Sexual dysfunction: classification and assessment

SummarySexual dysfunction is one of the most common psychiatric disorders, but it is often ignored in assessment. It can be primary or secondary (a result of psychiatric disorder or medication). Success rates in managing sexual dysfunction are relatively high, with good response to psychological and medical interventions. In ICD-10 and DSM-IV-TR, sexual dysfunctions are broadly classified on the basis of the stages of sexual activity, from arousal to orgasm. There are major similarities between ICD and DSM in diagnosis and classification of sexual dysfunction, but both systems raise challenges. These include definitions of what is 'normal' and how abnormality is defined. In this article, we describe the role of the two systems and possible amendments that might help researchers and clinicians. We also present key principles for the assessment and treatment of people who experience sexual dysfunction. We consider problems that need to be managed in engaging and in the therapeutic alliance

Globalization: Mental Health and Social Economic Factors

Several factors associated with globalization have mental health consequences. This article reviews the literature on mental health and inequality, occupational patterns and identity shifts before considering the role of globalization as an acculturative stressor. We argue that a re-evaluation of mental health policy in light of globalization must look further than current studies of migrants to consider indigenous communities where models of social experience and behaviour are changing

The Global Prevalence of Schizophrenia

Bhugra discusses the implications of a new study in PLoS Medicine that challenges widely held assumptions about the epidemiology of schizophrenia

Mental Health and Quality of Life of Frontline Health Care Workers After One Year of Covid-19 Pandemic

Abstract Aim: This study aimed to investigate the impact of more than one year of COVID-19 pandemic on the quality of life and mental health (in terms of depression, anxiety, stress, fear, burnout – workload) among Frontline Health Care Workers (HCWs). Subjects and methods: This is a cross-sectional survey based on 1,479 frontline HCW participants aged 20-65 years in Turkey who completed a survey including the 21-item Depression, Anxiety, Stress Scale (DASS-21), Burnout, Fear of COVID-19 Scale (FCV-19S), and WHO (World Health Organization) Quality of Life instruments during March-July 2021. Bivariate, factorial and multivariate statistical analyses were performed. Results: Statistically significant differences were found between three frontline groups of HCWs (Physicians, Nurses, Others) including: age (p<0.001), gender (p<0.001), educational level (p<0.001), income (p<0.001), number of calls per week (p<0.001). There were significantly high scores of fear of COVID-19 for all items among physicians. The findings also showed that the prevalence of depression (p=0.002), anxiety (p<0.001), and stress (p<10.005) and Pittsburgh Sleep Quality Index (p=0.011) were significantly different among the three groups of frontline HCWs. The work-related burnout was over 30% in general. The Kaiser-Meyer-Olkin Measure was 0.840 and indicated that the data of the study were suitable for a factor analysis. The factor analysis found out three factors with eigenvalue greater than one. These factors were consistent with the original scale. The multiple linear regression analysis revealed anxiety (p<0.001), stress(p<0.001), fear of COVID-19 and Burnout (p=0.008), depression (p=0.004), lack of sleeping- Pittsburgh Sleep Quality Index (p=0.014) and feeling exhausted (p=0.025) were associated with the quality of life during the COVID-19 pandemic after adjusting for the age and gender. Conclusion: The findings of this study show that fear and burnout related to COVID-19 were significantly associated with high scores of depression, anxiety, stress, and burnout after one year of pandemic among frontline-HCWs, with poor quality of life and sleep

PrEP in India’s HIV Prevention Policy in the Era of Social Media and Sex Positivity

Introduction: The global revolution of online social media and connectivity had a tremendous effect on sexual behavior in both developed and developing countries. This global change is influencing the societal structure and existing social principles. Moreover, it has a significant impact on the epidemiology of different infectious diseases, especially HIV.Discussion: India is one of the most diverse democratic countries that has undergone a social-cultural transition in the last decade. However, having the second-highest HIV infection rate in the world, India does not have any other new prevention tools in their national HIV prevention strategy. Pre-Exposure Prophylaxis (PrEP), a boon of HIV prevention widely used in different countries, is still not implemented in India. The concept of “Digital India” by the Government of India is giving wide access of internet to the people of India. Furthermore, people are exposed to social media, and that is impacting their sex seeking behavior. Interestingly, recent legal changes in India promotes sex positivity. It also calls for introspection on existing HIV preventive strategies.Conclusion: Given the current scenario of PrEP and other existing preventive measurements of HIV, further research is needed to determine the acceptance and efficacy of PrEP and improve engagement in care for individuals in India. Various international studies recommend effective implication of PrEP to reduce the rate and economic burden of HIV infection