Sexual dysfunction in females with depression: a cross-sectional study.

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.

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.

A comparative study of caregiver burden in late-onset depression and Alzheimer's disease.

BACKGROUND: Alzheimer's disease (AD) and major depressive disorder are the two most common psychogeriatric disorders. Late-onset depression (LOD) is the most common cause of emotional suffering in the elderly and is associated with a poor quality of life in caregivers. Although the burden on caregivers of individuals suffering from AD has been well studied, there is a paucity of comparative studies on caregiver burden between AD and LOD. The objectives of this study were to compare the caregiver burden in LOD and AD and to identify factors associated with caregiver burden in LOD. METHODS: The study included two groups of 25 patients and their caregivers. Group 1 consisted of LOD patients diagnosed with major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision, with onset after age 60, and their caregivers. Group 2 consisted of AD patients and their caregivers. Caregiver burden was assessed by the Zarit Caregiver Burden Interview. Sociodemographic and clinical correlates of caregiver burden in LOD and AD were analyzed. RESULTS: There was no significant difference in caregiver burden between LOD and AD (P = 0.27). In LOD, the factors positively associated with caregiver burden included the patient's education and the caregiver being a woman, married, unmarried, and a student. Factors negatively associated with caregiver burden included being the son of the patient and high income status. Multivariate stepwise regression analysis showed that caregiver burden in AD is predicted by the Behavioural Pathology in Alzheimer's Disease Scale score, income, presence of diabetes, and in-laws as caregivers (adjusted R(2) = 0.847, P < 0.001). In LOD, caregiver burden is predicted by income, the patient's education, and whether the caregiver is a student or spouse (adjusted R(2) = 0.388, P < 0.001). CONCLUSION: This study highlights the finding that caregiver burden in LOD is comparable to that in AD and requires interventions to reduce the caregiver strain.

Late onset clozapine induced agranulocytosis.

Agranulocytosis is defined as an absolute neutrophil count less than 100/mm(3) in association with infectious disease. The risk of agranulocytosis is 0.38% of all clozapine treated cases and there is a relatively lesser incidence in Indian population. The risk of clozapine-induced agranulocytosis and neutropenia is highest in the first 6 months and higher in the initial 18 months after the onset of treatment. There have been very few reports of neutropenia and agranulocytosis after this period. There have so far been no reports of late onset clozapine induced agranulocytosis has been reported from India. A case of late onset clozapine induced agranulocytosis with possible mechanism of the same is reported.

Fetishistic transvestism in a patient with mental retardation and psychosis.

Fetishistic transvestism is a disorder of sexual preference associated with fantasies and sexual urges to dress in opposite gender clothing as a means of arousal and as an adjunct to masturbation and coitus. The disorder has been reported in people with learning disabilities. The disorder has been reported in a young male with dull normal intelligence. Transvestism though has been described in schizophrenia and psychosis and fetishism has been described in the course of simple schizophrenia, there are no reports of fetishistic transvestism in a patient with mental retardation and psychosis. A case of fetishistic transvestism in a patient with mental retardation and psychosis with treatment and relevant review of literature is reported.