and rarely investigated in clinical trials. The most frequent psychotropic compounds that could deteriorate sexuality and quality of life include antidepressants, antipsychotics and mood regulators. There are important differences between them related to some variations in mechanisms of action including serotonin, dopamine and prolactin levels. Little is known about the relevance of sexuality and its dysfunctions in chronic and frequent mental and neurological disorders, such as psychosis, mood disorders, anxiety, phobias, eating disorders, alcohol or drug dependencies, epilepsy and childhood pathology. Poor sexual life, low satisfaction and more frequent risky sex behavior than in the general population are associated with severe mental diseases. There is a need for increasing research in this field, including epidemiological, psychological, neurophysiological, neuroanatomical and genetic variables related to sexual life to get a better understanding of the implicated mechanisms. To increase the sensibility of clinicians, the identification and management of sexual disturbances after the onset of any mental disorder should be highlighted. This would avoid unnecessary suffering and deterioration of quality of life.
Prof. Angel L. Montejo
Manuscript Submission Information
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- mental health
- mental disorder
- sexual dysfunction
- psychotropic (antidepressant, antipsychotic, antiepileptic)
- mechanism of action
- clinical management
The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.
Title 1: Sexual Dysfunction and Obsessive-Compulsive Disorder: A Systematic Review
Authors: Javier I. de la Iglesia, Rubén de Alarcón, Nerea M Casado, Angel L Montejo
Abstract: Among the disorders listed in psychiatric diagnostic manuals world-wide, obsesive-compulsive disorder (OCD) is potentially one of the most disabling for the patients in the real life. Such disability tends to distort the patient’s laboral, social and intimate sphere, causing a wide range of dysfunctions among which the sexual are prevalent. The sexual obsessive symptoms tend to be underestimated for physicians and under communicated by patients. In this review we attempt to provide a summary of the existing data about the effect of OCD on sexuality, focusing on areas such as epidemiology, aetiology, neurobiology, clinical features and options for treatment.
Title 2: Predictors of sexual impairment at 6months after a manic episode: A post-hoc analysis of the MANACOR study
Authors: Laila Al Chaal
Abstract: Bipolar Disorder Type I (BDI) often involve direct or indirect sexual dysfunction, which has an important impact on the patients’ life quality, adherence to treatment and functional outcomes. We offer a post-hoc analysis of the MANACOR study, an observational, open-label study recruiting BDI patients with a recent manic episode who underwent a prospective follow-up for 6 months. We found that almost 25% of bipolar patients showed mild to severe sexual dysfunction, which was related to an older age of onset and to a higher rate of affective episodes and suicidal ideation. Although we acknowledge the possibility of the treatment constituting a bias modifying the clynical presentation of BDI.
Title 3: Sexuality among eating disorder patients. A systematic review
Authors: Celia González Soria, David González Parra, Laila Al Chaal Marcos, Ángel Luis Montejo González
Abstract: Eating disorders are complex and serious psychiatric diseases, potentially deadly medical conditions, which particularly affect female sex. In most cases, they are chronic illnesses, being anorexia nervosa and bulimia nervosa the most reported ones. Patients with eating disorders have a high rate of comorbidity with other serious diseases as affective disorders and anxiety disorders. Many published studies have analyzed on these issues, suggesting the possibility of a common psychopathological path related to the emotional dysregulation between these syndromes. Nowadays, there are still very few evaluative studies of the high turnout among these disorders and sexual dysfunction, particularly with regard to the evaluation of sexuality, sex drive, sexual activity and sexual satisfaction.
Title 4: Frequency and Severity of Antipsychotic-related Hyperprolactinaemia: Clinical Symptoms and Sexual Dysfunction in 834 patients.
Authors: Hernández, Ana I.; Acosta, José M.; Alvarez, Aida; Bote, Berta; Buch, Bárbara; Calama, Julia; de la Iglesia, Javier; Fernandez, Blanca; Gallego, Maria T; Guerro, Delio; Lorenzo ,Carolina; Martín, Carmen; Martín-Pinto, Tomás; Matías, Juan; Matos, Claudia; Pelayo-Terán, José M; Prieto, Nieves; Sánchez-Iglesias, Santiago; Montejo AL
Abstract: Hyperprolactinaemia is a common side effect of some APS, associated to important clinical manifestations (sexual dysfunction, breast disturbances and even increase of certain types of cancer risk). The objective of this study is to evaluate the frequency and levels of severity of prolactin increased associated to different APS, and its association with sexual dysfunction (SD). METHODS: Observational cross-sectional study. Adult patients treated with one APS for at least 4 weeks and with no other prolactin-rising treatment were included. Hyperprolactinaemia was defined as > 20 microgr/L in women, >18 microgr/L in men, although usually is not clinically significant until higher than 30-60 micrograms / L levels are reached, even greater. SD was evaluated with the specific SD questionnaire PRSexDQ-SALSEX (Montejo et al, 2001). RESULTS: 834 adults patients were evaluated with different diagnoses with the following APS treatments distribution: aripiprazole risperidone olanzapine quetiapine long-acting paliperidone long-acting risperidone oral paliperidone oral risperidone and others APS with N<10 were not evaluated). The mean PRL level was 53,94 ng/ml. Paliperidone was associated with the higher mean PRL levels (98.28 and 71.48 ng/mL for LAP and OP respectively), followed by oral risperidone (71.36 ng/mL). Quetiapine, oral olanzapine and aripiprazole showed the lower PRL levels (28.55, 27.10 and 13.25 ng/mL respectively). Antipsychotics were divided according to the degree of hyperprolactinemia in low(<50 ng/mL), moderate (50-100 ng/mL) and severe (>100 ng/mL) grade. Sexual dysfunction was found in 70% of the sexually active patients treated with paliperidone or risperidone an much less frequent in aripiprazole, olanzapine and quetiapine. CONCLUSIONS: SD must be taken in consideration when electing long-term treatment for patients
Title 5: Sexual dysfunction after treatment with methadone
Authors: Carlos Llanes , Ana I. Álvarez, M. Teresa Pastor, M. Ángeles Garzón, Nerea González, Ángel L. Montejo.
Abstract: Methadone maintenance therapy (MMT) is an effective substitute treatment for opium dependency, and has led to a considerable reduction in drug abuse. However, sexual disorder has remained as one of the main adverse effects of this treatment. It is important to monitor sexual problems among these patients because any sexual dysfunction can lead to treatment cessation and relapse to opium re-use. This study aim to estimate the prevalence and clinical relevance of sexual disorders among a sample of opium users during methadone replacement therapy. Using the PRSexDQ-SALSEX questionnaire patients showed frequent sexual dysfunction including decreased libido, erectile and orgasm problems both in males and females but spontaneous communication was very scarce.
Title 6: Sexual dysfunction in patients with alcohol use disorder and its impact on quality of life: a 6-month prospective and controlled study
Authors: R. Fernández Ovejero, A. Ballesteros, P. Galindo Villardón, B. Buch, José J. Avila, Angel L. Montejo
Abstract: Alcohol Consumption Disorder impacts sexuality and quality of life (QOL) of patients. Longitudinal studies show some improvement in QOL and sexual function with abstinence. This 6-months prospective and controlled study assesses the influence of chronic alcohol abuse on sexuality and QOL previously and after the abstinence period in patients treated at the Alcohol Consumption Disorders Unit of Salamanca (Spain). Method: Sexual function using SALSEX, Kinsey and IIEF-5 questionnaires, severity of dependence and quality of life (EQ-5D) in patients with alcohol dependence were studied and compared with a control group. Patients were evaluated at baseline and after 6 months of abstinence. Results: 53 patients and 33 controls were studied. Sexuality was considered "very important" in both groups. The patients showed greater dissatisfaction and sexual dysfunction, less confidence and greater difficulties with the erection than the controls. Abstinence improved sexual functioning but did not significantly change erectile dysfunction(ED). QOL significantly improved personal care, daily activities and health perception. Conclusions: Patients with ED have worse sexual performance and worse QOL. There was no relationship between sexual affectation and severity of consumption and neither reversibility in ED after abstinence. Nevertheless, an improvement in ejaculation, orgasm, sexual desire and QoL was found at six months. All patients showed normal sex hormone values. Alcohol-dependent patients considered sexuality "very important" as much as controls but patients were less sexually satisfied affecting their QoL. Addressing the sexual functioning in the treatment process of these patients would optimize their holistic care.
Title 7: Sexual satisfaction and mental health in prison inmates
Authors: Rodrigo J. Carcedo, Daniel Perlman, Fernando Pérez, Noelia Fernández-Rouco, and Diego Hervalejo
Abstract: The main goal of this study is to investigate the association between sexual satisfaction and mental health, and the combined effect of two significant moderators previously found: partner status and sexual abstinence. In-person interviews were conducted with 227 participants (48.9% males and 51.1% females). The effect of sexual satisfaction on mental health and the interactions sexual satisfaction*partner status, sexual satisfaction*sexual abstinence, and sexual satisfaction*partner status*sexual abstinence were tested using hierarchical linear regression after controlling for a set of sociodemographic, penitentiary, and interpersonal variables. Results revealed a direct relationship between sexual satisfaction and mental health only for the sexually abstinent group. These findings point to the importance of sexual satisfaction as a predictor of mental health in sexual situations of extreme disadvantage.
Title 8: Mental health and personal and interpersonal aspects in transgender people
Authors: Noelia Fernández-Rouco, Rodrigo J. Carcedo, Felix López and M. Begoña Orgaz
Abstract: This paper explores the subjective perception of transgender people in regard to certain personal and interpersonal aspects of their lives and their relationship with mental health. One-hundred and twenty transgender people (60 men and 60 women) participated by way of semi-structured interviews. Following quantitative methodology, analysis highlighted that sexual satisfaction and loneliness are the main predictors of mental health (Anxiety and Depression). The results act as a guide in the improvement of institutional and social responses and provide an opportunity to promote mental health.
Title 9: The role of sexual satisfaction in adolescents and young adults’ mental health
Authors: Rodrigo J. Carcedo and Noelia Fernández-Rouco
Abstract: The purpose of this study was to assess the role of sexual satisfaction and subjective well-being in adolescents and young adults, both men and women, and to determine their effect on mental health (anxiety and depression). One thousand and seven hundred and four participants answered to a questionnaire regarding these variables (43,8% men and 56,2% women; 55,8% from secondary school and 44,2% from university). Results showed the important role of sexual satisfaction in adolescents and young adults’ mental health. Subjective well-being intervened as an important aspect in the relationship between these two variables. The importance of further research about sexual satisfaction, subjective well-being, and mental health in adolescents and young adults is discussed in this work.
Title 10: The Link Between Childhood Physical, Emotional And Sexual Abuse And Adult Mental Disorders
Authors: Alvela Fernández, S.; Mateos Agut, M; Osorio Guzmán, A.; Abadín Vázquez, M.; Blasco Garrido, A.; Sanz Cid, B.; Martín Martínez, E. ; De La Gándara Martín, J.J.
Abstract: Traumatic childhood experiences are frequently described in patients suffering from mental disorders. The aim of this research study is to analyse the link between childhood trauma and mental illness. For that purpose, 128 psychiatric patients and 128 healthy controls were assessed with the Early Trauma Inventory, Spanish version, which assesses general traumatic events, emotional, physical and sexual abuse. When comparing the results between the two groups, significant differences were found in every category (Sig<0.004 for Sexual Abuse, Sig<0.002 for Physical Punishment, Sig<0.000 for General Trauma and Emotional Abuse). In respect of gender, women reported more traumatic events than men (Sig < 0.004). Significant correlations between certain diagnoses and certain kinds of abuse were also found, being the link between sexual abuse and cluster B personality disorders (p<0.02). Physical punishment, emotional abuse and the loss of a family member were found to be more related to affective, neurotic and psychotic disorders whereas sexual abuse was found to be more related to personality disorders. These results suggest that assessing and approaching traumatic experiences in usual clinical practise.
Title 11: Hormonal contraceptives and female sexual function: a systematic review
Authors: Nerea M. Casado-Espada; Rubén de Alarcón; Javier Ignacio de la Iglesia-Larrad; Berta Bote; Ángel Luis Montejo
Abstract: In recent decades, hormonal contraception (HC) has made a difference in the control of female fertility, taking an unequivocal role in improving contraceptive efficacy. Some side effects of hormonal treatments have been carefully studied, however, the influence of these drugs on female sexual function is not so clear, although variations in plasma levels in the medium-long term of sex hormones could be associated with sexual dysfunction, like the one described in hormonal alterations such as those that take place during menopause or some endocrine pathologies. In this review we attempt to provide a summary of the existing data about the impact of Hormonal Contraceptives on sexuality, focusing on areas such as route of administration, hormonal composition and options for treatment.
Title 12: Frequency of Sexual Dysfunction in patients treated with desvenlafaxine. A prospective 6-month switching strategy
Authors: Montejo, Angel L; Acosta, José M.; Becker, Joemir; Bote, Berta; Buch, Bárbara; Bueno, Gloria; Fernández, Raquel; Gallego, María T; González, Nerea; Juanes, Adrián; Pérez-Urdániz, Antonio; Prieto, Nieves; Villegas, José L; Armada Beatriz
Abstract: Sexual dysfunction (SD) caused by serotonergic antidepressants (SAD) is one of its most frequent and lasting adverse effects although clinically underestimated. Desvenlafaxine (DVLX) is an antidepressant with noradrenergic and serotonergic action that could cause lower SD than other serotonergic antidepressants although there are still few studies on this subject…
Title 13: Personality characteristics, psychopathology and copying strategies in women sexual interest and arousal disorder
Authors: Domínguez-Cagnon, H. y Farré, J.M.
Abstract: Sexual interest and arousal disorder (SIAD) are the most common female sexual dysfunction. It happens in women of all the ages and has a strong negative impact in their well-being, relationships and quality of life. Given it´s high resistance to treatment, in order to optimize the different therapeutic options a more comprehensive approach to the multiple psychological factors that contribute to its appearance and maintenance is needed. In this descriptive- comparative study, a sample of 10 women with SIED was compared to a control sample group of healthy women using semi-structured interviews and standardized questionnaires. Statistical analysis was performed using SPSS 17.0 software. Results showed significant differences in psychopathological symptoms, personality dimensions and copying strategies.