Sexual dysfunction in the climacteric period and associated factors / Disfunção sexual no climatério e fatores associados

Abstract Objectives: to evaluate associated factors with sexual dysfunction among middle-aged women. Methods: cross-sectional and analytical study was carried out with climacteric women attended at a Family Health Strategy Unit in the city of Montes Claros, MG. Brazil. The eligible women answered a question form containing sociodemographic, behavioral, anthropometric, gynecological factors and sexuality. The Body Mass Index and waist circumference were used to assess nutritional status and metabolic risk. To evaluate quality of life and sexual performance the Menopause Rating Scale and the Sexual Quotient - Female Version were used, respectively. Bivariate analysis and hierarchical multiple regression were used to identify associated factors with sexual dysfunction in the climacteric period. Results: among 195 women, 29.6% had sexual dysfunction. The prevalence of unsatisfactory sexual performance was higher among women who reported moderate to severe climacteric symptoms (OR=2.47) and lower schooling level was also associated (OR=1.95). However, age at menarche below 12 years (OR=0.43) and non-white (OR=0.36) seem to have a protective effect for good sexual performance. Conclusion: the prevalence of sexual dysfunction was high and the level of schooling and climacteric symptomatology were associated factors with this outcome.

Resumo Objetivos: avaliar os fatores associados à disfunção sexual entre as mulheres de meia-idade. Métodos: estudo de corte transversal e analítico realizado com mulheres climatéricas atendidas em uma Unidade de Estratégia de Saúde da Família no município de Montes Claros-MG, Brasil. As mulheres elegíveis responderam a um formulário contendo questões sociodemográficas, comportamentais, antropométricas, fatores ginecológicos e sexualidade. Utilizou-se o Índice e Massa Corporal e a circunferência da cintura para avaliar o estado nutricional e risco metabólico. Para avaliar a qualidade de vida e o desempenho sexual foram utilizados a Menopause Rating Scale e o Quociente Sexual -Versão Feminina, respectivamente. Empregou-se análise bivariada e regressão múltipla hierarquizada para identificar fatores associados à disfunção sexual no climatério. Resultados: dentre 195 mulheres, 29,6% apresentaram disfunção sexual. A prevalência de desempenho sexual insatisfatório foi maior entre as mulheres que declararam sintomas climatéricos moderados a graves (OR = 2,47) e o menor grau de escolaridade (OR = 1,95). No entanto, a idade da menarca abaixo de 12 anos (OR = 0,43) e a cor de pele não branca (OR = 0,36) parecem ter efeito protetor para o bom desempenho sexual. Conclusão: a prevalência de disfunção sexual foi elevada e o nível de escolaridade e a sintomatologia climatérica foram fatores associados a esse resultado.

The Impact of the COVID-19 Pandemic on Depression and Sexual Function: Are Pregnant Women Affected More Adversely? / O impacto da pandemia de COVID-19 na depressão e na função sexual: as mulheres grávidas são afetadas de forma mais adversa?

Abstract Objective To investigate depression and sexual function among pregnant and nonpregnant women throughout the COVID-19 pandemic. Methods A total of 188 women, 96 pregnant and 92 non-pregnant were included. The Beck Depression Inventory (BDI) and the Arizona Sexual Experience Scale (ASEX) were applied to the participants after obtaining sociodemographic data. Results The depression scores of pregnant and non-pregnant women were similar (p = 0.846). We found that the depression scores were significantly higher among the group of participants who have lower economic status (p = 0.046). Moreover, the depression score was significantly higher among women who lost their income during the pandemic (p = 0.027). The score on the ASEX was significantly higher, and sexual dysfunction was more prevalent among women who have lower levels of schooling and income (p < 0.05). Likewise, the ASEX scores were significantly higher (p = 0.019) among the group who experienced greater income loss throughout the pandemic. Upon comparing the pregnant and non-pregnant groups, we detected that sexual dysfunction had a significantly higher rate among pregnant women (p < 0.001). Conclusion In times of global crisis, such as the current pandemic, low-income families have an increased risk of experiencing depression and sexual dysfunction. When we compared pregnant women with non-pregnant women, depression scores were similar, but pregnant women were at a 6.2 times higher risk of developing sexual dysfunction.

Resumo Objetivo Investigar a depressão e as funções sexuais de mulheres grávidas e não grávidas durante a pandemia de Covid-19. Métodos Um total de 188 mulheres, 96 grávidas e 92 não grávidas, foram incluídas. O Inventário de Depressão de Beck (Beck Depression Inventory, BDI, em inglês) e a Escala de Experiências Sexuais do Arizona (Arizona Sexual Experience Scale, ASEX, em inglês) foram aplicados aos participantes após a obtenção dos dados sociodemográficos. Resultados As pontuações de depressão de mulheres grávidas e não grávidas foram semelhantes (p = 0,846). Verificou-se que as pontuações de depressão foram significativamente maiores no grupo de participantes de menor nível econômico (p = 0,046). Além disso, a pontuação de depressão foi significativamente maior em mulheres que perderam sua renda durante a pandemia (p = 0,027). A pontuação na ASEX foi significativamente maior, e a disfunção sexual foi mais prevalente em pessoas com menores escolaridade e nível de renda (p < 0,05). Da mesma forma, as pontuações na ASEX foram significativamente mais altas (p = 0,019) no grupo que experimentou maior perda de renda durante a pandemia. Ao comparar os grupos de gestantes e não gestantes, detectou-se que a disfunção sexual apresentava índice significativamente Conclusão Em tempos de crise global, como a atual pandemia, famílias de baixa renda têm um risco maior de sofrer depressão e disfunção sexual. Quando comparamos mulheres grávidas e mulheres não grávidas, as pontuações de depressão foram semelhantes, mas as mulheres grávidas apresentaram um risco 6,2 vezes maior de desenvolver disfunção sexual.

Prevalencia y caracterización de disfunciones sexuales masculinas en el personal de la Unidad Académica de Salud y Bienestar de la Universidad Católica de Cuenca, año 2019 / Prevalence and characterization of male sexual dysfunctions in the staff of the Academic Unit of Health and Welfare of the Catholic University of Cuenca, 2019

Objetivo: determinar la prevalencia y caracterizar la disfunción sexual masculina en el personal docente y administrativo de la Unidad Académica de Salud y Bienestar de la Universidad Católica de Cuenca en el 2019. Metodología: estudio cuantitativo, observacional y transversal. Se encuestaron a 114 varones que cumplieron los criterios de inclusión. El análisis se realizó mediante estadística descriptiva, para variables cuantitativas se empleó media y desviación estándar y para las cualitativas frecuencias y porcentajes. Resultados: la prevalencia de disfunciones sexuales masculinas fue de 75.4%. Un 60.5% tuvieron edades entre 20 a 39 años, 60.5% estaban casados, 87.2% religión católica, 67.4% eran docentes. Según trastornos del deseo, el 27.9% presentó hiperactividad masculina, el 18.6% fobia y un 9.3% hipoactividad; según los trastornos de excitación, el 53.5% presentó disfunción eréctil, siendo un 93.5% leve. El trastorno orgásmico y la dispareunia masculina se presentó en el 30.2% y el 29.1% respectivamente. Conclusiones: la prevalencia de disfunciones sexuales fue elevada en comparación con la bibliografía consultada

Objective: to determine the prevalence and characterize male sexual dysfunction in the teaching and administrative staff of the Academic Unit of Health and Welfare of the Catholic University of Cuenca in 2019. Methodology: It is a quantitative, observational and cross-sectional study. A total of 114 men who met the inclusion criteria were surveyed. The analysis was performed using descriptive statistics; mean and standard deviation were used for quantitative variables, and frequencies and percentages for the qualitative variables. Results: the prevalence of male sexual dysfunctions was 75.4%. The 60.5% were between 20 and 39 years old, 60.5% were married, 87.2% were Catholic, and 67.4% were teachers. According to desire disorders, 27.9% presented male hyperactivity, 18.6% phobia and 9.3% hypoactivity; according to arousal disorders, 53.5% presented erectile dysfunction, 93.5% being mild. Orgasmic disorder and male dyspareunia occurred in 30.2% and 29.1% respectively. Conclusions: the prevalence of sexual dysfunctions was high compared to the literature consulted

Evaluation of obesity influence in the sexual function of postmenopausal women: A cross- sectional study / Avaliação da influência da obesidade na função sexual de mulheres após a menopausa: um estudo transversal

Abstract Objective The incidence of obesity, which is a chronic condition, has increased in recent years. The association between obesity and female sexual dysfunction remains unclear, particularly in postmenopausal women. In the present study, we evaluated whether obesity is a risk factor for sexual dysfunction in postmenopausal women. Methods This is a cross-sectional study that analyzed data from interviews of postmenopausal women at the Climacteric Outpatient Clinic from 2015 to 2018. After applying the inclusion and exclusion criteria, 221 women aged between 40 and 65 years old were selected and invited to participate in the study. Obesity was diagnosed according to body mass index (BMI). The participants were grouped into the following BMI categories: group 1, 18.5-24.9 kg/m2 (normal); group 2, 25.0- 29.9 kg/m2 (overweight); and group 3, ≥30.0 kg/m2 (obese). Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire. Cutoff points of ≥23 and ≥26.5 were adopted to define a diagnosis of female sexual dysfunction (FSD) based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision by the American Psychiatric Association (DSM-IV-TR). Results The desire and arousal scores were statistically higher in the normal BMI group than in the obese group (p=0.028 and p=0.043, respectively). The satisfaction scores were statistically higher in the normal BMI group than in the overweight and obese groups (p<0.05). The total FSFI score statistically differed among the BMI categories (p=0.027). Conclusion In the present study, obese and overweight postmenopausal women had higher total scores than women with normal BMI. Our results show that obese and overweight postmenopausal women had a higher index of dysfunction in desire and arousal and lower sexual satisfaction than normal-weight women.

Resumo Objetivo A incidência de obesidade, que é uma condição crônica, aumentou nos últimos anos. A associação entre obesidade e disfunção sexual feminina ainda não está clara, particularmente emmulheres após amenopausa. No presente estudo, avaliamos se a obesidade é um fator de risco para disfunção sexual em mulheres após a menopausa. Métodos Este é umestudo transversal que analisou dados de entrevistas demulheres após a menopausa no Ambulatório de Climatério a partir de 2015 até 2018. Após a aplicação dos critérios de inclusão e exclusão, 221 mulheres com idade entre 40 e 65 anos foram selecionadas e convidadas a participar do estudo. Obesidade foi diagnosticada de acordo com o índice de massa corpórea (IMC). Os participantes foram agrupados nas seguintes categorias de IMC: grupo 1: 18,5-24,9 kg/m2 (normal); grupo 2: 25,0-29,9 kg/m2 (sobrepeso); e grupo 3: ≥30,0 kg/m2 (obesidade). A função sexual foi avaliada através do questionário Female Sexual Function Index (FSFI, na sigla em inglês). Pontos de corte de ≥23 e ≥26,5 foram adotados para definir um diagnóstico de disfunção sexual feminina (DSF) com base no Manual de Diagnóstico e Estatística das Perturbações Mentais, 4ª Edição, Texto Revisto DSM-IV-TR. Resultados Os escores de desejo e excitação foram estatisticamente maiores no grupo com IMC normal do que no grupo obesidade (p=0,028 e p=0,043, respectivamente). Os escores de satisfação foram estatisticamente maiores no grupo com IMC normal do que nos grupos comsobrepeso e obesidade (p<0,05). A pontuação total do FSFI diferiu estatisticamente entre as categorias de IMC (p=0,027). Conclusão No presente estudo,mulheres após a menopausa obesas e com sobrepeso tiveram escores totais mais altos do que mulheres com IMC normal. Nossos resultados mostram que mulheres obesas e com sobrepeso após a menopausa apresentaram índices mais altos de disfunção no desejo e excitação e menor satisfação sexual do que mulheres com peso normal.

Evaluation of the occurrence of sexual dysfunction and general quality of life in female patients with psoriasis

Abstract: Background: Psoriasis has a significant impact on quality of life (QoL). Sexual life can also be affected, with sexual dysfunction being reported by 25-70% of patients. Objectives: To determine the occurrence of sexual dysfunction and evaluate QoL in women with psoriasis. Methods: This case-control study included women aged 18-69 years. The validated Brazilian Portuguese versions of the Female Sexual Function Index (FSFI) and of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were administered to all participants to assess sexual function and QoL, respectively. Patients with psoriasis underwent clinical evaluation for the presence of comorbidities, especially psoriatic arthritis and other rheumatic manifestations. Location of lesions and the extent of skin involvement were also assessed. Results: The sample consisted of 150 women, 75 with diagnosis of psoriasis and 75 healthy controls. Prevalence of sexual dysfunction was high in women with psoriasis (58.6% of the sample). Prevalence was statistically higher in women with psoriasis than in controls (P = 0.014). The SF-36 domain scores were also lower in women with psoriasis, with role limitations due to physical health, limitations due to emotional problems, and mental health being the most affected domains. Study limitations: Sample size was calculated to evaluate the association between the occurrence of sexual dysfunction and psoriasis, but it did not include the determination of the possible causes of this dysfunction. Conclusions: QoL and sexual function were altered in women with psoriasis and should be taken into consideration when assessing disease severity.

Personality traits of postmenopausal women with sexual dysfunction / Características de personalidade de mulheres na pós-menopausa com disfunção sexual

Abstract Objective The aim of the present study is to identify the association between personality traits of postmenopausal women and the occurrence of sexual dysfunction. Methods A total of 43 postmenopausal women were evaluated according to their self-perception of the quality of their sexual life. They answered the following questionnaires: Sociodemographic Profile Questionnaire, Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI) and Factorial Personality Inventory (FPI-II). Results Women with poorer sexual self-perception showed low affective need (p< 0.01) and low need for organization (p< 0.01). Based on the need for control and opposition, there was no difference between the groups. Groups separated by the scores obtained on the FSFI showed no significant differences. Conclusion Postmenopausal women with lower schooling and personality characteristics that demonstrate low affective and organizational needs are more likely to present sexual dysfunction.

Resumo Objetivo O objetivo do presente estudo foi identificar a associação entre características de personalidade de mulheres na pós-menopausa e ocorrência de disfunção sexual. Método No total, 43 mulheres na pós-menopausa foram avaliadas de acordo com suas percepções da qualidade de suas vidas sexuais. Elas responderam aos seguintes questionários: Perfil Sociodemográfico, Índice de Função Sexual Feminino (FSFI, na sigla em inglês), Inventário de Depressão Beck (BDI, na sigla em inglês) e Inventário Fatorial de Personalidade (IFP-II). Resultados Mulheres com pior percepção sexual demonstraram baixa necessidade afetiva (p< 0,01) e baixa necessidade de organização (p< 0,01). Com base na necessidade de controle e oposição, não houve diferença entre os grupos. Os grupos de mulheres separadas pelo FSFI não demonstraram diferenças significativas. Conclusão Mulheres na pós-menopausa com menor escolaridade e características de personalidade que demonstre baixa necessidade afetiva e de organização possuem maior chance de apresentar disfunção sexual.

Sexual function of undergraduate women: a comparative study between Brazil and Italy / La función sexual de universitarias: estudio comparativo entre Brasil e Italia / Função sexual de universitárias: estudo comparativo entre Brasil e Itália

ABSTRACT Objective: to evaluate the sexual function of Italian and Brazilian nursing students using the Female Sexual Function Index (FSFI), to estimate the prevalence of sexual dysfunctions and related factors. Method: this is a cross-sectional study involving 84 Brazilian and 128 Italian undergraduate. For the evaluation of sexual function, the Female Sexual Function Index (FSFI) questionnaire was used. Results: Italian women presented significantly higher sexual dysfunction index (n=78/60.9%) than the Brazilian women (n=32/38.1%) (p=0.00). Only the "desire" and "excitation" domains showed no difference between groups. Younger, single and without a steady relationship women had a higher rate of sexual dysfunction (p<0.05). Conclusion: the high rate of sexual dysfunction in a young public suggests the need for more research to increase knowledge about the influence of psychosocial and related factors on female sexual function, directing care towards the promotion of sexual and reproductive health.

RESUMEN Objetivo: evaluar la función sexual de académicas italianas y brasileñas de enfermería utilizando el Female Sexual Function Index (FSFI), estimar el predominio de las disfunciones sexuales y los factores relacionados. Método: estudio transversal, de lo cual participaron 212 universitarias, siendo 84 brasileñas y 128 italianas. Para evaluar la función sexual, se utilizó el cuestionario Female Sexual Function Index(FSFI). Resultados: Las italianas presentaron índice de disfunción sexual significativamente superior (n=78/60,9%) en comparación con el de las brasileñas (n=32/38,1%) (p=0,00). Sólo los dominios "deseo" y "excitación" no presentaron diferencia entre los grupos. Las mujeres más jóvenes, solteras y sin relación estable presentaron un índice de disfunción sexual más alto (p<0,05). Conclusión: el elevado índice de disfunción sexual en un público tan joven sugiere la necesidad de realizar más investigaciones que incrementen el conocimiento sobre la influencia de los factores psicosociales y relacionales en la función sexual femenina, dirigiendo el cuidado para la promoción de la salud sexual y reproductiva.

RESUMO Objetivo: avaliar a função sexual de acadêmicas de enfermagem italianas e brasileiras utilizando o Female Sexual Function Index (FSFI), estimar a prevalência das disfunções sexuais e os fatores relacionados. Método: estudo transversal, o qual participaram 212 universitárias, sendo 84 brasileiras e 128 italianas. Para a avaliação da função sexual, empregou-se o questionário Female Sexual Function Index (FSFI). Resultados: As italianas apresentaram índice de disfunção sexual significativamente superior (n=78/60,9%) do que as brasileiras (n=32/38,1%) (p=0,00). Apenas os domínios "desejo" e "excitação" não apresentaram diferença entre os grupos. As mulheres mais jovens, solteiras e sem relacionamento estável apresentaram índice de disfunção sexual maior (p<0,05). Conclusão: o elevado índice de disfunção sexual em um público tão jovem sugere a necessidade da realização de mais investigações que incrementem o conhecimento sobre a influência dos fatores psicossociais e relacionais na função sexual feminina, direcionando o cuidado para a promoção da saúde sexual e reprodutiva.

Sexual function, anxiety and depression in women with benign breast disease. A case-control study / Disfunção sexual, ansiedade e depressão em mulheres com câncer de mama benigno. Um estudo de caso-controle

Summary Introduction: Sexual dysfunction is highly prevalent, affecting 40% of the female population. The incidence of such dysfunction is known to be higher among women with malignant breast disease and in patients with depression or anxiety. However, there are few data regarding the prevalence of sexual dysfunction among women with benign breast disease (BBD). Objective: To evaluate the incidence of sexual dysfunction, depression and anxiety among women with BBD, in comparison with that observed for healthy women. Method: We evaluated the incidence of sexual dysfunction in 60 patients with benign breast disease (fibroadenomas, breast cysts, breast pain and phyllodes tumor) and 69 healthy women (control group). Participants completed the Sexual Quotient Questionnaire for Females (SQQ-F), the Beck Depression Inventory and the Beck Anxiety Inventory. Statistical analysis revealed that depression and anxiety were comparable between BBD and control groups (10.3 vs. 20.3% and 38.7 vs. 34.3%, respectively, p>0.05). The mean SQQ-F score (65.6±22.7 vs. 70.1±16.8; p>0.05) and sexual dysfunction (33.3 vs. 25.4%; p=0.324) were similar between BBD and control groups. Conclusion: We found no differences between women with BBD and healthy women in terms of the incidence of sexual dysfunction, anxiety and depression. Nevertheless, given the high prevalence of this condition, it is important to assess sexual quality of life, as well as overall quality of life, in women with BBD.

Resumo Introdução: A disfunção sexual é altamente prevalente, afetando 40% da população feminina. A incidência de tal disfunção é conhecida por ser maior entre as mulheres com câncer de mama e pacientes com ansiedade e depressão. No entanto, existem poucos dados sobre a prevalência de disfunção sexual entre mulheres com doença benigna da mama (BBD). Objetivo: Avaliar a incidência de disfunção sexual, depressão e ansiedade em mulheres com BBD, em comparação a mulheres saudáveis. Método: Avaliamos a incidência de disfunção sexual em 60 pacientes com doença benigna da mama (fibroadenomas, cistos mamários, dor mamária e tumor phyllodes) e 69 mulheres saudáveis (grupo controle). As participantes completaram o Questionário de Quociente Sexual para Mulheres (SQQ-F), o Inventário de Depressão de Beck e o Inventário de Ansiedade de Beck. A análise estatística revelou que a depressão e a ansiedade eram comparáveis entre os grupos BBD e controle (10,3 vs. 20,3% e 38,7 vs. 34,3%, respectivamente, p>0,05). O escore médio de SQQ-F (65,6±22,7 vs. 70,1±16,8; p>0,05) e a disfunção sexual (33,3 vs. 25,4%; p=0,324) foram semelhantes entre os grupos BBD e controle. Conclusão: Não encontramos diferenças entre mulheres com BBD e mulheres saudáveis em termos de incidência de disfunção sexual, ansiedade e depressão. No entanto, dada a alta prevalência dessa condição, é importante avaliar a qualidade de vida sexual, bem como a qualidade de vida global, em mulheres com BBD.

Sexual dysfunction in females with depression: a cross-sectional study / Disfunção sexual em mulheres com depressão: um estudo transversal

Abstract Introduction Female sexual dysfunction (FSD) in depression albeit common is strikingly understudied. The condition, if addressed properly, can be readily cured, improving the quality of life of the patient. Methods A consecutive sample of drug-naïve married female patients with depression was assessed. Depression was diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D), and sexual dysfunction, the Female Sexual Function Index (FSFI). Results Sexual dysfunction was found in 90% of the patients in our study. Patients with medical comorbidities showed a significant decrease in the desire subset of the FSFI (Mann-Whitney U=11.0, p=0.009), however there was no significant association with other subsets. Patients who expressed passive death wishes had higher scores on all indicators of sexual function and a significantly higher score in the orgasm subset of the FSFI (Mann-Whitney U=11.0, p=0.009). Conclusion The study showed a high prevalence of FSD in depressed females regardless of type and severity of depression. Depression with medical comorbidities was associated with a significant decrease in desire. Patients who expressed passive death wishes showed improved sexual function and significantly better orgasm.

Resumo Introdução Disfunção sexual feminina (DSF) na depressão, apesar de comum, é pouco estudada. Se tratada adequadamente, a condição pode ser prontamente curada, aumentando a qualidade de vida da paciente. Métodos Foi avaliada uma amostra consecutiva de mulheres casadas, virgens de tratamento, com depressão. A depressão foi diagnosticada utilizando a Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). A gravidade da depressão foi avaliada utilizando a Escala de Avaliação de Depressão de Hamilton (HAM-D), e a disfunção sexual, com o Índice da Função Sexual Feminina (Female Sexual Function Index, FSFI). Resultados Foi observada disfunção sexual em 90% das pacientes do estudo. As pacientes com comorbidades médicas mostraram uma diminuição significativa no subdomínio desejo da FSFI (Mann-Whitney U=11,0, p=0,009), porém não houve associação significativa com os outros subdomínios. Pacientes que expressaram desejos passivos de morte apresentaram escores mais altos em todos os indicadores de função sexual e um escore significativamente mais alto no subdomínio orgasmo da FSFI (Mann-Whitney U=11,0, p=0,009). Conclusão O estudo revelou uma alta prevalência de DSF em mulheres deprimidas, independentemente do tipo e da severidade da depressão. A depressão com comorbidades médicas foi associada a uma diminuição significativa do desejo. Pacientes que expressaram desejos passivos de morte mostraram função sexual melhor e orgasmo significativamente melhor.

Analysis of sexual function of patients with dermatomyositis and polymyositis through self-administered questionnaires: a cross-sectional study / Análise da função sexual de pacientes com dermatomiosite e polimiosite através de questionários autoaplicados: um estudo transversal

Abstract Introduction: To date, there are no descriptions in the literature on gynecologic and sexual function evaluation in female patients with dermatomyositis (DM) and polymyositis (PM). Objective: To assess sexual function in female patients with DM/PM. Patients and methods: This is a monocentric, cross-sectional study in which 23 patients (16 DM and 7 PM), with ages between 18 and 40 years, were compared to 23 healthy women of the same age group. Characteristics on sexual function were obtained by applying the questionnaires Female Sexual Quotient (FSQ) and Female Sexual Function Index (FSFI) validated for the Brazilian Portuguese language. Results: The mean age of patients was comparable to controls (32.7 ± 5.3 vs. 31.7 ± 6.7 years), as well as the distribution of ethnicity and socioeconomic class. As for gynecological characteristics, patients and healthy controls did not differ with respect to age at menarche and percentages of dysmenorrhea, menorrhagia, premenstrual syndrome, pain at mid-cycle, mucocervical secretion, and vaginal discharge. The FSQ score, as well as all domains of the FSFI questionnaire (desire, arousal, lubrication, orgasm and satisfaction), were significantly decreased in patients vs. controls, with 60.9% of patients showing some degree of sexual dysfunction. Conclusions: This was the first study to identify sexual dysfunction in patients with DM/PM. Therefore, a multidisciplinary approach is essential for patients with idiopathic inflammatory myopathies, in order to provide prevention and care for their sexual life, providing a better quality of life, both for patients and their partners.

Resumo Introdução: Até o presente momento, não há descrições na literatura da avaliação ginecológica e da função sexual em pacientes do sexo feminino com dermatomiosite (DM) e polimiosite (PM). Objetivos: Avaliar a função sexual em pacientes do sexo feminino com DM/PM. Casuística e métodos: Estudo transversal unicêntrico em que 23 pacientes (16 DM e sete PM), entre 18 e 40 anos, foram comparadas com 23 mulheres saudáveis, com a mesma faixa etária. As características sobre a função sexual foram obtidas por meio da aplicação dos questionários Female Sexual Quotient (FSQ) e Female Sexual Function Index (FSFI) validados para a língua portuguesa do Brasil. Resultados: A média de idade das pacientes foi comparável à dos controles (32,7 ± 5,3 vs. 31,7 ± 6,7 anos), assim como a distribuição de etnia e da classe socioeconômica. Quanto às características ginecológicas, pacientes e controles saudáveis não apresentaram diferenças em relação à idade na menarca e às porcentagens de dismenorreia, menorragia, síndrome pré-menstrual, dor no meio do ciclo, secreção mucocervical e corrimento vaginal. O escore de pontuação do FSQ, assim como todos os domínios do questionário do FSFI (desejo, excitação, lubrificação, orgasmo e satisfação), estavam significantemente diminuídos nas pacientes comparativamente com os controles, 60,9% das pacientes apresentavam algum grau de disfunção sexual. Conclusões: Este foi o primeiro estudo que identificou disfunção sexual nas pacientes com DM/PM. Assim, uma abordagem multidisciplinar é essencial para pacientes com miopatias inflamatórias idiopáticas para fornecer medidas de prevenção e cuidados para sua vida sexual e propiciar uma melhor qualidade de vida das pacientes e de seus parceiros.

Prevalencia y factores de riesgo de la disfunción sexual femenina: revisión sistemática / Prevalence and risk factors of female sexual dysfunction: a systematic review

ANTECEDENTES: La disfunción sexual femenina (DSF) se define como un trastorno en el deseo, excitación, orgasmo y/o dolor durante la relación sexual, que genera estrés personal y tiene impacto en la calidad de vida. OBJETIVO: Analizar datos epidemiológicos sobre prevalencia y factores de riesgo de DSF que permita disponer de un conocimiento unificado sobre estos. MÉTODOS: Se revisaron bases de datos: PubMed y LILACS, entre el 01/01/2004 al 12/10/2014. Se incluyeron estudios de corte transversal que garantizaran los datos de prevalencia y de frecuencia de factores de riesgo. Se evaluó la calidad metodológica utilizando los criterios del STROBE (Strengthening the Reporting of Observational Studies in Epidemiology); se publicaron los resultados en tablas, reportando prevalencia y factores de riesgo con sus respectivos OR. RESULTADOS: Se incluyeron quince artículos, todos cumplieron con más del 70% de los ítems evaluados por el STROBE. La prevalencia de DSF se encontró entre 5,5 - 73,2%. El dominio más afectado fue el deseo, con prevalencias entre 10,4% - 52%. Al combinar los datos las variables asociadas a la presencia de DSF fueron: baja frecuencia de relaciones, edad >40 años, bajo nivel educativo, posmenopausia, pareja con disfunción eréctil, entre otros. CONCLUSIÓN: La DSF posee una alta prevalencia a nivel mundial; la presencia de los múltiples factores de riesgo que presentan las mujeres son motivo de estudio exhaustivo. Un mejor entendimiento de la epidemiologia es vital para planear estrategias de prevención y esquemas de tratamientos efectivos.

BACKGROUND: Female sexual dysfunction (FSD) is defined as a disorder in desire, arousal, orgasm and / or pain during intercourse, which generates personal stress and impacts the quality of life. AIMS: The objective of this review is to analyze epidemiological data on prevalence and risk factors of FSD to provide a unified knowledge. METHOD: Databases such as PubMed and LILACS were reviewed, from January first of 2004 to October twelve of 2014; cross-sectional studies that ensured information about prevalence and frequen-cy of risk factors were included. Methodological quality was assessed using the criteria of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology); the results were published in ta-bles, reporting prevalence and risk factors with their respective OR. RESULTS: Fifteen items were included, all met over 70% of the items evaluated by the STROBE. The prevalence of FSD was found between 5.5 to 73.2%. The most affected domain was the desire with a prevalence between 10.4% - 52%. The variables associated with the presence of FSD were: low frequency of intercourse, age> 40 years, low education level, menopause, couples with erectile dysfunction (ED), among others. CONCLUSION: The FSD has a high prevalence worldwide; the múltiple risk factors presented by women require further study, because a better understanding of the epidemiology is vital for planning prevention strategies and effective treatment regimens.

Disfunção sexual: avaliação de mulheres durante o terceiro trimestre gestacional / Sexual dysfunction: evaluation of women during the third trimester of gestation

INTRODUÇÃO: Disfunção sexual (DS) é caracterizada pela falta, excesso, desconforto e/ou dor no desenvolvimento do ciclo da resposta sexual, se manifestando de forma persistente ou recorrente. OBJETIVO: Determinar a prevalência das disfunções sexuais femininas em gestantes de baixo risco no terceiro trimestre e verificar sua associação com fatores de risco. MÉTODOS: É um estudo transversal composto por 102 gestantes de baixo risco durante o terceiro trimestre gestacional e com vida sexual ativa, que estiveram em acompanhamento nos postos de saúde das cidades de Petrolina (PE) e Juazeiro (BA) entre setembro de 2013 e março de 2014. Para isso, utilizou-se uma ficha de dados pessoais, com características sociodemográficas e clínicas e o questionário Female Sexual Function Index (FSFI). Foram calculadas prevalências e possíveis associações por meio do teste χ2. Em todas as análises foi adotado o nível de significância de p<0,05. Intervalos de confiança (IC95%), quando determinados, foram exatos. RESULTADOS: Do total da amostra, 45,1% apresentaram disfunção sexual com taxa média de função sexual feminina de 26,15. Os menores escores de domínios foram em desejo e excitação. Ocorreu ainda associação de disfunção sexual com paridade. CONCLUSÃO: O presente estudo evidenciou uma taxa moderada de mulheres com disfunção sexual no terceiro trimestre gestacional, mostrando uma diminuição significativa em todos os domínios do FSFI. Além disso, constatou-se diferença estatisticamente significativa na associação de disfunção sexual com a variável paridade. Contudo, não foi encontrada diferença significativa na disfunção sexual com a variável idade, índice de massa corpórea, escolaridade e renda familiar.

INTRODUCTION: Sexual dysfunction is characterized by lack, excess, discomfort and/or pain in the development of the sexual response cycle, manifesting persistent or in recurring basis. OBJECTIVE: To determine the prevalence of female sexual dysfunctions in low risk pregnant women in the third quarterand its association with risk factors. METHODS: A cross-sectional study comprising 102 women with low risk pregnancy during the third trimester of pregnancy and sexually active, who had been monitored in the health centers of the cities of Petrolina (PE) and Juazeiro (BA), Brazil, between September, 2013 and March, 2014. To do so it was used the Personal Data Sheets with the members' demographic and clinical characteristics and the Female Sexual Function Index questionnaire (FSFI). The prevalence and possible associations using χ2 test were calculated. In all analysis, it was used a significance level of p<0.05. Confidence intervals (95%CI) when determined were accurate. RESULTS: Of the total sample, 45.1% reported sexual dysfunction with an average rate of female sexual function 26.15%. The lowest scores were in the areas of desire and arousal. The association of sexual dysfunction with parity also occurred. CONCLUSION: The present study demonstrated a moderate rate of women with sexual dysfunctions in the third gestational quarter, highlighting significant decrease in all FSFIdomains. Furthermore, it was verified significant statistical difference in the association of sexual dysfunctions with the parity variable. However, it was not found significant difference on sexual dysfunctions with age, body mass index, schooling and family income variables.

Sexual function in women in rural Tamil Nadu: Disease, dysfunction, distress and norms.

Background. We examined the nature, prevalence and explanatory models of sexual concerns and dysfunction among women in rural Tamil Nadu. Methods. Married women between 18 and 65 years of age, from randomly selected villages in Kaniyambadi block, Vellore district, Tamil Nadu, were chosen by stratified sampling technique. Sexual functioning was assessed using the Female Sexual Function Index (FSFI). The modified Short Explanatory Model Interview (SEMI) was used to assess beliefs about sexual concerns and the General Health Questionnaire-12 (GHQ- 12) was used to screen for common mental disorders. Sociodemographic variables and other risk factors were also assessed. Results. Most of the women (277; 98.2%) contacted agreed to participate in the study. The prevalence of sexual dysfunction, based on the cut-off score on the FSFI, was 64.3%. However, only a minority of women considered it a problem (4.7%), expressed dissatisfaction (5.8%) or sought medical help (2.5%). The most common explanatory models offered for sexual problems included an unhappy marriage, stress and physical problems. Factors associated with lower FSFI included older age, illiteracy, as well as medical illness and sexual and marital factors such as menopause, poor quality of marital relationship, history of physical abuse and lack of privacy. Conclusion. The diagnosis of female sexual dysfunction needs to be nuanced and based on the broader personal and social context. Our findings argue that there is a need to use models that employ personal, local and contextual standards in assessing complex behaviours such as sexual function.

Factores biopsicosociales asociados a la disfunción sexual femenina en una población mexicana / Biopsychosocial factors associated with female sexual dysfunction in a mexican population

Objetivo: Determinar los factores biopsicosociales asociados a la disfunción sexual femenina en una población mexicana. Métodos: Estudio comparativo en mujeres que acudieron como acompañantes a una Unidad de Medicina Familiar de Querétaro, México. Se aplicaron las encuestas de Laumman, Chávez y Velazco, Faces III, y Grajales para valorar sexualidad, funcionalidad conyugal, funcionalidad familiar y estado de la autoestima. Los resultados fueron analizados con Odds Ratios, Chi cuadrado y t de Student. Resultados: De 110 mujeres entrevistadas, 65 (59 por ciento) refirieron alguna disfunción sexual y 45 (41 por ciento) lo negaron. Se formaron aleatoriamente dos grupos de 44 mujeres: con y sin disfunción sexual. Los factores que se asociaron significativamente a las alteraciones sexuales fueron: edad mayor a 40 años, laborar fuera del hogar, presencia de obesidad y/o sobrepeso, hipertensión arterial, diabetes mellitus, histerectomía previa, maternidad, disfuncionalidad conyugal, autoestima alta, depresión leve a severa, familia disfuncional, estrato socioeconómico bajo. Las alteraciones sexuales más frecuentes fueron: disminución en el deseo sexual (34,1 por ciento), disfunción eréctil de la pareja (22,7 por ciento), dispareunia y falta de excitación (20,5 por ciento), sexo referido como desagradable e incapacidad para llegar al orgasmo (13,6 por ciento), ansiedad por el desempeño sexual (6,8 por ciento) y eyaculación precoz (4,5 por ciento). Conclusiones: Es importante identificar los factores que afectan la sexualidad femenina para ofrecer un manejo multidisciplinario y prevenir implicaciones a nivel del entorno familiar y conyugal.

Objective: To determine the biopsychosocial factors associated with female sexual dysfunction in a Mexican population. Methods: A comparative study in women who were attended at a Family Medicine Unit of Queretaro, Mexico. Surveys of Laumman, Chavez and Velazco, Faces III, and Grajales, were applied to assess sexuality, marital functionality, familiar functionality and state self-esteem. The results were analyzed with Odds Ratios, chi-square and Student t test. Results: Of 110 women interviewed, 65 (59 percent) reported sexual dysfunction and 45 (41 percent) denied. They formed two groups randomly from 44 women with and without sexual dysfunction. Factors that were significantly associated with sexual disorders were: age greater than 40 years, labor outside the home, presence of obesity and/or overweight, hypertension, diabetes mellitus, prior hysterectomy, maternity, marital dysfunction, high self-esteem, mild to severe depression, dysfunctional family, low socioeconomic status. The most common sexual dysfunction were: decrease in sexual desire (34.1 percent), erectile dysfunction couples (22.7 percent), dyspareunia and lack of arousal (20.5 percent), referred to as unpleasant sex and inability to reach orgasm 13.6 percent) sexual performance anxiety (6.8 percent) and premature ejaculation (4.5 percent). Conclusions: It is important to identify the factors affecting female sexuality to offer multidisciplinary management and prevention implications at the level of family and marital environment.

Índice de función sexual en trabajadoras de la salud / Sexual function index in health workers

Objetivo: Determinar la función sexual femenina de trabajadoras de la salud. Método: Estudio cuantitativo, descriptivo, transversal. Universo formado por mujeres que se desempeñan en un hospital de alta complejidad, cuyas edades fluctúan entre 20 a 64 años. Se caracterizó el perfil biosociodemográfico de la trabajadora junto al Índice de Función Sexual Femenina (IFSF). El análisis estadístico se realizó aplicando análisis univariados y bivariados, coeficiente de correlación de Pearson o Spearman y análisis de varianza. Resultados: El puntaje del IFSF logra su máxima expresión alrededor de los 35 a 39 años (29,7 +/- 4,9) y luego disminuye progresivamente (23,0 +/- 8,9). Se observa un 32,6 por ciento de disfunción sexual, 29 por ciento de desorden del deseo, 10,4 por ciento de dificultades de excitación, 5,6 por ciento de problemas de lubricación, 9,7 por ciento de desorden en el orgasmo, 14 por ciento de problemas de satisfacción sexual y 9,9 por ciento de dispareunia. Conclusiones: El IFSF en trabajadoras de la salud varió en concordancia con la edad, menopausia, educación y problemas de sexualidad en la pareja. El estamento auxiliar de servicio alcanzó mayores índices de disfunción sexual.

Objective: To determine the female sexual function of health workers. Method: quantitative, descriptive, cross-sectional study. The universe is made by women who work in a high complexity hospital, ranging from 20 to 64 years old. The biosociodemographic profile of the worker was characterized by the Female Sexual Function Index (FSFI). Statistical analysis was performed using univariate and bivariate analysis. Pearson or Spearman correlation coefficient was used and analysis of variance was applied. Results: The FSFI score achieved its best around 35-39 years (29.7 +/- 4.9) and then it decreases progressively (23.0 +/- 8.9). It shows 32.6 percent of sexual dysfunction, 29 percent of desire disorder, 10.4 percent of arousal difficulties, 5.6 percent of lubrication problems, 9.7 percent of orgasm disorder, 14 percent of problems of sexual satisfaction and 9.9 percent of dyspareunia. Conclusions: The FSFI in health female workers vary in accordance with age, menopause, education and sexual problems in couples. The auxiliary service establishment reached higher rates of sexual dysfunction.

The prevalence of sexual dysfunction among patients with end stage renal disease in Jamaica / Prevalencia de la disfunción sexual entre los pacientes con enfermedad renal en etapa terminal en Jamaica

BACKGROUND: Sexual performance and gratification impact quality of life. Although recognized in the literature as a problem, sexual dysfunction among patients with end stage renal disease (ESRD) has never been studied in Jamaica. SUBJECTS AND METHOD: The prevalence ofsexual dysfunction was determined among 268 adult Jamaican patients (166 males, 102 females) with ESRD who had been on haemodialysis for at least three months. Erectile dysfunction (ED) was assessed using the International Index of Erectile Function (IIEF). Female sexual dysfunction (FSD) was determined using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases (ICD)-10 classifications of sexual disorders. Prevalence, severity of sexual dysfunctions and relationships with the primary aetiology ofESRD and anaemia were assessed. RESULTS: Erectile dysfunction, desire disorder and orgasmic disorder were found in 91.4%, 88.3%, and 81.6% of male subjects, respectively. The majority of male patients were dissatisfied with their performance at intercourse after progressing to ESRD. Hypoactive sexual disorder, sexual arousal and orgasmic disorders, and aversion sexual disorder were prevalent, found in 96%, 88.1% and 87.1% of female patients. All diabetic patients with ESRD reported hypoactive sexual disorder and orgasmic dysfunction; arousal disorder was found in 94.7%. Aversion sexual disorder was found more among patients with underlying chronic glomerulonephritis. All patients with severe anaemia were found to have hypoactive sexual disorder and among these, 87.5% and 97.8% had severe arousal and orgasmic disorders, respectively. CONCLUSION: Sexual dysfunction among patients with ESRD in Jamaica was prevalent in males and females. Associations exist between sexual dysfunction and diabetes mellitus, chronic glomerulonephritis and anaemia.

ANTECEDENTES: El funcionamiento y la satisfacción sexual afectan la calidad de vida. Aunque la literatura la reconoce como un problema, la disfunción sexual entre los pacientes con enfermedad renal en etapa terminal (ERET) nunca se ha estudiado en Jamaica. SUJETOS Y MÉTODOS: Se determinó la prevalencia de la disfunción sexual entre 268pacientes jamaicanos adultos (166 varones y 102 hembras) con ERET, que habían estado en hemodiálisis por al menos tres meses. La disfunción eréctil (DE) fue evaluada mediante el índice internacional de función eréctil (IIFE). La disfunción sexual femenina (DSF) se determinó usando el Manual diagnóstico y estadístico de trastornos mentales, cuarta edición (DSM-IV) y las clasificaciones de trastornos sexuales en la Clasificación internacional de enfermedades (CIE)-10. Se evaluaron laprevalencia, la gravedad de las disfunciones sexuales y las relaciones con la principal etiología de ERETy la anemia. RESULTADOS: Se halló disfunción eréctil, trastorno de deseo, y trastorno orgásmico en 91.4%, 88.3% y 81.6% de los sujetos masculinos, respectivamente. La mayoría de los pacientes masculinos estaban insatisfechos con su desempeño en las relaciones sexuales después del avance de ERET. Trastornos sexuales hipoactivo, trastornos de la excitación sexual y del orgasmo, así como trastornos de aversión se caracterizaron por su prevalencia, y fueron hallados en 96%, 88.1% y 87.1% de los pacientes femeninos, respectivamente. Todos los pacientes diabéticos con ERET reportaron trastorno sexual hipoactivo y disfunción orgásmica. Se hallaron trastornos de excitación en el 94.7%. El trastorno de aversión sexual se observó más entre los pacientes con glomerulonefritis crónica subyacente. Se halló que todos los pacientes con anemia presentaban trastorno sexual hipoactivo y entre éstos, 87.5% y 97.8%presentaban trastornos severos de excitación y orgasmo, respectivamente. CONCLUSIÓN: La disfunción sexual entre los pacientes con ERET en Jamaica fue prevalente tanto en los varones como en las hembras. Existen asociaciones entre la disfunción sexual y la diabetes mellitus, la glomerulonefritis crónica y la anemia.

Prevalência de disfunção sexual em primigestas, no Município de Rio Branco, Acre, Brasil / Prevalence of sexual dysfunction in primigravidae in Rio Branco, Acre State, Brazil / Prevalencia de disfunción sexual en primigestas en el municipio de Río Branco, Acre, Brasil

O objetivo deste estudo foi estimar a prevalência das disfunções sexuais antes e durante a gravidez por meio de um estudo transversal, realizado com 778 primigestas, com companheiro, que pariram nas duas maternidades de Rio Branco, Acre, Brasil, entre 1º de fevereiro e 31 de julho de 2010, utilizando entrevista no pós-parto. A mediana de idade das primigestas foi de 20 anos, 45% eram adolescentes, 19% possuíam escolaridade até o ensino fundamental; 30% tinham trabalho remunerado, 86,5% utilizaram o serviço público (SUS) para os partos. A prevalência de disfunção sexual foi de 23,9% antes da gravidez e de 67,7% na gravidez. Antes da gestação, a falta de desejo sexual foi de 20,2% e, na gestação, de 51%. A diminuição da lubrificação vaginal durante a gestação foi de 29,1%, a dispareunia foi de 1,2% antes da gestação e de 14,4% na gestação, 3,3% tiveram insatisfação sexual antes da gravidez, e 10,8%, na gestação. Os achados indicam que as mulheres estudadas apresentaram maior prevalência de disfunção sexual durante a primeira gravidez do que no período anterior a essa gestação.

This study aimed to estimate the prevalence of sexual dysfunction prior to and during the first pregnancy. This was a cross-sectional study using postpartum interviews with 778 primigravidae who were married or in stable unions and had given birth at the two maternity hospitals in Rio Branco, Acre State, Brazil, from February 1st to July 31st, 2010. Median age was 20 years, 45% were adolescents, 19% had completed elementary school, 30% had paid jobs, and 86.5% had used public healthcare services (SUS) for childbirth. Prevalence of sexual dysfunction was 23.9% prior to pregnancy and 67.7% during pregnancy. Decreased libido was present in 20.2% prior to pregnancy and 51% during pregnancy. Decreased vaginal lubrication occurred in 29.1% during pregnancy. Dyspareunia was present in 1.2% prior to pregnancy and 14.4% during pregnancy. Some 3.3% reported sexual dissatisfaction prior to pregnancy, as compared to 10.8% during pregnancy. Women with more schooling showed higher prevalence of sexual dysfunction during (as compared to before) their first pregnancy.

El objetivo de este estudio fue estimar la prevalencia de las disfunciones sexuales, antes y durante el embarazo. Es un estudio transversal realizado con 778 primigestas, con pareja, que dieron a luz en las dos maternidades de Río Branco, Acre, Brasil, entre el 1º de febrero y el 31 de julio de 2010, mediante entrevista en el posparto. La media de edad de las primigestas fue de 20 años, un 45% eran adolescentes, un 19% poseían escolaridad hasta la enseñanza fundamental; un 30% tenían trabajo remunerado, un 86,5% utilizaron el servicio público (SUS) para los partos. La prevalencia de la disfunción sexual fue de un 23,9% antes del embarazo y de un 67,7% durante el embarazo. Antes de la gestación, la falta de deseo sexual fue de un 20,2%, y en la gestación de un 51%. Disminución de la lubrificación vaginal durante la gestación fue de un 29,1%, la dispareunia fue de un 1,2% antes de la gestación y un 14,4% durante la gestación, un 3,3% sufrieron insatisfacción sexual antes del embarazo y un 10,8%, en el embarazo. Los hallazgos indican que las mujeres estudiadas presentaron una mayor prevalencia de disfunción sexual durante el primer embarazo que en el período anterior a esta gestación.

Correlates of psychosexual issues in the Jamaican population / Correlatos de problemas psicosexuales en la población Jamaicana

OBJECTIVE: To examine the relationship between the psychopathological correlates of psychosexual phenomena in post-colonial Jamaica. METHODS: A total of 1506 adult individuals were sampled from 2150 households using a stratified sampling method and assessed with the Jamaica Personality Disorder Inventory (JPDI). Responses to the seven questions on the psychological features of homosexual practices, sexual practices and dysfunction were tabulated and analysed using the Statistical Package for the Social Sciences (SPSS) version 17. RESULTS: Of the sample, 79.38% denied having phenomenological symptoms of psychosexual phenomena while 20.33% of the population admitted to having some degree of heterosexual and homosexual phenomena, ranging from mild (5.13%), to moderate (11.40), or severe (3.80%). Sixteen (1.06%) responders described homosexual practices in their lives, and 53 (3.52%) described thinking frequently about homosexual experiences in their subjective psychic lives. Significantly more (p > 0.001) male responders (348, 23.11%) had difficulty being sexually faithful to one person at a time than females (122, 8.10%). The lower class cohort members (348, 23.11%) were more likely to have had multiple sexual relationships over the previous 12 months than socio-economic class (SEC) 1-3 responders (54, 3.58%) and were more likely (681, 45.21%) to fantasize about sexual relationships with persons other than their partners (p < 0.001) than SEC 1-3 responders (94, 6.24%). CONCLUSION: Significant levels of multiple sexual partnerships and feelings of infidelity in a swathe of Jamaican people reveal underlying psychosexual anxiety and guilt, poor impulse control and difficulties with partner intimacy. This psychopathology is correlated to concomitant high-risk public health sexual behaviour such as teenage pregnancy, sexually transmitted diseases (STDs) and HIV/AIDS existing in the Jamaican society.

OBJETIVO: Examinar la relación entre los correlatos psicopatológicos de los fenómenos psicosexuales en la Jamaica postcolonial. MÉTODOS: Un total de 1506 individuos adultos fueron tomados como muestras a partir de 2150 hogares, usando un método de muestreo estratificado, y evaluados mediante el Inventario de Trastornos de la Personalidad de Jamaica (JPDI). Las respuestas a las siete preguntas sobre las características psicológicas de las prácticas homosexuales, las prácticas sexuales, y la disfunción, fueron tabuladas y analizadas mediante el Paquete Estadístico para las Ciencias Sociales (SPSS) versión 17. RESULTADOS: De la muestra, 79.38% negó tener síntomas fenomenológicos de fenómenos psicosexuales, mientras que el 20.33% de la población admitió haber tenido algún grado de fenómenos heterosexuales y homosexuales, desde leves (5.13%) a moderados (11.40) o severos (3.80%). Once encuestados (0.73%) reportaron prácticas homosexuales en sus vidas, y 53 (3.52%) reportaron pensar con frecuencia acerca de experiencias homosexuales en su vida psíquica subjetiva. Significativamente más encuestados varones (p > 0.001) (348, 23.11%) tuvieron dificultades para ser fieles sexualmente a una persona alguna vez, en comparación con las hembras (122, 8.10%). Los miembros de la cohorte de clase baja (348, 23.11%) eran más propensos a tener múltiples relaciones sexuales en los 12 meses anteriores (3.58%), y tuvieron una mayor probabilidad (681, 45.21%) de tener fantasías acerca de relaciones sexuales con personas que no eran sus parejas (p < 0.001) en comparación con los encuestados de SEC 1-3 (94, 6.24%). CONCLUSIÓN: Los niveles significativos de las relaciones sexuales múltiples y los sentimientos de la infidelidad en un sector del pueblo jamaicano, revelan ansiedad psicosexual subyacente y sentimientos de culpa, control de impulsos pobre, y dificultades con la intimidad de la pareja. Esta psicopatología está correlacionada con comportamientos sexuales concomitantes de alto riesgo en la salud pública, tales como el embarazo adolescente, las enfermedades de transmisión sexual (ETS), y el VIH/SIDA, existentes en la sociedad jamaicana.

Factores de vulnerabilidad y de protección del impacto emocional en mujeres adultas víctimas de agresiones sexuales / Risk and protective factors in the emotional impact of adult female victims of sexual aggression

El objetivo de este estudio fue describir las reacciones psicopatológicas de las víctimas según las circunstancias de la agresión sexual, la historia previa y el apoyo familiar/social. La muestra constó de 269 mujeres adultas víctimas de una agresión sexual en la infancia o en la vida adulta. Se evaluaron las reacciones postraumáticas, la sintomatología ansioso-depresiva, la autoestima, las conductas sexuales y el funcionamiento cotidiano. Los resultados mostraron una alta prevalencia de malestar emocional (63,6%), de baja autoestima (59,7%), de TEPT (44,5%), de sentimientos de culpa (48,3%) y de evitación sexual (38,9%), así como problemas de adaptación. La gravedad de la sintomatología estaba relacionada con las circunstancias de la agresión sexual, tales como la penetración vaginal/anal o las heridas provocadas, la historia de victimización, los sucesos estresantes recientes y la falta de apoyo socio-familiar. Sin embargo, las conductas de evitación sexual no estaban relacionadas con circunstancias específicas de la agresión sexual.

The aim of this paper was to describe the psychopathological reactions of the victims according to the circumstances surrounding sexual aggression, the previous clinical record, and the role of family/social support. The sample consisted of269 adult female victims who suffered any kind of sexual aggression either in childhood or in adult life. Participants were assessed with the PTSD Severity Scale, the STAI, the BDI, the Self-Esteem Scale and the Misadjustment Scale. The results showed a high prevalence of emotional trouble (63.6%), low self-esteem (59.7%), PTSD (44.5), guilt feelings (48.3%), sexual avoidance (38.9%), as well as a poor adaptation to daily life activities. The severity of emotional problems was related to the circumstances of sexual aggression, such as vaginal/anal penetration or physical injuries, the history of victimization, the recent stressful life events and the lack of family/social support. However sexual avoidance behaviors were not associated with circumstances of sexual aggression.

Study of Psychiatric Morbidity and Psychosexual Dysfunctions in Patients of Alcohol Dependence.

Introduction: Alcohol dependence is a major threat to public health throughout the world. Just as a virus, use of alcohol and alcohol trafficking knows no bounds or limitations. It spreads all over a country; from nation to nation, to the entire globe infecting every civilized society irrespective of caste, creed, culture and geographical location. Aims: To study the psychiatric morbidity and psychosexual dysfunctions among patients of alcohol dependence. Material and Methods : 50 alcohol dependence patients attending psychiatry OPD and admitted in Deaddiction ward under Department of Psychiatry, J.L.N. Hospital, AJMER, who fulfilled the inclusion criteria constituted the sample of study (study group). These alcohol dependence cases were compared with 50 matched controls preferably relatives or family members of alcohol dependence, who were not abusing any substance at present or in the past except tobacco (control group). Psychiatric morbidity and psychosexual dysfunctions were assessed by Eysenck’s Personality Inventory, Indian psychiatry interview schedule, and Brief sexual functioning questionnaire. Results and Conclusion: In conclusion our study highlights that most of studied groups were Hindu male between 31-35 years age and belong to urban area, mostly were married, primary educated, unemployed and belong to joint families, lower and lower middle class status. Most of patients suffered from depression and impotence due to alcohol dependence in comparison of normal healthy control.