Influence of Antipsychotic Agents on the Sexuality of Patients Diagnosed with Schizophrenia.

Background: Sexuality is a natural component of human behavior. The general population has been extensively studied since the first half of the 20th century. On the other hand, regarding patients treated for schizophrenia, discussing sexual disorders was initially considered inappropriate because it was believed they should not be sexually active. Given these findings, this work proposes to study the sexuality of patients with schizophrenia. Objectives: Our objectives were to assess the sexuality of patients with schizophrenia, to identify factors associated with sexual dysfunction among these patients, and to determine practitioners' attitudes toward the sexuality of our study population. Methods: This is a cross-sectional study carried out in the Psychiatry Department of Kairouan (outpatient department), including 46 patients diagnosed with schizophrenia. A pre-established information sheet was completed for each patient recruited, including sociodemographic and clinical data; on the other hand, 3 scales ensured a sexual psychometric evaluation: Psychotropic-Related Sexual Dysfunction Questionnaire, Arizona Sexual Experiences Scale, and Changes in Sexual Functioning Questionnaire-Male Clinical Version. Results: Concerning the evaluation of sexuality according to the scales used, sexual dysfunction according to Psychotropic-Related Sexual Dysfunction Questionnaire scores was observed in 31 patients (67.4%). According to Arizona Sexual Experiences Scale scores, 24 patients (52%) had a sexual dysfunction, and for the total score of the Changes in Sexual Functioning Questionnaire-Male Clinical Version, 27 patients (58.7%) had a sexual dysfunction. We cannot confirm the existence of a relationship between the dose of the current treatment (in chlorpromazine equivalent) used and the results of the test assessing sexuality. In addition to these results, we can deduce the existence of a statistically significant association between the antipsychotic agent used and the results of the Psychotropic-Related Sexual Dysfunction Questionnaire only. Conclusions: We recommend that screening for sexual dysfunction in patients followed for schizophrenia should be systematic, regardless of the antipsychotic molecule type and dosage. In this regard, we recommend the establishment of a better therapeutic relationship between caregivers and patients with schizophrenia, based on empathy and trust, so that the latter feel comfortable enough to address the sexual dimension in general and sexual dysfunction in particular.

Assessment of self-esteem and community integration in spondyloarthritis / Evaluación de la autoestima y la integración comunitaria en la espondiloartritis

Introduction: The aim of this study was to identify the associated factors with lower self-esteem and restriction in community reintegration in SpA patients. Methods: This study was a cross-sectional study including SpA patients (ASAS criteria) aged 18–50 years. The level of self-esteem was assessed using the Rosenberg Self-Esteem Scale (RSES). The Reintegration to Normal Living Index (RNLI) evaluated the degree of reintegration to normal social activities. Anxiety, depression, and fibromyalgia were screened by the Hospital Anxiety and Depression Scale (HADS)-A, HADS-D, and FiRST, respectively. Statistical analysis was performed. Results: A total of 72 patients were enrolled (sex-ratio=1.88), with median (IQR) age of 39 years (28.25–46). Median (IQR) disease duration was 10 (6–14) years. Median (IQR) BASDAI and ASDAS were 3 (2.1–4.7) and 2.7 (1.9–3.48), respectively. Anxiety symptoms were screened in 10% of SpA patients, depression in 11%; and fibromyalgia in 10%. Median (IQR) RSES and RNLI scores were 30 (23.25–34), and 83 (53.25–93.25), respectively. Multivariate regression analysis identified the domain (work) of pain interference, VAS pain, HAD anxiety, PGA, marital status, and morning stiffness as factors associated with lower self-esteem. Restriction in the reintegration community was predicted by the presence of IBD, VAS pain, FIRST, deformity, enjoyment of life, and HAD depression. Conclusion: Pain intensity and interference, deformities, extra-articular manifestations, and deterioration of mental health were associated with low self-esteem and severe restriction in community reintegration among patients with SpA rather than inflammatory parameters.(AU)

Introducción: El objetivo de este estudio fue identificar el factor asociado a la baja autoestima y la restricción en la reintegración comunitaria en pacientes con espondiloartritis (EspA). Métodos: Este estudio fue un estudio transversal llevado a cabo incluyendo a pacientes con EspA (criterios ASAS) de entre 18 y 50 años de edad. El nivel de autoestima se evaluó mediante la Rosenberg Self-Esteem Scale (RSES). El Reintegration to Normal Living Index (RNLI) evaluó el grado de reintegración a las actividades sociales normales. La ansiedad, la depresión y la fibromialgia se evaluaron mediante la Hospital Anxiety and Depression Scale (HADS)-A, HADS-D y FIRST, respectivamente. Se realizó un análisis estadístico. Resultados: Se inscribieron 72 pacientes (razón por sexo: 1,88), con una mediana (IQR) de edad de 39 años (28,25-46). La IQR de la duración de la enfermedad fue de 10 (6-14) años. La IQR de BASDAI y ASDAS fue de 3 (2,1-4,7) y 2,7 (1,9-3,48), respectivamente. Se detectaron síntomas de ansiedad en el 10% de los pacientes con EspA, depresión en el 11% y fibromialgia en el 10%. La IQR de las puntuaciones RSES y RNLI fue de 30 (23,25-34) y 83 (53,25-93,25), respectivamente. El análisis de regresión multivariante identificó el dominio (trabajo) de la interferencia del dolor, el dolor VAS, la ansiedad HAD, la PGA, el estado civil y la rigidez matinal como factores asociados a una menor autoestima. La restricción en la comunidad de reintegración se predijo por la presencia de EII, el dolor VAS, la herramienta FIRST, la deformidad, el disfrute de la vida y la depresión HAD. Conclusiones: La intensidad y la interferencia del dolor, las deformidades, las manifestaciones extra-articulares y el deterioro de la salud mental se asociaron a una baja autoestima y de una severa restricción en la reintegración a la comunidad entre los pacientes con EspA más que los parámetros inflamatorios.(AU)

Assessment of self-esteem and community integration in spondyloarthritis.

INTRODUCTION: The aim of this study was to identify the associated factors with lower self-esteem and restriction in community reintegration in SpA patients. METHODS: This study was a cross-sectional study including SpA patients (ASAS criteria) aged 18-50 years. The level of self-esteem was assessed using the Rosenberg Self-Esteem Scale (RSES). The Reintegration to Normal Living Index (RNLI) evaluated the degree of reintegration to normal social activities. Anxiety, depression, and fibromyalgia were screened by the Hospital Anxiety and Depression Scale (HADS)-A, HADS-D, and FiRST, respectively. Statistical analysis was performed. RESULTS: A total of 72 patients were enrolled (sex-ratio=1.88), with median (IQR) age of 39 years (28.25-46). Median (IQR) disease duration was 10 (6-14) years. Median (IQR) BASDAI and ASDAS were 3 (2.1-4.7) and 2.7 (1.9-3.48), respectively. Anxiety symptoms were screened in 10% of SpA patients, depression in 11%; and fibromyalgia in 10%. Median (IQR) RSES and RNLI scores were 30 (23.25-34), and 83 (53.25-93.25), respectively. Multivariate regression analysis identified the domain (work) of pain interference, VAS pain, HAD anxiety, PGA, marital status, and morning stiffness as factors associated with lower self-esteem. Restriction in the reintegration community was predicted by the presence of IBD, VAS pain, FIRST, deformity, enjoyment of life, and HAD depression. CONCLUSION: Pain intensity and interference, deformities, extra-articular manifestations, and deterioration of mental health were associated with low self-esteem and severe restriction in community reintegration among patients with SpA rather than inflammatory parameters.