• Title/Summary/Keyword: Changes in sexual functioning

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Prevalence of Psychiatric Disorders and Psychosocial Adjustment in Patients with Acquired Immune Deficiency Syndrome(AIDS) (후천성면역결핍증후군(Acquired Immune Deficiency Syndrome ; AIDS) 환자의 정신질환 유병률과 심리사회적 적응)

  • Park, Hwi-Jun;Hong, Jin-Pyo;Woo, Jun-Hee;Ahn, Joon-Ho
    • Anxiety and mood
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    • v.5 no.2
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    • pp.103-111
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    • 2009
  • Objectives : We examined quality of life, psychosocial adjustments to illness, changes in sexual functioning, and prevalence of psychiatric disorders in AIDS patients compared to patients with chronic hepatitis B virus infection (CHB). Methods : Thirty-one men with AIDS and 50 men with CHB were enrolled. The Short-Form 12-Item Health Survey (SF-12), the Psychosocial Adjustment to Illness Scale (PAIS), and the Changes in Sexual Functioning Questionnaire short form (CSFQ-14) were administered. Results on these assessments were compared between the 31 AIDS patients and 50 CHB patients. The Structured Clinical Interview for DSMIV (SCID) was administered to determine the psychiatric diagnosis only for the AIDS patients. Results : The Physical Component Summary score (PCS) was lower in AIDS patients than in CHB patients (p<0.001). In the section examining sexual relationships, AIDS patients exhibited a lower level of adjustment (p<0.05) and had more changes in sexual function (p<0.05) than did CHB patients. Administration of the SCID to AIDS patients indicated that the lifetime prevalence of any psychiatric disorder was 56.7% ; 43.3% for mood disorders, 33.3% for alcohol use disorders, 26.7% for anxiety disorders, and 20% for adjustment disorder. Patients who had experienced any psychiatric disorder had more severe psychosocial distress (p=0.004) and evidenced a lower level of overall psychosocial adjustment (p=0.030) than patients who had not. Conclusion : We showed that AIDS patients have a high prevalence of psychiatric disorders, and that AIDS patients with psychiatric disorders were particularly low in levels of psychosocial adjustment. Thus, careful attention should be given to psychiatric aspects of AIDS patients emphasizing the early diagnosis and treatment of psychiatric disorders.

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Antidepressant-Induced Adverse Effects and Management Strategy - Focused on Sexual Dysfunction - (항우울제의 부작용과 대처 방안(1) - 성기능 장애를 중심으로 -)

  • Kim, Jeong-Gee;Lee, Soo Jin
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.252-259
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    • 2006
  • Sexual dysfunction is a relatively common adverse effect in the use of antidepressants. The sexual side effects may result in a lack of compliance with the prescribed antidepressants. The author reviewed the prevalence and updated treatment for the antidepressant-induced adverse effects focusing on sexual dysfunction. The incidence of sexual dysfunction is reported to exceed more than 50% especially with SSRIs. In order to obtain a quantified baseline and as an ongoing evaluation tool, clinicians may use some of the established questionnaires and validated instruments such as the Arizona Sexual Experience scale and Changes in Sexual Functioning Questionnaire. Clinicians should be aware that delayed ejaculation and orgasm, symptoms most frequently associated with antidepressants, are not usually associated with depression itself. Although many antidotes have been proposed, few have been subjected to double-blind trials. Some evidences have suggested that bupropion and buspiron may be the effective antidotes for SSRI induced sexual dysfunction. Additional trials will be requied to define what role, if any, bupropion and buspiron might have in the treatment of SSRI-induced sexual side effects. The available evidence is rather limited, with only small number of trials assessing each strategy. While further randomized data is awaited, for men with antidepressant induced erectile dysfunction, the addition of sidenafil or tadalafil may appear to be an effective strategy.

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A Comparative Study on the Sexual Interest and Sexual Adjustment between the Unmarried and the Married with Spinal Cord Injuries (결혼상태에 따른 척수장애인의 성적 관심과 성적 적응 비교 연구)

  • Kang, Hyun-Sook;Suh, Yeon-Ok
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.2
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    • pp.176-183
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    • 1999
  • Sexual life is one of the most important things for the quality of living, which nobody can ignore. Especially, spinal cord injury is one of the most typical disabilities, which can cause abrupt changes of sexuality. Hence, sexual adjustment and its subordinate problems have to be dealt with among various problems caused by spinal cord injury. The purpose of this study was to comparative sexual interest and adjustment between the married and the unmarried people with SCI. A total of 134 persons who were registered members of SCI organization and admitted rehabilitation unit between February and June 1999 were included in the study. The sample consisted of 69 unmarried and 64 married people with SCI. Participants answered the 15 items concerning sexual interest, sexual adjustment. The results are as follows: 1) The mean score of sexual interest for the unmarried was 16.4. From seven topics related to sexuality, the greatest interest was to cope emotionally with changes in sexual functioning. For the married, mean score of sexual interest was 13.8 and the greatest interest was to help a partner cope emotionally with limitation on sexual dysfunction. There were significant difference sexual interest between two groups (t=3.75, p= .00). 2) Each mean score for sexual adjustment in the married and the unmarried was 20.0, 19.6. There were no significance difference sexual interest between two groups (t=.24, p= .811). However, there was a statistically significant difference of sexual interest. 3) Sexual interests and adjustments are not correlated in case of the unmarried that have r score= .224, while they are corrlated in case of the married that have r= .398. Because the average age of the SCI becomes lower and lower, sexual rehabilitation programs should be given the unmarried as well as the married with SCI. In conclusion, the spinal injured's major concerns about their sexual life are different between the married and the unmarried-the unmarried are interested in practical problems such as methods and techniques to achieve sexual satisfaction and their fertility, while the married give priority to considerations about their spouse. Paying attention to different sexual interest according to marital status, we should make two different sexual rehabilitation programs for each group. One program including support groups with their sposes for the married, the other program to give a chance t o solve problems of sexuality for the unmarried with SCI.

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Review of Sexual Dysfunction in Male Schizophrenics (남자 정신분열병 환자에서 성기능장애에 대한 검토)

  • Choi, Yeong Tae;Cheon, Jin Sook;Oh, Byoung Hoon
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.85-98
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    • 2000
  • Objective : There are four possible explanations for the sexual dysfunction of schizophrenics. The first is the possibility of a real structural aspect. The second possibility is that sexual function changes secondary to the illness. The third possibility is that there are medical and sociocultural barriers to sexual expression for chronic schizophrenics. The fourth possibility is that sexual dysfunction due to antipsychotic medication. However, we didn't know the precise cause of sexual dysfunction in schizophrenics. Therefore, the purpose of this study was to explore the mechanism of illness itself and antipsychotics on sexual dysfunction in male schizophrenics. Methods : The serum prolactin(PRL), testosterone(TST), and the plasma serotonin(5-HT) concentrations were measured by radioimmunoassay and high performance liquid chromatography method for 100 healthy male schizophrenics according to the DSM-IV. Concomitantly, the severity of psychotic symptoms using Clinical Global Impression(CGI), Brief Psychiatric Rating Scale(BPRS), Positive and Negative Syndrome Scale(PANSS), and the severity of side effects for antipsychotics using Extrapyramidal Side Effects Scale(EPSE), Anticholinergic Side Effects Scale(ACSE), the cognitive function using PANSS-Cognitive Function(PANSS-CF), Mini Mental State Exam-Korean(MMSE-K), and the sexual dysfunction using Sexual Functioning Questionnaire(SFQ), Questionnaire for Sexual Dysfunction in Men were assessed. The PRL, TST, and 5-HT levels of 50 healthy male controls who had no medical, neurological, and psychiatric illnesses were evaluated. The sexual function using SFQ(items FGa, FNa) were also assessed. Furthermore, the correlation with age, education, religion, economic status, age at onset, duration of illnesses, duration of admission, levels of PRL, TST, 5-HT, antipsychotic dosages, potency, benztropine, total duration of medication, EPSE, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K and sexual dysfunctions were identified in male schizophrenics. Results : 1) The frequencies of sexual dysfunctions for schizophrenics(80%) were significantly(p<0.001) higher than those for controls(42%). The sexual dysfunctions according to sexual response cycle were 'low sexual desire' 76%, 'impairment of achieving erection' 75%, 'impairment of maintaining erection' 75%, 'impairment of obtaining orgasm' 32%, 'impairment in the quality of orgasm' 61%, 'impairment in quantity of ejaculate' 44%, 'premature ejaculation' 15%, and 'delayed ejaculation' 50%. 2) The PRL, 5-HT levels of schizophrenics($28.5{\pm}20.6ng/ml$, $298.5{\pm}89.1ng/ml$) were significantly(p<0.001) higher than those of controls($10{\pm}5.6ng/ml$, $169.2{\pm}37.8ng/ml$), while the TST levels of schizophrenics($4.3{\pm}1.5ng/ml$) and controls($4.5{\pm}1.2ng/ml$) were not significantly different. The sexual dysfunctions of schizophrenics who had abnormal 5-HT levels($4.7{\pm}1.3$ scores) were significantly(p<0.05) higher than those of who had normal 5-HT levels($3.8{\pm}1.6$ scores) on item D7. 3) The sexual dysfunctions of unmarried schizophrenics were significantly(p<0.01 : p<0.05) higher than those of married schizophrenics($6.1{\pm}2.8$ scores, $4.7{\pm}1.3$ scores on item FGa : ${\beta}$=-0.211 on item FNa). The sexual dysfunctions were positively correlated with the rise of 5-HT levels(r=0.209, p<0.05 on item D4 and r=0.241, p<0.05 on item D7), the higher age at onset(r=0.275, p<0.01 on item FNa : r=-0.202, p<0.05 on item FDa), the longer duration of illnesses(r=0.237, p<0.05 on item D6), the longer duration of admission(r=0.234, p<0.05 on item D4 : r=0.328, p<0.05 on item D6), the longer total duration of medication(r=0.237, p<0.05 on item D6). However, age, education, religion, economic status, PRL, TST levels, antipsychotics dosage, potency, benztropine, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K scores were not correlated with increased sexual dysfunctions. Conclusions : Male schizophrenics have significantly more sexual dysfunction to compare with controls. The higher frequencies of sexual dysfunctions were low sexual desire and erectile disorder. The unmarried, higher age at onset, and longer duration of diseases were positively correlated with increased sexual dysfunctions. Also high 5-HT levels were positively correlated with increased sexual dysfunctions. This means that studies of plasma 5-HT levels, albeit questionable indicators of central 5-HT function, offer some additional support for the association of sexual dysfunction with excess 5-HT activity as primary pathology of schizophrenia. Our findings suggest that excess 5-HT activity seems to affect the patient's sexual function.

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Efficacy and Safety of Red Ginseng on Women's Health Related Quality of Life and Sexual Function (여성의 건강관련 삶의 질과 성기능에 대한 홍삼의 효과 및 안전성 연구)

  • Kim, Dong-II;Choi, Min-Sun;Alm, Hong-Yeop
    • Journal of Ginseng Research
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    • v.33 no.2
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    • pp.115-126
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    • 2009
  • To evaluate the efficacy and safety of red ginseng on women's health-related quality of life (QOL) and sexual function. A randomized, double-blind, placebo-controlled, crossover clinical study was performed. The main efficacy was measured using the Female Sexual Function Index (FSFl) and the 36-Item Short-Form Health Survey (SF-36). Twenty-four healthy, married women aged 30-45 years with FSFl scores below 25 were randomly divided into two groups: the red-ginseng group (N=12) and the placebo group (N=12). During the first six-week period (Study 1), each group was given red ginseng or placebo twice a day. Before the start of the second six-week period (Study 2), a crossover design was chosen with a two-week break (washout period). Interchanging the two groups after the washout period, red ginseng and placebo were given to each group. The outcomes were measured before and after each six-week period. Overall, 23 participants completed the study. In Study 1, the changes relative to the baseline in the FSFl total score were 22.50% and 22.99% for red ginseng and placebo, respectively. In Study 2, the relative changes were 8.14% for red ginseng and 6.29% for placebo. The results showed a greater improving trend in Study 1 with respect to all of the participants' sexual functions, but no significant difference was found between the groups (P=0.9567). After taking red ginseng, all the participants exhibited an improving trend in the desire domain of FSFl, but no significant difference was shown. In the measurement of SF-36, no significant difference was likewise shown. After taking red ginseng, though, all the participants exhibited an improving trend in the physical functioning (PF) domain of SF-36, with no significant difference. Moreover, there was no significant adverse event related to red ginseng. The QOL and sexual function of the study participants in the red-ginseng group were mostly improved, but no statistically significant effect of red ginseng was shown. It is supposed that this result was partly due to the affirmative impression of red ginseng in Korea. Thus, it is anticipated that a long-term clinical trial will show a significant effect of red ginseng on the QOL and sexual function.

A Case Report : Hypersexuality and Obsessive-Compulsive Behaviors in a Stroke Patient with the Left Mesial Frontal Cortex and Both Basal Ganglia Lesion (좌측 정중 전두엽과 양측 기저절 경색 후 과잉성욕 증상과 강박 증상을 보인 환자 1례)

  • Kim, Se Joo;Kim, Young Shin;Choi, Nak Kyung;Lee, Byung-Chul;Lee, Man Hong
    • Korean Journal of Biological Psychiatry
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    • v.8 no.2
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    • pp.271-275
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    • 2001
  • Hyposexuality after stroke has been frequently observed, but hypersexuality as a sequela of stroke has not been commonly documented. We report a patient who exhibited hypersexuality and obsessive-compulsive behaviors after stroke in the region of the left mesial frontal cortex and both basal ganglia. At 2 months after stroke, he visited psychiatric unit due to these symptoms. His motor function was almost full recovered. He was treated with fluvoxamine and perphenazine. With two-month medication, his hypersexuality and obsessive-compulsive behavior disappeared. This case may indicate that basal ganglia-thalamocortical circuit plays an important role in the mediation of sexual behavior and obsessive-compulsive behavior. Since changes in sexual activity may not be spontaneously reported, a systemic inquiry into patient's sexual functioning after infarction in frontal lobe or basal ganglia is warranted.

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Parishioner's role Expectations of Parish Nursing (한국 교인들의 목회간호 역할기대)

  • Kim, Chung-Nam;Kwon, Young-Sook
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.231-244
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    • 2000
  • Parish nursing is a community health nursing role developed in 1983 by Lutheran Chaplain Granger Westberg. An increasing emphasis on holistic care, personal responsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The purpose of this study is to investigate what the korean parishioners want in parish nursing and what type of role expectation from parish nurse. The subjects were 1138 parishioners of 23 churches of various denominations in nationwide Korea. Data were collected by self-reported question naires from Feb 4 to June 25. 1999. The data were analyzed by using percentage. frequency. $x^2-test$. multiple Response set with SPSS program. The results are as follows: 1. Desired parish nursing contents by parish nurses are: psychological counselling(23.4%) out of private counselling. stress management(21.1 %) out of private health education. Emergency care(14.1%) out of group health education. Blood Pressure check-ups (19.0%) out of Health check ups. home visiting(44.9%) out of patient visiting method. B T. pulse, respiration and blood pressure check(15.0%) in Care to serve in home visiting. spiritual preparation to accept the death(41.7%) in hospice care, advices to choice of medical treatment using guide(50.1%) in introducing and guiding of health care facilities, pray(21.7%) in spiritual care' faith support. 2. Desired Health Teaching Content According to Period of Clients by Parish Nurse are: Vaccination(22.5%) in infant and toddler health management. sexual education(25.3%) in adolescent health management. prenatal care (29.5%) in pregnant health management. osteoporosis prevention and management (22.4%) in Middle aged health management. dementia prevention and management(25.5%) in elderly health management. 3. The expectant role from parish nurse is spiritual care faith support(14.1%). patient visiting care(13.2%), hospice care(12.9%), private counseling(12.8%), health check ups (11.1 %), volunteer organization and training out of believer(11.0%), private health education (9.3%), group health education (8.3%). 4. In Necessity of Performing Parish Nursing according to Region, Most(over 95%) responded that nursing program is needed. so there is no significance between regions. In Performing Parish Nursing in their church, Most(92.2%) responded they want to perform program. 5. In case of performing parish nursing, 52% out of the subjects responded they want to participated in parish nursing volunteer's activity, for example. to be in active to be a companion to chat(42.1%), necessity support (25.3%), donation support(25.0%), exercise support(18.2%), vehicles support (9.9%). As a result. in holistic care and spiritual care, the need of parish nursing and the role expectation from parish nurse are very high among korean believers. Therefore, I suggest parish nursing centering around Taegu and Kyungbuk province should be extended to nationwide. For extending parish nursing program. more active advertisement and research is needed. After performing parish nursing program through out the country, further comparative research between regions should be practiced and Korean parish nursing program will be developed and activated.

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