Search Results (309)

Introduction: Sexual minority men (SMM) are at increased risk for psychosocial stressor exposure, substance use, and poor mental health relative to heterosexual men. While the burden of mental health is growing in the United States, among SMM these trends are increasing at a greater rate, driving health disparities. Methods: Framed within a minority stress framework, these analyses examine how stressors explain substance use and poorer mental health over time. Participants were asked questions on stressor exposure (stigma, discrimination, internalized homophobia, perceived stress), mental health (anxiety, depression, PTSD), and substance use (alcohol to intoxication, club drugs, poly club drugs) over 36 months among 528 SMM in NYC. Results: Perceived stress increased frequency of all substance use, whereas discrimination decreased days of club and poly club drug use. Depression severity predicted increased days of club drug and poly club drug use. PTSD severity predicted increased days of club drug and poly club drug use. Conclusion: We are able to expand on the literature with granular substance use data to highlight associations with stressors and mental health. These findings support an increased need for systematic policy solutions and public health interventions to address drivers of substance use disparities among young SMM. Full article

Hormonal contraceptives (HCs) are widely used and generally well tolerated; however, their neuroendocrinological effects remain underappreciated in clinical decision-making. Beyond ovulation suppression, HCs influence brain function by modulating key neurotransmitters such as GABA, serotonin, and dopamine, as well as neurosteroids like allopregnanolone and β-endorphin. These interactions help explain why some users experience mood swings, anxiety, or changes in sexual desire, while others report improvements in well-being. In this narrative review, we explore how different estrogenic and progestin components affect central pathways involved in emotional regulation and cognition. Evidence suggests that estradiol or estetrol-based formulations combined with anti-androgenic progestins like drospirenone or nomegestrol acetate may offer a more favourable neuroendocrine profile, particularly in women with a history of mood disorders or hormonal sensitivity. Understanding these neuroendocrine mechanisms may support more personalized contraceptive choices, particularly in women with mood disorders and hormonal vulnerability. Full article

Ergogenic supplements are becoming increasingly popular in the diet of trained individuals, due to their potential benefits. Ashwagandha (Withania somnifera) is one of the supplements that has recently grown in popularity. Despite growing interest, its scientific background remains limited and sometimes inconsistent. Objective: This overview of systematic reviews aimed to evaluate the effects of Ashwagandha supplementation on sports performance and health-related outcomes. Methods: A systematic literature search was carried out on the following electronic databases: PUBMed, Scopus, Academic Search Complete, SPORTDiscus, Web of Science, and Google Scholar, using the search terms “ashwagandha” and “systematic review” in the title or abstract of the publication in July 2024. The eligibility of the articles was assessed using the PICOS (Population, Intervention, Comparator, Outcomes, and Study Design) approach, and risk of bias was assessed using the AMSTAR-2 checklist. Results: Of the 2388 systematic reviews found, 11 met the inclusion criteria, which included 151 original studies representing 9005 individuals. Findings suggest that Ashwagandha supplementation may improve various aspects of sports performance, such as endurance and muscular strength, as well as health-related outcomes, including anxiety reduction, improved sleep quality, and enhanced sexual function. The most commonly used doses of Ashwagandha supplementation are between 500 mg and 1000 mg a day. Conclusion: While current evidence indicates promising effects of Ashwagandha on physical and psychological parameters, further high-quality randomized controlled trials are needed. Therefore, its use in athletes or healthy individuals should be considered with caution and based on individual needs. Full article

Background/Objectives: Young female cancer survivors often face specific informational needs related to the physical and emotional effects of cancer and its impact on life plans, particularly fertility and parenthood. However, few tools are tailored to assess these needs during this critical life stage. This study aimed to (i) validate a multidimensional measure—the Satisfaction with Information Provided to Young Oncology Patients Scale (SIPYF-CPS)—to assess the specific informational needs of young adult female cancer survivors; and (ii) explore preferences regarding the provision of information and counseling. Methods: A total of 124 women (M[age] = 38.18; SD = 5.49; range 21–45), 76.6% diagnosed with breast cancer, participated in the study. Psychometric analyses included exploratory factor analysis and correlation coefficients to assess reliability and construct validity. Convergent validity was evaluated through standardized measures of anxiety, reproductive concerns, and quality of life. Results: A final 22-item measure demonstrated strong reliability and validity, capturing four factors: (i) Disease-Related Information, (ii) Symptoms and Functional Limitations, (iii) Implications for Fertility and Parenthood, and (iv) Support Services. Participants expressed low satisfaction with information on fertility preservation, sexual health, and support services. Lower satisfaction was moderately associated with higher anxiety and depression while positively related to quality of life. Most participants preferred phased, face-to-face communication throughout the illness trajectory. Conclusions: The SIPYF-CPS is a valid, multidimensional tool that captures the complex and evolving informational needs of young female cancer survivors. Its clinical use may promote earlier, personalized, and emotionally responsive communication—supporting psychological well-being, informed decision-making, and long-term survivorship care. Full article

Background and objectives: Duloxetine is widely used for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and various types of neuropathic pain. While its efficacy is well documented in clinical trials, less is known about how it is perceived and utilized in routine psychiatric practice. To address this knowledge gap, we conducted a cross-sectional observational study involving 80 psychiatrists from Spain to assess real-world clinical attitudes toward duloxetine. Methods: Participants completed a 20-item multiple-choice questionnaire that examined familiarity, perceived efficacy in multiple conditions (MDD, GAD, neuropathic pain, somatization, and quality of life), and perspectives on tolerability, safety, adherence, and overall satisfaction. Results: Survey results indicated that a large majority of psychiatrists frequently prescribe duloxetine, particularly for patients with MDD and comorbid chronic pain. Notably, 94% rated it as either “more effective” or “much more effective” for diabetic peripheral neuropathic pain. Psychiatrists reported a high perceived efficacy of duloxetine: 94% rated it as “more effective” or “much more effective” for diabetic peripheral neuropathy, and 93% gave similarly positive ratings for general neuropathic pain. For somatization, 70% found it “effective” or “very effective”, and 83% observed improvements in quality of life for many of their patients. Psychiatrists generally reported favorable perceptions of duloxetine’s tolerability profile: 97.5% rated it as the antidepressant associated with the least weight gain, and 82.5% perceived fewer sexual side effects compared to other options. Sedation and gastrointestinal side effects were generally considered mild or less severe. In terms of treatment adherence, 69% rated it as “better” or “much better” than other antidepressants, and 80% found its combination with other antidepressants to be “favorable” or “very favorable”. Overall satisfaction was high, with 99% of psychiatrists reporting being either “satisfied” or “very satisfied” with its use. The side effect profile was generally viewed as manageable, with low perceived rates of weight gain, sedation, and sexual dysfunction. Furthermore, 96% of respondents expressed a willingness to recommend duloxetine to their colleagues. Conclusions: Psychiatrists reported highly favorable attitudes toward duloxetine, viewing it as a flexible treatment option in routine care. However, these findings reflect clinicians’ subjective perceptions rather than objective clinical outcomes and should be interpreted accordingly. Full article

Background/Objectives: Melanoma is a skin cancer that can lead to a poor prognosis. Unlike other oncologic diseases, there is scarce evidence regarding sexual function in melanoma patients, as well as factors associated with sexual dysfunction (SD). The aim of this study was to evaluate SD in a cohort of melanoma patients, as well as to describe associated factors. Methods: A cross-sectional analysis was conducted in individuals diagnosed with melanoma. Data regarding sociodemographic characteristics, clinical stage of the disease, quality of life, and sexual functioning were obtained through the use of validated assessment tools. The duration of the study was from 1 January 2023 to 1 January 2024. Results: Seventy-five patients were included. The mean age was 52.70 ± 14.07 years, and 61.33% (46/75) were females. Melanomas at stages III or IV comprised 18.67% (14/75) of the sample. A negative impact of the melanoma on sexual function was reported by 29.33% (22/75) of patients, with low sexual desire being the most frequent cause. Female SD was associated with older age, shorter disease duration, greater depression rates, and visible scar location after melanoma surgery (p < 0.05). Male SD correlated with higher anxiety and depression rates and worse quality of life (p < 0.05). No association was found for melanoma stage in any case (p > 0.30). Conclusions: Melanoma patients may suffer from SD, which can be associated with mood status disturbances, poor quality of life, and older age. Since the most frequent causes of a negative impact on sexuality are a reduction in sexual desire and the side effects of melanoma surgery, patients should be specifically asked about sexuality to improve holistic care of the disease, irrespective of disease stage. Full article

The commercial sexual exploitation (CSE) of children is a distinct form of sexual trauma, resulting in immediate mental health issues. Few studies explore associations between family-level factors in adolescence and health outcomes in adulthood among this population. Utilizing a nationally representative dataset, we explored differences and associations between mental health outcomes and domains of the Family Health Development framework among respondents who self-reported CSE (N = 502; mean age = 15.03, SD = 1.34; 67% male; 50% white). We conducted ordinary least squares and binary logistic regressions using a hierarchical approach to analyze the CES-D depression scale, anxious personality scale, and self-reported diagnoses of depression and anxiety/panic disorder. At Wave IV, when participants were aged 24–32, 20% of participants reported ever having a diagnosis of depression, and 12% reported ever having an anxiety/panic disorder diagnosis. Family receipt of public assistance during adolescence significantly predicted depression and anxiety symptoms in adulthood, highlighting associations between family structure and mental health. Gender and race significantly predicted anxiety symptoms and having a diagnosis of depression and anxiety/panic disorder. Findings underscore the need for targeted training and comprehensive health screenings for providers to better understand and address the long-term mental health needs of CSE-impacted groups. Full article

The COVID-19 pandemic significantly disrupted higher education worldwide, imposing strict isolation measures, transitioning learning online, and exacerbating existing social and economic inequalities. This literature review examines the pandemic’s impact on the mental health of college students, with a focus on those belonging to minority groups, including racial, ethnic, migrant, gender, sexuality-based, and low-income populations. While elevated levels of anxiety, depression, and loneliness were observed across all students, findings indicate that LGBTQ+ and low-income students faced the highest levels of psychological distress, due to compounded stressors such as family rejection, unsafe home environments, and financial insecurity. Racial and ethnic minority students reported increased experiences of discrimination and reduced access to culturally competent mental healthcare. International and migrant students were disproportionately affected by travel restrictions, legal uncertainties, and social disconnection. These disparities underscore the need for higher education institutions to implement targeted, inclusive mental health policies that account for the unique needs of at-risk student populations during health crises. Full article

Background/Objectives: Sexual attitudes, particularly those on the erotophilia (positive openness) to erotophobia (negative fear) scales, play a critical role in shaping behaviors and health decisions. While associations between sexual behavior and substance use have been documented, limited research has explored how sexual attitudes relate to mental health and substance use among Latin American university populations. This study aimed to examine the associations among erotophilic attitudes, mental health symptoms (anxiety and depression), substance use risk, and sexual behaviors in Mexican university students. Methods: A cross-sectional observational study was conducted between 2019 and 2023 with 1475 undergraduate students aged 17–25 years. Participants completed the Revised Sexual Opinion Survey (R-SOS) to assess sexual attitudes, the Hospital Anxiety and Depression Scale (HADS) for mental health evaluation, and adapted items from the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to measure substance use risk. Erotophilic attitudes were defined as R-SOS scores ≥ 70. Statistical tests included the Kolmogorov–Smirnov test for normality, t-tests or Mann–Whitney U tests for group comparisons, Fisher’s exact test for categorical variables, and Spearman’s correlations. Multivariate binary logistic regression was used to calculate adjusted odds ratios (AdORs) and 95% confidence intervals (CIs), with a significance level of p < 0.05. Results: Erotophilic students were more likely to be male, older, initiate sexual activity earlier, and report a greater number of sexual partners. Erotophilia was positively associated with anxiety and tobacco, alcohol and marijuana use, and negatively associated with depressive symptoms. Multivariate analysis indicated that erotophilia was independently associated with male sex, age ≥ 20, higher anxiety, lower depression, low socioeconomic status, and increased risk of tobacco and marijuana use. Lower rates of consistent condom use were also reported among erotophilic individuals. Conclusions: Erotophilia may serve as a behavioral risk marker linked to anxiety symptoms and increased substance use, but not to depression. These findings highlight the need for integrated interventions addressing sexual health, substance use, and mental well-being in university populations. Full article

Background: Bariatric surgery is an effective treatment for obesity, leading to significant weight loss and improvements in metabolic health. However, massive weight loss often results in excess skin, which can negatively impact body image, psychological well-being, and quality of life. Abdominoplasty is commonly performed after bariatric surgery to address these concerns. Our study aimed to evaluate the effects of post-bariatric abdominoplasty on psychological well-being, body image, social relationships, and sexual functioning in formerly obese patients. Methods: A single-center, cross-sectional recall study was conducted on 35 patients, out of 135 invited, who underwent sleeve gastrectomy followed by abdominoplasty 12–24 months after the initial surgery. Participants completed validated questionnaires assessing psychological well-being, depression, anxiety, self-esteem, body perception, social relationships, and sexual functioning. Pairwise comparisons were performed to assess changes across the preoperative, post-bariatric, and post-abdominoplasty stages. Results: Psychological well-being significantly improved post-bariatric surgery, with further reductions in anxiety and depressive symptoms after abdominoplasty. However, body shape perception and self-esteem improved after bariatric surgery but did not show additional enhancement following abdominoplasty. Social support remained largely unchanged, except for modest improvements in attachment and reliable alliance. Sexual functioning improved significantly after bariatric surgery but showed no further significant gains after abdominoplasty. Conclusions: While abdominoplasty is associated with additional psychological benefits, particularly in reducing anxiety and depressive symptoms, it does not significantly enhance body perception, self-esteem, or sexual functioning beyond the effects of bariatric surgery. These findings highlight the importance of setting realistic patient expectations regarding the benefits of body contouring surgery in post-bariatric care. Full article

University students from diverse sexual orientations encounter specific mental health challenges due to academic demands, minority stress, and societal stigma; however, research focusing on these issues is still scarce in Southeast Asia. This research aimed to examine the mental health outcomes of heterosexual and sexuality-diverse students in Thailand, concentrating on both negative aspects—such as depression, anxiety, and perceived stress—and positive aspects—like resilience, inner strength, and perceived social support. A cross-sectional survey was performed with 442 university students aged between 20 and 30, employing validated self-report instruments. Statistical methods, including t-tests and multiple regression analyses, were used to evaluate differences and relationships between sexual orientation and mental health outcomes while controlling for confounding variables. The findings revealed that sexuality-diverse students showed notably higher levels of depression (B = 0.115, p < 0.05) and lower perceived social support (B = −0.10, p < 0.05) when compared to their heterosexual counterparts. Nevertheless, there were no significant differences found in anxiety, perceived stress, resilience, or inner strength. Perceived social support proved to be a crucial protective factor, with greater levels linked to reduced depression, anxiety, and perceived stress (p < 0.01). These results underscore the necessity for inclusive university policies, specific mental health interventions, and peer and family support initiatives to enhance the well-being of sexuality-diverse students in Thailand. Full article

Background/Objectives: To evaluate the quality of life (QoL) of adolescent and young adult males who had testicular prosthesis surgery during their childhood, as well as their own and their parents’ inner perceptions and feelings. To our knowledge, this is the first qualitative study and one of few with an integrated approach on the QoL of pediatric testicular prosthesis recipients. Methods: Recipients and their parents were interviewed regarding their life with the testicular prosthesis. Major QoL domains (i.e., physical and mental health, interpersonal relationships, sexuality) were assessed. Results: Although there were participants who viewed the outcomes with negativity, most expressed satisfaction. Daily routine returned to normal after a postoperative period with precautions, such as fear of damaging either the implant or the healthy testis. Prosthesis feeling was acceptable and normalized with time, while self-image and self-confidence were boosted by the presence of the prosthesis. All participants outlined the importance of privacy as being kept in the inner family circle. Some exhibited introverted behavior. Regarding sentimental and sexual intimacy, the prosthesis produced anxiety and concern both in experienced recipients and minors, which was moderated by a normal scrotal appearance. Conclusions: Testicular prosthesis surgery performed from childhood to adulthood may create profound and variable concerns, which may affect the recipients and their companions in the long term. Therefore, it should not be considered in a simplistic manner as a routine procedure and should be preceded by thorough conversation with experts. Full article

Barriers to help-seeking behaviors in transgender populations in non-Western contexts are both understudied and poorly understood. Using a quantitative cross-sectional design, this study examined the psychological help-seeking attitudes of 109 transgender persons from Pakistan in relation to their psychological distress and attitudes toward sexuality. This research further identified which components of distress (stress, anxiety, or depression) were stronger predictors and assessed the role of particular demographic/behavioral factors in help-seeking attitudes. Participants completed three validated assessment tools translated into Urdu: Beliefs about Psychological Services Scale, the Depression, Anxiety, and Stress Scale (DASS-21), and the Sexual Attitude Scale. The results indicated that psychological distress predicted expertness and intent but not stigma tolerance. Post hoc analysis using DASS-21 subscales revealed that stress and anxiety were the stronger predictors of attitudes related to expertness and intent. The Sexual Attitude Scale marginally predicted stigma tolerance directly and also moderated the relationship between psychological distress and help-seeking attitudes for stigma tolerance. Finally, a role for demographic/behavioral factors—possibly serving as a proxy for mental health literacy—was identified for stigma tolerance. These findings reiterate the importance of tailored mental health awareness initiatives within the transgender community in non-Western settings and highlight the need for qualitative research to further understand the dynamics of psychological distress along with other linked factors. Full article

Objective: Sexual dysfunction (SD) is a prevalent but frequently overlooked condition that adversely affects women’s quality of life and psychological well-being. This study aimed to examine the relationship between SD and depression, anxiety, and stress levels during premenopausal, pregnancy, and postmenopausal. Methods: This prospective, cross-sectional study included 300 women aged 18–70 who presented with SD symptoms to a tertiary care gynecology outpatient clinic. Participants were categorized into premenopausal, pregnant, and postmenopausal groups. Sexual function was assessed using the Female Sexual Function Index (FSFI), and psychological status was evaluated with the Depression Anxiety and Stress Scale (DASS-21). Univariate and multivariate logistic regression analyses were conducted to identify risk factors associated with SD. Results: The results showed that SD prevalence varied across life stages, with the highest rate (96%) observed in postmenopausal women. Significant decreases were found in all FSFI subscales, particularly lubrication and orgasm, during the postmenopausal period (p < 0.001). Although DASS-21 total scores did not differ significantly between groups (p = 0.227), severe stress was more prevalent in premenopausal women (p = 0.018). Univariate logistic regression revealed that older age, higher parity, and menopause increased SD risk (p < 0.001), while employment (p = 0.006), higher education (p = 0.012), and pregnancy (p < 0.001) were protective factors. Multivariate analysis identified parity as the only independent variable significantly increasing SD risk (p = 0.011). Weak but significant negative correlations were found between FSFI total score and DASS-21 total (r = −0.137, p = 0.018), anxiety (r = −0.135, p = 0.019), and depression (r = −0.176, p = 0.002) scores. Conclusion: These findings highlight the importance of individualized assessment and treatment approaches for women’s sexual health across different life stages, considering the influence of various biological, psychological, and social factors. Full article

Objective: To explore the feasibility and acceptability of using an evidence-based Tai Chi intervention to manage the fatigue–sleep disturbance–depression symptom cluster (FSDSC) in female breast cancer patients. Methods: This study reported the feasibility outcomes of a pilot randomized controlled trial (RCT), along with a nested qualitative process evaluation. Seventy-two female breast cancer patients experiencing the FSDSC were randomized into either a Tai Chi group or a control group. The Tai Chi group received an eight-week Tai Chi intervention consisting of two one-hour sessions per week, along with routine care, while the control group received routine care only. The feasibility and acceptability of the study procedure and Tai Chi intervention protocol were assessed by measuring recruitment, referral, retention and drop-out rates, questionnaire completion rates (including the Brief Fatigue Inventory [BFI], Pittsburgh Sleep Quality Index [PSQI], Hospital Anxiety and Depression Scale-Depression [HADS-D], and Functional Assessment of Cancer Therapy-Breast [FACT-B]), intervention adherence, and safety outcomes. The nested qualitative process evaluation consisted of semi-structured interviews conducted among 22 participants to further explore their experiences of participating in this study and practicing Tai Chi. Descriptive data analysis was employed to present the feasibility and acceptability outcomes. Content analysis was employed to analyze the data from the qualitative process evaluation. Results: A total of 72 breast cancer patients were successfully recruited over six months, with a recruitment rate of 79.1%, retention rate of 95.8%, and dropout rate of 4.2%. No missing data was found in the BFI, PSQI, or HADS-D. However, a notable number of missing values were found in the FACT-B, particularly for items related to sexual satisfaction. The Tai Chi intervention demonstrated a high level of feasibility, with an average adherence rate of 86.8%. Only eight participants reported minor discomforts, such as minor musculoskeletal discomfort and dizziness, but they were transient and manageable after stopping Tai Chi practice. Semi-structured interviews with 22 participants highlighted that Tai Chi was experienced to be generally convenient, energy-saving, and low intensity for FSDSC management. Participants also felt that the study questionnaires were comprehensible and straightforward. Many interviewees from the Tai Chi group reported perceiving favorable effects on FSDSC management, as well as overall functional health and well-being. Conclusions: The evidence-based Tai Chi intervention proved feasible, safe, and convenient as a non-pharmacological intervention for managing FSDSC in breast cancer patients. Future large-scale studies are needed to evaluate Tai Chi’s definite effects on improving FSDSC among breast cancer patients. Full article