Exploring the adult sexual wellbeing and behavior during the COVID-19 pandemic. A systematic review and meta-analysis.

Implemented social distancing measures may have forestalled the spread of COVID-19, yet they suppressed the natural human need for contact. The aim of this systematic review was to explore the impact of the COVID-19 pandemic on adult sexual wellbeing and sexual behavior. An extensive search in Pubmed, Scopus, and PsycInfo databases based on PRISMA guidelines was conducted. After applying specific eligibility criteria, screening resulted in 38 studies. Results were drawn from 31,911 subjects and outlined the negative effect of the pandemic in sexual frequency, function, satisfaction, and the behavioral changes regarding masturbation and internet-based practices. Meta-analyses of the drawn data on 1,343 female, and 1,372 male subjects quantified the degree of sexual function change during the COVID-19 pandemic vs. prior the pandemic. A random effects model revealed the significant negative impact of the pandemic on female sexual function (SMD: 0.76, 95% CI:0.74 to 1.59), while no significant change was found for the males (SMD: 0.25, 95% Cl: -0.03 to 0.52). Significant heterogeneity was identified across included studies (p < 0.00001, I2 = 97%, I2 = 90% for females and males, respectively). As part of the global health, sexual wellbeing should be on the focus of clinicians and researchers.

Validation of the Greek Version of Hedonic, Eudaimonic, and Extrinsic Motives for Activities (HEEMA) Instrument.

Hedonia and eudaimonia are motivating forces through which individuals pursue well-being. The latter is a multidimensional concept, while hedonia and eudaimonia, both of which are realized through the reward system of the brain, are known to influence each other. Researchers have shown that specific extrinsic values (e.g., material wealth, power over other people, etc.) are associated with a sense of "good life" and may influence both hedonia and eudaimonia. The HEEMA (Hedonic, Eudaimonic, and Extrinsic Motives for Activities) scale was developed to evaluate all three ways of seeking well-being, hedonia, eudaimonia, and extrinsic values, in both a healthy and unhealthy fashion. The purpose of this study was to assess the psychometric properties of the HEEMA scale in a sample of 225 Greek individuals. Participants filled the HEEMA, SWLS, MLQ, Self-Esteem questionnaire, DASS-21, MHC-SF, and Big Five Inventory, anonymously. Reliability and validity indices of the scales were satisfactory (Cronbach's α were 0.734, 0.811, and 0.843 for the hedonic, eudaimonic, and extrinsic motives subscales, respectively). Indicatively, the study showed a positive correlation between aspects of well-being and positive emotions, satisfaction with life, sense of meaning and purpose, as well as with specific personality traits, while negative correlations were found between eudaimonic orientation and depression.

Hair cortisol concentrations in mental disorders: A systematic review.

OBJECTIVE: Research on HPA axis dysregulation has been associated with vulnerability to, or perseverence of, several mental disorders. Hoever, measurements of cortisol levels in blood, saliva and/or urine have yielded variable results. Nevertheless, cortisol analysis in scalp hair appears to be a consistent tool for measurement of long-term exposure to stress. This article provides a systematic review of studies exploring hair cortisol concentrations in patients with mental disorders in comparison with healthy controls. METHODS: This review was conducted according to PRISMA guidelines. The electronic databases of PubMed/Medline, Web of Science and Scopus were searched for relevant articles, using a specific syntax. RESULTS: A total of 582 articles were identified, of which 22 were finally included. Patients with depression show a general trend for higher hair cortisol concentrations (HCC) than controls, whereas patients with PTSD tend to demonstrate lower HCC. Very little is known about other mental disorders, including suicidality and drug abuse. The divergence of samples included and the timing of cortisol sampling, seem to play a key role in the discrepancies of the results. Correlations of HCC with self-reported measures of stress were found, at best, inconclusive. CONCLUSIONS: Further research should attempt to describe specific cortisol profiles for each psychiatric disorder and HCC could contribute in evaluating therapy outcomes and predicting relapses. Obtaining information on HCC in different stages of psychiatric disorders in association with pertinent clinical variables, might help in forging a neuroendocrine model for clinical staging of mental disorders.

Low hair cortisol concentrations in obsessive compulsive disorder: A cross-sectional study.

Recent findings have highlighted the association between changes in the activity of the HPA axis, primarily its end-hormone, cortisol and OCD. However, to date, cortisol levels of OCD patients have been assessed mainly in body fluids, such as serum, saliva or urine, frequently leading to ambiguous results because of their inherent lack of stability. The aim of this study was to investigate time-integrated levels of stress exposure in 32 OCD patients and 32 sex and age-matched healthy controls by measuring endogenous cortisol in hair segments reflecting the last 3 months preceding hair collection. Psychometric parameters, including BDI, FQ, STAI, PSS and ECQ-R, were obtained in all participants; Y-BOCS was performed in the OCD patients. The OCD patients exhibited significantly higher scores in all psychometric instruments administered and lower hair cortisol concentrations than the healthy controls (p = 0.001, r = 0.41). No significant correlations were found between the HCC and the Y-BOCS total scores. After having sorted OCD patients into subtypes, according to the nature of their symptomatology, the "washers/cleaners" category showed the lowest HCC (compared to the "checking/harming", "ordering/symmetry" and "sexual/religious obsessions" categories). The novel finding of chronic low cortisol secretion in OCD patients could be attributed to a possible down-regulation of the HPA axis, as an adaptive response to chronic stress exposure. Given that the OCD subtypes reflect the great heterogeneity in the OCD spectrum, studies with larger samples should extend the investigation of HCC in patients with distinctive symptomatology, so as to develop a basis for better neuroendocrine profiling and understanding of the pathophysiology of OCD. Further work is needed in exploring HPA axis' activity over the natural course and treatments of the disorder.