Partner relationship quality predicts later postpartum depression independently of the chronicity of depressive symptoms

Objective: Given the lifelong implications of extended postpartum depression (PPD), research is needed to examine the social factors implicated in its development (such as relationship quality) and associated predictors. This study sought to examine the association of partner relationship quality (PRQ) and decline of sexual life (DSL) with maternal PPD at 12-15 months after childbirth. Methods: Prospective study of 294 low-income postpartum women. A structured questionnaire and the Patient Health Questionnaire-9 (PHQ-9) captured responses for the main outcome variable and covariates. Results: The prevalence of the main outcome (PPD at 12-15 months) was 19.1%. Using logistic regression models, low PRQ (risk ratio [RR] = 1.58, 95%CI 1.01-2.49) and DSL (RR = 1.97, 95%CI 1.23-3.15) were associated with PPD at 12-15 months even after controlling for perinatal depression. Conclusions: Late PPD (12 to 15 months after giving birth) is very common among low-income women, and is independently associated with different aspects of the couple's relationship. Improving PRQ may prevent late PPD. Future investigations are warranted.

A Comparative Study on the Sexual Functioning among Men with and without Severe Mental Illness

Objective: The aim of the study isto compare the sexual functioning among men with and without severe mental illness. Materials and Methods: The study was conducted inPsychiatry Department, Sree Balaji Medical College and hospital, Chromepet, Chennai Tamilnadu, India from the period of August 2016 to February 2018 (18 months). Cross sectional analytical study: 1.Semi structured questionnaire to capture demographic variables, illness variable, type of sexual practice and their expectations from MHPs. 2. General health questionnaire(12) tamil and English, 3. CAGE screening tool for alcohol. 4. The Brief Male Sexual Function Inventory (BMSF) for males (70). Results: The study population covered 50% of men with severe mental illness and 50% of men without severe mental illness. Among the study population regarding the educational status it was inferred that 70% were literate and only 30% were illiterate.An attempt to identify the mental illness of the study population was made and it was found that among the total cases, the prevailing mental illness was Schizophrenia (27%). Bipolar affective disorder (17%) was ranked as second highest. Delusional disorder, major depressive disorder covered up to 4% and 1% respectively. The comparisons of quantitative variable between the groups were given in Table 7. The median (range) of the age in case was 40 (29, 58) and in controls was 39 (25, 55), which shows that the median value of age between the groups was not found to be statistically significant (P>0.05). The median value of general health questionnaire among the patients with severe mental illness was 26 (18, 34) and in controls it was 1 (0, 4) which shows that this median difference was highly significant (P<0.0001). The median value of CAGE among the cases was 1 (0, 4) and in normal males was 19 (15, 29) which shows that the median difference between the groups were found to be highly significant (P<0.0001). Similarly, the median difference of variables such as BSFI sexual drive, ejection score, ejaculation score, overall satisfaction score, problem assessment score and total score was found to highly significant (P<0.0001). This implies that the sexual function of men with severe mental illness differs significantly from the normal males. Conclusion: Sexual dysfunction is common among men with severe mental illness than persons without severe mental illness. The male patients with severe mental illness such as Schizophrenia, delusional disorders, BPAD, major depressive disorder have impaired sexual function compared with the persons without severe mental illness study group which is evident from the BFSI score(17 in persons with severe mental illness vs 34 in persons without severe mental illness) which is clinically significant. In our study, sexual dysfunction among the men with severe mental illness is not proportional to the duration of the illness & the age of the patients. Recommendations based on gender identity development, attachment, non-sexual and sexual abuse, puberty/adolescence.

Are you sexually empowered? Validation of the Female Sexual Subjectivity Inventory for Spanish-speaking women / ¿Sexualmente empoderada?: validación del Inventario de Subjetividad Sexual Femenina en mujeres hispanohablantes

Abstract The Female Sexual Subjectivity Inventory (FSSI) consists of 20 items that represent three principal elements distributed into five factors that assess: Sexual body-esteem, Pleasure-self, Pleasure-partner, Self-efficacy, and Sexual Self-reflection. The goal was to adapt and examine the psychometric properties of the FSSI. The sample consisted of 278 Ecuadorian adult women. Item analysis, confirmatory factorial analysis, reliability, and evidence for validity were provided by examining associations with socio-demographic variables as well as with body image dissatisfaction and sexual self-consciousness. Using a confirmatory factor analysis, we confirmed a five-factor structure in which items 1 and 6 were deleted. Regarding socio-demographic factors, older women indicated greater sexual self-efficacy, while the women involved in longer relationships indicated less sexual self-efficacy and more entitlement from their partners. The FSSI-factors were associated with body image dissatisfaction and self-consciousness, which revealed that the women reporting greater sexual subjectivity also reported less body dissatisfaction and lower self-consciousness. The reliability of this 18-item version was good, and Cronbach's alpha values ranged from .74 to .86. This study emphasises the need to re-examine the structure and psychometric properties of measures when applied to another context or culture. We provide evidence for the validity and reliability of the FSSI for Ecuadorian women.

Resumen El Inventario de Subjetividad Sexual Femenina (ISSF) consta de 20 ítems distribuidos en cinco factores que evalúan: la autoestima sexual, placer propio, placer con pareja, autoeficacia y autorreflexión sexual. El objetivo de este estudio fue adaptar y examinar las propiedades psicométricas del ISSF. La muestra consistió en 278 mujeres adultas ecuatorianas. Los cuestionarios se administraron en formato online. Se realizaron análisis de ítems, análisis factorial confirmatorio (AFC), se proporcionaron evidencias de fiabilidad y evidencias de validez al examinar las asociaciones con variables sociodemográficas, así como con la autoconciencia sexual y la insatisfacción con la imagen corporal. A través del AFC, se confirmó una estructura de cinco factores en el que se eliminaron los ítems 1 y 6. En relación con las variables sociodemográficas, las mujeres de mayor edad indicaron mayor autoeficacia sexual, en tanto que las mujeres que se encontraban en una relación indicaron menor autoeficacia sexual y mayor placer obtenido de la pareja. Los factores del ISSF se asociaron con la insatisfacción con la imagen corporal y la autoconciencia, en concreto, quienes informaron de mayor subjetividad sexual estaban más satisfechas con su cuerpo e informaron de menor autoconsciencia sexual. La fiabilidad fue adecuada, oscilando los valores alfa de Cronbach entre .74 y .86. Este estudio enfatiza la necesidad de reexaminar la estructura y las propiedades psicométricas de los instrumentos cuando son aplicados en otro contexto o cultura. Se ofrecen evidencias de validez y fiabilidad para el uso del ISSF en mujeres ecuatorianas.

Sexual satisfaction in patients with cancer / Satisfacción sexual en enfermos de cáncer / Satisfação sexual em pacientes com câncer

Abstract This study aimed to compare the dimensions of sexual satisfaction in subjects with and without cancer. Independent variables were: different types of cancer, time elapsed since diagnosis, types of treatment and changes in body image. The dependent variable was level of satisfaction with sexual relations. The sample consisted of 184 participants, of whom 95 belonged to the cancer group (ages between 26 and 84 years) and 89 to the non-cancer group (ages between 19 and 67 years). The instrument used was the Sexual Satisfaction Questionnaire (QSRS, for its Portuguese acronym). The results showed significant differences between the cancer group and the non-cancer group. Individuals with a history of cancer disease had lower values (17.93 ± 9.67) at the level of sexual function compared to individuals with no history of the disease (30.19 ± 4.2). Individuals with cancer who had higher values of self-esteem were those with urological cancer (16.76 ± 2.85), followed by breast cancer (14.83 ± 3.34) and "other cancers" (14.41 ± 5.5), whereas those with digestive cancer presented the lowest values (5.68 ± 13.63). In sexual functioning, the group of "other cancers" showed the highest levels of satisfaction (23.53 ± 10.12), while people with breast cancer (19.54 ± 9.36), digestive cancer (18.50 ± 12.57), and urological cancer (29.12 ± 7.22) presented the lowest levels of satisfaction. Within the group of people with cancer, those who had less than one year and between three to five years of having been diagnosed reflected less satisfactory sexual performance values. On the other hand, radiation treatments, surgery and "other treatments" showed negative effects on sexual functioning, as well as changes in body image. All independent variables had a negative impact on sexual satisfaction and performance, with the exception of weight loss, vomiting, and hair loss.

Resumen Este estudio tuvo como objetivo comparar las dimensiones de satisfacción sexual en sujetos con y sin cáncer, específicamente al comparar los diferentes tipos de cáncer, el tiempo de diagnóstico y los tipos de tratamiento, con cambios en la imagen corporal y el nivel de satisfacción con las relaciones sexuales. La muestra estuvo compuesta por 184 participantes, de los cuales 95 pertenecieron al grupo con cáncer (edades entre los 26 y 84 años) y 89 al grupo sin cáncer (edades entre los 19 y 67 años). El instrumento utilizado fue el Questionário de Satisfação com o Relacionamento Sexual (QSRS). Los resultados mostraron diferencias significativas entre el grupo con cáncer y el grupo sin cáncer, los individuos con antecedentes de enfermedad de cáncer presentaron valores más bajos (17.93 ± 9.67) en el nivel de la función sexual en comparación con los individuos sin antecedentes de dicha enfermedad (30.19 ± 4.2). Los individuos con cáncer que presentaron valores más altos en autoestima fueron los de cáncer urológico (16.76 ± 2.85), seguidos por los de cáncer de mama (14.83 ± 3.34) y "otros tipos de cáncer" (14.41 ± 5.5); siendo los de cáncer digestivo quienes presentaron los valores más bajos (5.68 ± 13.63). En el funcionamiento sexual, el grupo de "otros tipos de cáncer" mostró niveles más altos de satisfacción (23.53 ± 10.12), mientras que las personas con cáncer de mama (19.54 ± 9.36), cáncer digestivo (18.50 ± 12.57) y cáncer urológico (29.12 ± 7.22) presentaron los niveles más bajos de satisfacción. Dentro del grupo de personas con cáncer, los que tienen menos de un año y de tres a cinco años después de haber tenido el diagnóstico reflejaron valores de funcionamiento sexual menos satisfactorios. Por otro lado, los tratamientos de radiación, cirugía y "otros tratamientos" mostraron efectos negativos en el funcionamiento sexual, así como cambios en la imagen corporal. Todas las variables independientes tuvieron un impacto negativo en la satisfacción y el desempeño sexual, con excepción de la pérdida de peso, el vómito y la pérdida de cabello. Palabras clave: Cáncer, sexualidad, funcionamiento sexual, enfermedad maligna.

Resumo O objetivo foi comparar indivíduos em função das seguintes variáveis independentes: cancro e sem cancro, diferentes tipos de cancro, tempo de diagnóstico, diferentes tipos de tratamento e mudanças na imagem corporal tendo por variável dependente o nível da satisfação da relação sexual. A amostra foi constituída por 184 participantes (95 com cancro com idades entre 26 e 84 anos; 89 sem cancro, com idades entre 19 e 67 anos). Foi utilizado o Questionário de Satisfação com o Relacionamento Sexual (QSRS). Verificaram-se efeitos significativos entre os indivíduos com historial de doença oncológica ao nível do funcionamento sexual, comparativamente com os indivíduos sem historial de doença oncológica. Indivíduos com cancro urológico apresentam valores mais elevados ao nível da autoestima (16.76 ± 2.85), seguidos pelo cancro de mama (14.83 ± 3.34) e outros tipos de cancro (14.41 ± 5.05). O cancro digestivo é o que apresenta os valores mais baixos (13.63 ± 5.68). Com relação ao funcionamento sexual, o grupo "outros tipos de cancro" apresenta maiores níveis de satisfação (23.53 ± 10.12). Seguem-se o cancro de mama (19.54 ± 9.36) e os digestivos (18.50 ± 12.57) e, por último, o cancro urológico, que apresenta os níveis mais baixos (12.29 ± 7.22). Dentro do grupo de indivíduos com cancro, o período inferior a um ano e de três a cinco anos apresenta valores menos satisfatórios na dimensão funcionamento sexual, e os tratamentos de radioterapia, cirurgia e "outros tipos de tratamento" produzem efeitos negativos ao nível do funcionamento sexual, assim como as mudanças na imagem corporal. No presente estudo, com a exceção de perda de peso, vómitos e perda de cabelos, todas as variáveis independentes têm um impacto negativo na satisfação/desempenho sexual.

Adaptation, validation and reliability of the Massachusetts General Hospital-Sexual Functioning Questionnaire in a Colombian sample and factorial equivalence with the Spanish version / Adaptación, validación y fiabilidad del Cuestionario de funcionamiento sexual del Hospital General de Massachusetts en una muestra colombiana y equivalencia factorial con la versión en españo

Sexual dysfunctions are a highly prevalent problem. It is necessary to have instruments adapted to the Colombian population in order to evaluate their sexual functioning because to date none of them have been validated. The aim of this study was to adapt and validate the Massachusetts General Hospital-Sexual Functioning Questionnaire in Colombian population, and compare it with a similar sample from Spain. Two different samples were used in this study. On one hand, a sample of expert judges who performed the cultural adaptation and the evaluation of the scale, and on the other hand, a second end sample of 1117 participants -men and women of both nationalities- who answered the questionnaire -together with others-through a virtual platform. Some of the items were adjusted based on the initial results of the evaluation by the expert judges. Cronbach's alpha between .81 and .92 were obtained after the application of the test. The psychometric properties of the scale are adequate and this instrument properly correlates with other criterion variables. Construct validity was evaluated using factorial invariance. The unidimensional configural model for men (RMSEA= .000; CFI = 1) and for women (RMSEA= .048, CFI = .997) had an adequate fit, and a level of strict invariance was also reached. Screening can be performed with this first validated scale in order to evaluate the sexual difficulties of the Colombian population and compare them with the Spanish population.

Las disfunciones sexuales son un problema muy frecuente. Es necesario contar con instrumentos adaptados a la población colombiana con el fin de evaluar su funcionamiento sexual porque hasta la fecha ninguno de ellos se ha validado. El objetivo de este estudio fue adaptar y validar el Cuestionario de funcionamiento sexual del Hospital General de Massachusetts en la población colombiana y compararla con una muestra similar de España. Se utilizaron dos muestras diferentes en este estudio. Por una parte, una muestra de jueces expertos que realizaron la adaptación cultural y la evaluación de la escala, y por la otra, una segunda muestra final de 1.117 participantes - hombres y mujeres de ambas nacionalidades - que respondieron el cuestionario, junto con otros, a través de una plataforma virtual. Algunos de los elementos se ajustaron según los resultados iniciales de la evaluación realizada por jueces expertos. Se obtuvieron coeficientes alfa de Cronbach entre 0.81 y 0.92 después de la aplicación de la prueba. Las propiedades psicométricas de la escala son adecuadas y este instrumento se correlaciona debidamente con otras variables para el criterio. La validez del constructo se evaluó mediante invariancia factorial. El modelo configural unidimensional para los hombres (RMSEA = 0.000; CFI = 1) y para las mujeres (RMSEA = 0.048; CFI =0.997) tenía un ajuste adecuado, y también se alcanzó un nivel de estricta invariancia. Puede realizarse un cribado con esta primera escala validada para evaluar las dificultades sexuales de la población colombiana y compararlas con las de la población española.

Evidências de validade da versão brasileira da escala de autoeficácia sexual: função erétil / Validity evidences of Brazilian version of sexual self-efficacy: erectile function

Para contribuir com o desenvolvimento de instrumentos que avaliam as disfunções sexuais, o presente estudo buscou por evidências de validade baseadas na estrutura interna e nas relações com outras variáveis para a versão brasileira traduzida e adaptada da Escala de Autoeficácia Sexual - Função Erétil (SSES-E). Trata-se de um estudo retrospectivo em prontuários de arquivo permanente com aplicações realizadas em homens com queixas de disfunção erétil e ejaculação rápida de idades entre 18 e 62 anos. Os resultados indicaram a possibilidade de duas dimensões, denominadas de obtenção da ereção e manutenção da ereção. Tanto o instrumento quanto as dimensões foram capazes de discriminar importantes características da amostra a respeito das queixas primária e secundária, tipo de dificuldade eretiva e satisfação com o relacionamento sexual. Qualificam-se esses resultados como evidências de validade para SSES-E, além de destacar-se sua importância como um instrumento útil na avaliação de questões específicas da sexualidade, como a função sexual.

This current study has searched for evidences of validity based on the internal structure and the relations to other variables for the translated and adapted Brazilian version of the Sexual Self-Efficacy Scale - Erectile Function (SSES-E), which contributes to the development of instruments for the evaluation of sexual dysfunctions. This study is also related to the retrospective study of permanent files of medical reports about application on men complaining of erectile dysfunction and rapid ejaculation with ages between 18 and 62. The results have indicated the possibility of two dimensions, designated as achieving and maintaining erection. Not only the instruments but also the dimensions were able to discriminate important characteristics of the samples about the primary and secondary complaints, types of erectile difficulties and satisfaction with the sexual relationship. These results are qualified as evidences of validity on SSES-E, also important as being a useful instrument when evaluating specific questions about sexuality, like sexual functioning.

Sexual Functioning in Women with Gynecologic Cancer / 여성건강간호학회지

PURPOSE: This study was conducted to identify sexual functioning in women with gynecologic cancer. METHOD: Sexually active women with gynecologic cancer without evidence of distant metastasis were recruited in Seoul, Korea from a university medical center. Subjects were asked to complete an anonymous mail-back survey on their sexual functioning. RESULT: One hundred eighty four women completed questionnaires. Their mean age was 51.0 years and 96.2% lived with their husbands. Subjects were diagnosed with cervical cancer(53.8%), ovarian cancer (27.7%), or endometrial cancer(18.5%). Sexual functioning for women with gynecologic cancer was relatively low, 15.4, in comparison to Rosen's cutoff scores of 26.6. Univariate analyses indicated that age, employment status, and their monthly income were significantly associated with sexual functioning. Tumor staging, treatment modality, and hormone replacement therapy were also significantly associated factors with women's sexual functioning. Sexual arousal, orgasm, and pain were affected by time since last treatment. CONCLUSION: Sexual counselling or education for women with gynecologic cancer should be considered by medical professionals in order to improve their quality of life including sexual functioning.

Evaluation of Sexual Function in Adults with Cerebral Palsy

OBJECTIVE: To investigate current status of psychosexual function in adults with cerebral palsy (CP) by Derogatis Sexual Functioning Inventory (DSFI), which is a widely used multidimensional measure of sexual functioning. METHOD: Forty-two adults with CP and 150 healthy controls participated in this study. All participants were interviewed with DSFI, which consisted of 10 domains such as sexual information, experience, drive, attitude, psychological symptoms, affect, gender role, fantasy, body image and satisfaction. RESULTS: Adults with CP showed significantly lower scores in sexual information, experience and satisfaction, and higher scores in psychological distress symptoms and conservative attitude, compared with controls (p<0.05). Especially, unmarried men with CP had a significant sexual dysfunction in most substantive domains of DSFI (p<0.05). However, there was no statistical difference in married men, unmarried women and married women, compared with normal controls. Sexual experience, drive, body image and satisfaction were significantly distressed in non-ambulatory CP, compared with functional ambulators (p<0.05). The score of sexual satisfaction had a significant relationship with those of sexual experience, attitude, psychological symptoms and body image in adults with CP (p<0.05). CONCLUSION: Adults with CP showed a distress in psychosexual functioning, especially in unmarried men and non- ambulators. Therefore, active interventions of sexual counseling and education will be helpful for enhancing their sexual function.

Evaluation of Sexual Function with Derogatis Sexual Functioning Inventory (DSFI) in Spinal Cord Injured Men

OBJECTIVE: To investigate the current state of the psychological aspects for the sexual function in spinal cord injured (SCI) men and to provide a basis of sexual rehabilitation program. METHOD: Seventy-seven spinal cord injured men and 87 healthy adults participated and completed Derogatis Sexual Functioning Inventory (DSFI). This questionnaire consisted of 10 subtests such as sexual information, experience, drive, attitude, psychological symptoms, affect, gender role, sexual fantasy, body image, and sexual satisfaction. RESULTS: Compared with healthy adults, SCI men had lower sexual experience, drive and satisfaction with a statistical significance (p<0.05). They also had more psychological distress symptoms, negative affect, and negative body image (p<0.05). There was no significant differences between tetraplegia and paraplegia, complete and incomplete injury, nor inpatient and outpatient. However, the SCI men with independent mobility had significantly greater sexual satisfaction, compared with the SCI men with dependent mobility (p<0.05). CONCLUSION: Most SCI men had psychologic sexual dysfuctions as well as organic problems, especially among the married men with dependent mobility. We suggest that more aggressive intervention of sexual rehabilitation need to be provided for this group.