Women’s Experiences with Intimate Partner Violence and Their Mental Health Status in India: A Qualitative Study of Sambalpur City

The intimate partner violence (IPV) against women has been identified as a violation of human rights and a serious public health concern. There is not only the immediate consequence of partner violence, such as injury or death but also the other long-term health consequences. IPV can be associated with psychological effects such as depressive disorder, posttraumatic stress disorder, and substance abuse. The study aims to explore the nature and causes of IPV on women’s life and their personal experiences to deal with. This is an NGO-based study. For better understanding of the issues, Purposive sampling was used in selecting women with clinically diagnosed mental illness who experienced IPV. The qualitative research methodology was employed to explore the experiences and impact of IPV on the mental health status of women. For analysis, we used a phenomenological approach and conducted in-depth interviews. Findings show the participating women were suffering from IPV in physical, psychological, and sexual forms. Majority of respondents felt that wife-beating and abusing was fairly common. Most of the women had to face violence on a frequent and occasional basis. IPV experienced women were facing a mental illness like anxiety, depression and sleeping-disorder. The women, who were facing mental illness due to IPV, have been and continue to be exposed to such violence. Despite being employed and suffering from IPV deeply, women choose to stay with their abusive partner because of their children future, lack of support, and social security. The mental health of victims’ was clinically diagnosed, including self-assessed symptoms. It means participants were aware that they are mentally ill because of IPV. The healthy and quick recovery treatment should be given according to the need of women, rather than providing comprehensive standardised treatment for all.     

Hormonal and Psychogenic Risk Factors for Erectile Dysfunction in Men with HTLV-1

IntroductionErectile dysfunction (ED) is associated with neurological damage due to human T-lymphotropic virus 1 (HTLV-1) infection, but hormonal and psychogenic factors also cause ED.AimTo evaluate the association of psychogenic and hormonal factors with ED in men infected with HTLV-1.MethodsIn this cross-sectional study, we compared total testosterone, follicle stimulating hormone, luteinizing hormone, prolactin, anxiety symptoms, depressive symptoms, and neurologic manifestations in HTLV-1-infected men with or without ED. The International Index of Erectile Function was used to determine the degree of ED. Participants were grouped according to Osame’s Motor Disability Scale and the Expanded Disability Status Scale: HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP), probable HAM/TSP, or HTLV-1 carrier. Chi-square and Fisher’s exact tests were used to compare the groups, and regression analyses were used to show predictors of ED.Main Outcome MeasureSexual hormonal levels, psychogenic factors, and neurologic disabilities were found to be associated with ED.ResultsED was associated with age older than 60 years (P < .001), degree of neurologic involvement (P < .001), depression (P = .009), and anxiety (P = .008). In the multivariate analyses, only age and degree of neurological injury remained as risk factors for ED.Clinical ImplicationsNeurological manifestations are a stronger predictor of ED than hormonal and psychogenic factors in HTLV-1-infected men.Strengths & LimitationsThe statistical power of the study was limited due to the low number of participants, but neurologic manifestations were clearly associated with ED. There was no strong association between hormonal and psychogenic factors and ED.ConclusionHormonal and psychogenic factors did not show a strong association with ED in individuals with HTLV-1, but neurological manifestations were strongly associated with ED in these individuals.de Oliveira CJV, Neto, JAC, Andrade RCP, et al. Hormonal and Psychogenic Risk Factors for Erectile Dysfunction in Men with HTLV–1. J Sex Med 2019; 16:1763–1768.     

基于文献研究PCI术后伴焦虑抑郁中医药治疗进展

冠心病PCI术后伴焦虑抑郁状态患者逐年增多,严重影响患者预后及生命质量,因此,我们需要将心理干预与心血管疾病的防治置于同等地位。对此,系统收集和整理冠心病PCI术后伴心理问题的相关文献,共计28篇文献,有完整处方名称25首,没有处方名称自拟方3首,涉及中药15类79种中药,治疗患者2 099例。使用频率较多的中药种类:补虚药、理气药、安神药、活血化瘀药、清热药。28篇文献中应用随机对照试验文献26篇,心理因素评估最常用的方式为汉密尔顿焦虑量表及汉密尔顿抑郁量表。     

中医情志护理联合耳穴揿针对椎间孔镜手术患者焦虑的影响

目的:观察中医情志护理联合耳穴揿针对椎间孔镜手术患者焦虑的影响。方法:择期局麻下椎间孔患者60例,随机数字表法分组,每组30例,传统护理组(对照组)和中医情志护理联合耳穴揿针组(治疗组),对照组采用一般护理法,治疗者组采用在一般护理的基础上采用耳穴揿针,取穴神门、交感、皮质下、心区,观察揿针对患者术前1 d、局麻时及术后2 d焦虑情况,观察患者血压、心率变化情况,并记录各时点患者数字评分法(Numerical Rating Scale,NRS)疼痛评分和焦虑自评量表(Self-Rating Anxiety Scale,SAS)焦虑评分。结果:与术前比较,对照组在局麻时、术后第2天最高值NRS评分均升高(P<0.05),局麻时焦虑指数升高,术后第2天降低(P<0.05);与术前比较,治疗组在局麻时NRS、SAS均升高,术后第2天均降低。与对照组比较,治疗组在局麻时、术后第2天NRS、SAS均降低(P<0.05)。结论:采用中医情志护理联合耳穴揿针对行椎间孔镜患者进行护理,能够降低患者焦虑,提高患者围术期舒适度,值得在临床中推广和应用。     

乌灵胶囊治疗焦虑性失眠症临床研究

目的:观察乌灵胶囊对焦虑性失眠症患者的心理及睡眠质量的改善效果,为临床治疗焦虑性失眠症提供参考。方法:选择159例焦虑性失眠症患者为研究对象。按照随机数字表法分为对照组79例与观察组80例。对照组给予盐酸帕罗西汀片治疗,观察组给予乌灵胶囊治疗。治疗1个月后,比较分析2组患者睡眠质量、汉密尔顿焦虑量表评分(HAMA)及不良反应发生情况。结果:观察组总有效率为91.25%,明显高于对照组的78.48%(P<0.05)。治疗前,2组患者HAMA评分比较,差异无统计学意义(P>0.05);治疗1、2个月后,观察组HAMA评分明显低于对照组,差异有统计学意义(P<0.05)。观察组总不良反应发生率为6.25%,明显低于对照组的18.99%(P<0.05)。结论:乌灵胶囊治疗焦虑性失眠症能明显改善患者的睡眠质量以及心理状况,值得推广应用。     

Comprendre les troubles du sommeil de patients adultes atteints d’une maladie de Crohn pris en charge en ambulatoire

ObjectivesResearch has shown that sleep disturbances can negatively influence the progression of chronic inflammatory diseases, including chronic inflammatory bowel disease (IBD). More specifically, poor sleep quality is strongly related to the clinical activity of the disease. Nevertheless, some patients suffer from sleep disorders even when the disease is clinically inactive. Psychological factors, such as depression and anxiety, are also known to contribute to poor sleep quality. Depression and anxiety are common in chronic diseases. In addition, while the link between depression or anxiety and sleep disorders is well-known, the link between sleep disorders and inflammation has only been studied recently. Sleep studies in IBD patients have generally excluded patients with clinically diagnosed depression or anxiety in order to neutralize their effects on the relationship between inflammation and sleep disorders. Nevertheless, there is no consensus on the relationship between depression and anxiety and the clinical activity of the disease. When a patient with chronic inflammatory bowel disease (Crohn's disease here) complains of fatigue or poor sleep, the subjective aspects of these complaints therefore lead the clinician to consider them simply as: a characteristic of IBD, exhaustion related to the chronicity of the disease, unsatisfactory sleep quality, a manifestation of a depressive mood, or a consequence of an anxious state. When a patient reports a subjective complaint of poor sleep or fatigue in a complex, multi-determined clinical situation, it can thus be difficult to identify its most likely cause and to establish the best possible therapeutic intervention.Patients, materials and methodsThe aim of this work was to determine which element (disease activity, inflammation, depression, anxiety) is most closely related to sleep disorders in patients with Crohn's disease (CD) referred for outpatient psychological assessment. Ninety-seven patients with CD participated in this study. Their mean age was 34.70 (± 10.85) years. They were asked about their sleep (IQSP, ISI, ESD) and mood (HADS). They also provided details of clinical disease activity (Harvey–Bradshaw Index) and inflammation (CRP). In order to determine the nature and extent of the relationship between the variables, Spearman correlation coefficients were calculated, supplemented by multiple regression analyses to determine the variables that could explain the sleep disorders.ResultsThe results show that sleep quality (IQSP) was significantly predicted by the Harvey–Bradshaw score (β = 0.21; β standardized = 0.24; t = 2.6; P = 0.01) and depression (β = 0.45; β standardized = 0.41; t = 4.55; P < 0.001). The Harvey–Bradshaw score (β = 26; β standardized = 2; t = 2.27; P = 0.026) and depression score (β = 75; β standardized = 47; t = 5.34; P < 0.001) were related to the insomnia score (ISI). Finally, daytime sleepiness (DSA) was predicted by the depression score (β = 42; β standardized = 432; t = 3.17; P = 0.002) and by the CRP (β = − 0.05; β standardized = − 0.21; t = − 2.13; P = 0.036). The results show that the severity of clinical activity of the disease was associated with poor sleep quality and insomnia. However, there was a stronger association between the intensity of depression and sleep disturbances than between these variables and clinical disease activity. It therefore seems important that sleep disorders and their management should be considered first from the perspective of depression. However, it is important that CD is not assumed to be the sole cause of depression: other factors (dispositional or situational) should also be taken into consideration. Nevertheless, while our results show a weaker link between inflammation and sleep disorders than other studies, they confirm the link between sleep disorders and disease activity.ConclusionsIn order to predict the likelihood and nature of relapses, it seems important that future research should take into account not only disease activity and inflammation, but also disorders of arousal and nocturnal awakenings experienced by the patient.     

La thérapie par exposition en réalité virtuelle pour les états de stress post-traumatiques,les troubles obsessionnels compulsifs et les troubles anxieux : indications,plus-value et limites

The exposure in cognitive behavioral therapy (CBT) is a well-known intervention, widely investigated in scientific research. Several studies have shown the benefits of this intervention in the treatment of anxiety disorders, obsessive-compulsive disorders (OCD) and post-traumatic stress disorders (PTSD). The different exposure techniques are mainly based on the emotional processing of fear theory and use an emotional stimulation of fear, following by its habituation. However, new approaches have emerged and are based on the inhibitory learning theory. The virtual reality technology allows emotional involvement from patients and represents a complementary approach to the classical modalities of exposure therapy (e.g., mental or in vivo expositions). This modern approach presents specific features that need to be taken into account by the therapist. Firstly, the presence feeling, which is defined as the “be there” feeling. This feeling is dependent on immersive technical features and personality factors. Secondly, virtual reality sickness, similar to motion sickness, represents a limitation that might prejudice a virtual therapy. The main scientific investigations of Virtual Reality Exposure Therapy (VRET) for treating social phobia, specific phobia, PTSD, and panic disorders are encouraging and demonstrate a similar effectiveness between both in vivo and in virtuo exposures. The scarce investigations on generalized anxiety disorders and OCD also suggeste a similar effectiveness between these exposures. However, further scientific investigations are needed to support these preliminary findings. The attrition rates and deteriorating states are similar to classical CBT approaches. Nevertheless, scientific literature presents several limits: 1) much of the research on this topic has interest conflicts (e.g., developers are also authors of a large number of studies); 2) there is a high heterogeneity of materials and virtual environments used; 3) important measures are not always taken into account in scientific research (e.g., the presence feeling); and 4) a massive use of waiting lists as a control measure. Despite these limitations, the VRET have strong silver linings: 1) the easy access to exposure (less limited than standard exposure techniques) and a cost reduction; 2) highly guaranteed security; 3) the anonymization of exposures (i.e., the patients do not risk meeting someone they know during the exposure therapy); 4) the therapist has a greater control of exposures; 5) a standardization of the exposures; 6) a greater involvement in therapy for technophile patients. Virtual exposure also seems to be generally more accepted by patients.