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1.
The aim of the investigation was to establish the prevalence of psychosocial problems in men with haemophilia and HIV infection, and to identify factors associated with psychological morbidity. A cross-sectional controlled study including 37 HIV seropositive and 36 HIV seronegative men with haemophilia under the care of the Oxford Haemophilia Centre were included in the investigation. The outcome measures included current psychological status (PSE, POMS, Beck Hopelessness Scale and Self-Esteem) and psychiatric history; coping and health beliefs (Self-Control Schedule, Hardiness Scale, Health Locus of Control Scale); social functioning (Modified Social Adjustment Scale); and sexual functioning. The results showed that seropositive individuals, whether symptomatic or not, had significantly worse total PSE scores and had higher levels of hopelessness. In addition, symptomatics had worse depression scores (POMS) than seronegatives. However, levels of psychiatric morbidity were generally low, even in the seropositive group. High levels of psychological morbidity were associated with high levels of hopelessness, unfavourable social adjustment, past psychiatric history and symptomatic HIV disease. Seropositives reported greater negative impact on their sex lives, and sexually active seropositives reported a significantly greater prevalence of sexual dysfunction than seronegatives. The majority of seropositives reported regular condom use during intercourse, and also continuing concerns about infecting their sexual partners in spite of it. In summary, it was found that men with haemophilia an HIV infection have higher levels of psychological distress and sexual problems than seronegatives. The skilled staff involved in their treatment are in a good position to identify their difficulties and ensure that good care is provided.  相似文献   

2.
Abstract. Sexuality in patients with amyotrophic lateral sclerosis (ALS) has received little attention so far. Although sexual function is not directly affected by the disease process, several patients have reported problems within their sexual relationship. We performed a questionnaire survey to ascertain the extent and clinical relevance of sexual problems experienced by patients with ALS and their partners. Of 91 patients and partners asked, 62 agreed to participate in the study. Compared with the time before disease onset, sexual interest had decreased from 72 % to 44% for patients and from 78 % to 44% for partners. Sexual activity had moderately decreased from 94 % to 76% for the patients and from 100% to 79 % for the partners. Before the disease, 19% of the patients and 20% of the partners reported sexual problems. This increased to 62% of the patients and 75% of the partners at time of survey. The problems reported were mainly decreased libido, passivity of the partner and own passivity. The most frequent reasons for these problems were the physical weakness and the body image changes due to ALS. The data show that sexuality is an important and problematic issue for a large proportion of ALS patients and their partners. This topic is rarely discussed in the medical setting. Counselling and information should be made available in order to better address this important aspect of quality of life.  相似文献   

3.
Sexual function and behavior in social phobia   总被引:4,自引:0,他引:4  
BACKGROUND: Social phobia is a type of performance and interpersonal anxiety disorder and as such may be associated with sexual dysfunction and avoidance. The aim of the present study was to evaluate sexual function and behavior in patients with social phobia compared with mentally healthy subjects. METHOD: Eighty subjects participated in the study: 40 consecutive, drug-free outpatients with social phobia (DSM-IV) attending an anxiety disorders clinic between November 1997 and April 1999 and 40 mentally normal controls. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Liebowitz Social Anxiety Scale were used to quantitatively and qualitatively assess sexual function and behavior. RESULTS: Men with social phobia reported mainly moderate impairment in arousal, orgasm, sexual enjoyment, and subjective satisfaction domains. Women with social phobia reported severe impairment in desire, arousal, sexual activity, and subjective satisfaction. In addition, compared with controls, men with social phobia reported significantly more frequent paid sex (p < .05), and women with social phobia reported a significant paucity of sexual partners (p < .05). CONCLUSION: Patients with social phobia exhibit a wide range of sexual dysfunctions. Men have mainly performance problems, and women have a more pervasive disorder. Patients of both genders show difficulties in sexual interaction. It is important that clinicians be aware of this aspect of social phobia and initiate open discussions of sexual problems with patients.  相似文献   

4.
Out of 100 first referrals to a newly started family/marital - sex therapy clinic in Nairobi, 52 cases were studied for sociodemographic characteristics, help-seeking pattern for their sexual problems, presentation of the sexual problems, factors that might sustain the sexual problems, types of sexual problems and the treatment approaches. There was a male preponderance. Both married and non-married patients were seen. The problems tended to occur in relatively young people, and for those who were married in relatively early years of their marriage. The patients attributed the causes of the sexual problems to physical rather than psychological factors, although objective assessment found relatively very few possible physical causes. Elementary rather than subtle psychological causes were frequent. These formed fertile grounds for intervention. The findings are discussed in the light of the social-cultural context in which they were obtained.  相似文献   

5.
Sexual problems are common in Parkinson's disease and contribute to poor quality of life of patients and partners. Nonmotor and motor disease manifestations can affect sexual function. This article reviews the progressive and multidimensional sexual manifestations and provides practical suggestions for taking sexual history and treating sexual problems, which may enable clinicians to contribute to the sexual wellbeing of patients.  相似文献   

6.
Bronner G, Elran E, Golomb J, Korczyn AD. Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention.
Acta Neurol Scand: 2010: 121: 289–301.
© 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Female sexual functioning is a complex process involving physiological, psychosocial and interpersonal factors. Sexual dysfunction (SD) is frequent (40–74%) among women with multiple sclerosis (MS), reflecting neurological dysfunction, psychological factors, depression, side effects of medications and physical manifestations of the disease, such as fatigue and muscle weakness. A conceptual model for sexual problems in MS characterizes three levels. Primary SD includes impaired libido, lubrication, and orgasm. Secondary SD is composed of limiting sexual expressions due to physical manifestations. Tertiary SD results from psychological, emotional, social, and cultural aspects. Sexual problems cause distress and may affect the family bond. Practical suggestions on initiation of discussion of sexual issues for MS patients are included in this review. Assessment and treatment of sexual problems should combine medical and psychosexual approaches and begin early after MS diagnosis. Intervention can be done by recognizing sexual needs, educating and providing information, by letting patients express their difficulties and referring them to specialists and other information resources.  相似文献   

7.
Women who have sex with women (WSW) have been underrepresented in studies on sexual function. Consequently, much of what is known of female sexual function may not be representative of, or generalizable to, the experiences of WSW. The purpose of this paper is to provide a comprehensive and critical review of the literature on the sexual function of WSW, followed by an integration of the literature in a conceptual model to guide and stimulate research. Twenty-six articles are reviewed and 15 factors are identified as contributing to sexual functioning in WSW and are subsequently included in the conceptual model. Of these, it is suggested that eight factors may contribute directly to sexual function. These include: age, income, religion, cultural recognition, relationship duration, sexual satisfaction, psychological well-being, and relationship satisfaction. The literature suggests the remaining seven factors may indirectly contribute to sexual function. These include: sexual frequency, desire discrepancy between partners, internalized homonegativity, power, social support, emotional intimacy, and a discrepancy between partners in level of being “out” as a lesbian or bisexual woman. Comparisons are made to the sexual function of women who have sex with men and the implications of having a model that recognizes similarities while also considering unique influences for WSW are discussed.  相似文献   

8.
Clinical research confirms that declining sex activity is one of the most common and vexing problems of menopausal women. Numerous physical conditions, many of which are treatable, contribute to this decline. Aging male partners also experience changes that can interfere with sex. Research, however, indicates that psychological and emotional factors are equally or more important causes of the decline in sexual activity. Accumulation of resentment toward one's partner and other dissociated sexual trauma are two important psychological factors that the author believes contribute to a decline in sexual interest and activity at menopause. This paper reports on a two-part treatment approach that helps menopausal patients bring dissociated sexual trauma to consciousness and allows them to reconnect with sexual desire. Clinical examples illustrate the use of this treatment.  相似文献   

9.
Erectile dysfunction (ED) affects millions of men, and their partners, worldwide (Fisher, Meryn, et al. 2005). Viagra, widely used to treat ED, impacts on both individuals and interpersonal relationships yet social and psychological aspects of treatment are absent from the majority of research on the drug. The advent of Viagra has seen diminishing sexual capacities once linked with normal ageing now viewed as dysfunctional, with possible alternative psychological factors largely ignored. Research reveals a lack of discussion relating to the key users of Viagra (older men), with partners largely absent from the consultation process. We identify gaps in the extant literature on Viagra, including the social, psychological and emotional impact on sexual relationships and the experiences of older men and women.  相似文献   

10.
The sexual and marital life of people with multiple sclerosis (MS) and their partners is frequently affected by the disease. One hundred and sixteen MS sufferers (72 females, 44 males) and their partners were questioned about their sexual and marital satisfaction; specific sexual difficulties caused by MS; and ways of coping with sexual problems. Demographic data, impact and acceptance of MS, cognitive functioning and mood state were also measured. Results showed that both male and female patients had sex lives that were greatly affected by their disability. Problems included indirect physical changes (numbness, spasms and fatigue); direct sexual dysfunctions (impotence, vaginismus and anorgasmia); concerns about future changes (incontinence, fertility); and sexuality-related changes (priorities, expectations and communication with partner). Men had higher levels of sexual dysfunction and talked to their doctors more frequently compared with women. Three percent of women and 25% of men had been to a sexual therapist. Spouses also indicated high levels of sexual dysfunction, including the area of non-sensuality. Relationship difficulties were present in a third of the sample, with female partners being the most dissatisfied. Sexual dysfunction in patients was not associated with age, duration of illness or mood state. Partners' sexual dysfunction was associated with patients' age, duration of MS and illness impact.  相似文献   

11.
Borderline personality disorder (BPD) is a common psychiatric disorder, the core features of which are affective dysregulation, identity disturbances, and problems in social interaction, with an intense fear of loss, abandonment, or rejection by social partners. Self-injurious behaviors (SIB), such as superficial cutting, occur in 70–80 % of BPD patients, which are associated with emotional relief. Intriguingly, the majority of BPD patients report reduced or no pain associated with SIB, whereas BPD patients are over-represented in chronic pain patients. Thus, studying pain perception in such patients may help to understand the pathophysiology of BPD, but also the interaction between affective and physical dimensions of pain. We conducted a systematic review dealing with physical and social pains in BPD patients, with a special focus on neuroimaging data. SIB appear to be an inadequate strategy to regulate negative emotions that may be related to social/psychological pain, by increasing dorsolateral prefrontal cortex activation in order to regulate amygdala activation. In addition, abnormal hyperactivation of the insula is a possible trait marker of BPD, and might contribute to modified pain sensitivity. When considering psychological pain in BPD patients, neuroanatomical studies have shown a hyper-responsive subcortical limbic network and a deficient regulatory control system operating through anterior brain regions. Promising therapeutic strategies should target neuroanatomical and neurobiological dysfunctions, which lead to altered pain perception in BPD patients.  相似文献   

12.
OBJECTIVE: To identify patterns of psychological problems in Parkinson's disease (PD). METHOD: A sample of 3075 patients was surveyed to determine frequencies of psychological problems and cross-validated cluster analyses were computed to identify patterns of these problems. RESULTS: An increase of symptoms during arousal was reported by 68%, sleep disturbances by 32% of the sample, and sexual problems by 57% of men and 22% of women. Less frequently reported were difficulties in communicating (27%), needing help of others (38%), and depressive moods (20%). Four patterns of psychological problems were identified: general low stress, general high stress, sexual and social problems, and non-social problems. CONCLUSION: The study confirms the clinical observation that PD patients differ not only in degree, but also in structure of psychological stress. Social and non-social stress constitute principal types of stress experienced in PD. This distinction should be taken into account for any approach to support people with PD.  相似文献   

13.
Summary It was hypothesised that the problems occurring in an abortion situation might be even more pronounced at a repeat abortion. Forty-five women with repeated abortion and 92 women seeking their first abortion have been studied as regards their psycho-social background, the present social situation, sexual history, the present pregnancy and their experience of contraceptives. The groups differed significantly only in a few variables. The repeat-aborters had more children, were more often employed outside their homes, had had more sexual partners, had a greater experience of contraceptives and displayed more symptoms during the present pregnancy. The abortion groups differed significantly from a group of 118 pregnant women intending to go to term in several aspects of their psycho-social background and the present situation, which were more favourable for the mothers.  相似文献   

14.
Objectives Based on the investigation of 144 families (144 patients affected by Multiple Sclerosis (MS), 109 partners, and 192 children) examined in three different European child and adolescent psychiatric University centres by means of questionnaires, we evaluated the prevalence of psychological symptoms in the offspring and associated risk factors such as duration and severity of the disease as well as depression of the ill and the healthy parent. Results Indicate that the severe disease of MS is associated with depression of the ill and healthy parent. Ill parents, especially ill mothers, as well as depressed ill, or depressed healthy parents evaluate their children’s mental health problems with a higher prevalence within the internalizing spectrum. Healthy parents report normal psychological adjustment of their children. If two parents present a depressive state, the prevalence of relevant psychological internalizing symptoms is twice or three times as high as the age norms. Conclusion Children in families with a parent affected by MS and associated depression of the parental couple are at high risk of mental health problems, especially internalizing disorders. In focusing on the mental health of children one must also be aware of the potential opportunities to address the parents’ own psychological needs.  相似文献   

15.
Three patients with Asperger's disorder who were sent to Juvenile Court for sexual offenses are presented, and the relationship between this disorder and their crimes is discussed. All three adolescents showed unusual behaviors related to their crimes. The analysis of these cases suggested: 1) the idiosyncrasies seen in the crimes were closely related to their social deficits and obsessive traits, which are the two major problems in pervasive developmental disorder (PDD), 2) their offensive behaviors were not the direct results of their deficits due to PDD, and 3) their criminal behaviors should be understood in the unique context that is specific to PDD, not from conventional psychological viewpoints. Finally, current problems associated with PDD in Japan are discussed.  相似文献   

16.
IntroductionPatients with Parkinson disease (PD) and their partners may experience a worsening of their sexual life.AimTo assess quality of sexual life (QoSL) in male and female PD patients and their partners.Materials and methodsMedical, demographic and clinical data was collected regarding consecutive PD patients, including depression, and motor symptom rating.Partners' data included the short form-12 health questionnaire (SF-12). All patients and partners filled the 5-item QoSL questionnaire.ResultsData from 89 PD patients (66 men) and 69 spouses (52 women) was analyzed. Male patients rejected sex significantly less than female patients and their sexual desire was higher, but female patients reported higher sexual satisfaction. Patients and partners similarly perceived their relationship which was averagely good. Analysis within couples demonstrated that better QoSL of patients could be predicted by gender (male), better QoSL of their partners and, motor severity, but not the patient's depression, age or use of l-dopa. The partner's QoSL was explained by younger age, and better motor scores of their parkinsonian partner. Treatment of the PD patient with l-dopa or dopamine agonist was associated with worse partner's QoSL.ConclusionDifferences in QoSL of male and female PD patients and within couples were found. These findings suggest that focusing on partner's needs may improve QoSL of patients and partners troubled by PD.  相似文献   

17.
Whilst previous research has detailed the impact of TBI on an individual’s sexuality, few studies have investigated couples’ sexuality where one partner has sustained a TBI. The study assessed sexual function in individuals with TBI and their partners. Fifty five individuals who had sustained TBI and their partners completed the Derogatis Interview for Sexual Function—Self Report (DISF-SR). All participants scored below the 50th percentile in relation to norms. Whilst participants with TBI obtained lower T-scores than partners on all subscales (except for sexual behaviour/experiences where scores were equivalent), as well as the total score, none of these differences was significant. Item analysis indicated that female participants with TBI reported significantly lower scores than female partners on frequency of having normal lubrication. Normative comparisons revealed that approximately one-third of individuals with TBI and one-fifth of their partners scored below the second percentile. Given the high frequency of sexual problems in individuals with TBI, which also impact their partners, addressing sexual problems should be a priority in rehabilitation and beyond.  相似文献   

18.
Posttraumatic stress disorder (PTSD) is associated with myriad relationship problems and psychological distress in partners of individuals with PTSD. This study sought to develop a self-report measure of partner accommodation to PTSD (i.e., ways in which partners alter their behavior in response to patient PTSD symptoms), the Significant Others’ Responses to Trauma Scale (SORTS), and to investigate its reliability and construct validity in 46 treatment-seeking couples. The SORTS demonstrated strong internal consistency and associations with individual and relationship distress. Accommodation was positively correlated with partners’ ratings of patients’ PTSD symptoms, patient self-reported depressive and trait anger severity, and partner self-reported depressive and state anger severity. Accommodation was negatively correlated with patient and partner relationship satisfaction and partners’ perceived social support received from patients. Findings suggest that accommodation may be an attempt to adapt to living with a partner with PTSD but may have negative implications for patient and partner well-being.  相似文献   

19.
This study aimed to examine the relationships between childhood sexual abuse (CSA) and other adverse development factors and a range of adverse adult psychological and socioeconomic outcomes. Postal questionnaires were sent to a random community sample of women with a screen included for CSA. Two hundred and fifty-four women who reported CSA were interviewed as well as an equal-sized control group with no CSA. A range of negative outcomes in adulthood were more likely to occur in women reporting CSA compared with controls. These outcomes included psychiatric disorder, lowered self-esteem, deliberate self-harm, increased sexual problems, adolescent pregnancy, difficulties in intimate relationships, decline in socioeconomic status and increased likelihood of separation or divorce. The results after logistic regression modelling demonstrated that a variety of childhood risk factors such as poor parental mental health, relationship to parents and being physically punished as well as CSA contributed to negative adult outcomes. The precise patterns varied for each negative outcome. It was concluded that CSA is best conceptualised as a non-specific risk factor for a wide range of adverse psychological and social adult outcomes. It is frequently found in families which have other risk factors for adverse outcomes. Copyright © 1997 Whurr Publishers Ltd.  相似文献   

20.
Dimensions of sexual dysfunction in Parkinson disease.   总被引:1,自引:0,他引:1  
OBJECTIVE: The authors sought to better understand the factors related to sexual dysfunction in Parkinson disease (PD). METHODS: Twenty-one PD patients and their partners received the Derogatis Interview for Sexual Functioning-Self Report (DISF-SR). Additional measures assessed disease severity, autonomic dysfunction, mood, and social circumstance. RESULTS: Data from 17 male patients demonstrated profound impairment in the dimensions of sexual arousal, behavior, orgasm, and drive, with most patients scoring below the 1st percentile on these Derogatis Interview subscales. All four dimensions showed significant intercorrelations. In contrast, 53% of patients scored above the 50th percentile in sexual fantasy. Sexual fantasy subscale scores were positively correlated with duration of PD. CONCLUSIONS: The usefulness of the DISF-SR in this PD population was limited by extremely low scores and strong correlations among the subscales. The increase in sexual fantasy with greater PD duration suggests that patients with advancing disease remain interested in sex and that sexual dysfunction in PD is clinically relevant in this group.  相似文献   

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