Estimating the indirect prevalence of female genital mutilation/cutting in Switzerland

BACKGROUND: We updated the indirect estimates for women and girls living with Female Genital Mutilation Cutting (FGM/C) in Switzerland, using data from the Swiss Federal Statistical Office of migrant women and girls born in one of the 30 high-prevalence FGM/C countries that are currently living in Switzerland. METHODS: We used Yoder and Van Baelen's "Extrapolation of FGM/C Countries' Prevalence Data" method, where we applied DHS and MICS prevalence figures from the 30 countries where FGM/C is practiced, and applied them to the immigrant women and girls living in Switzerland from the same 30 countries. RESULTS: In 2010, the estimated number of women and girls living with or at risk of FGM/C in Switzerland was 9059, whereas in 2018, we estimated that 21,706 women and girls were living with or at risk of FGM/C. CONCLUSION: Over the past decade, there have been significant increases in the number of estimated women and girls living with or at risk of FGM/C in Switzerland due to the increase in the total number of women and girls originally coming form the countries where the practice of FGM/C is traditional

Diagnoses and procedures of inpatients with female genital mutilation/cutting in Swiss University Hospitals: a cross-sectional study

BACKGROUND: Female genital mutilation/cutting (FGM/C) can result in short and long-term complications, which can impact physical, psychological and sexual health. Our objective was to obtain descriptive data about the most frequent health conditions and procedures associated with FGM/C in Swiss university hospitals inpatient women and girls with a condition/diagnosis of FGM/C. Our research focused on the gynaecology and obstetrics departments. METHODS: We conducted an exploratory descriptive study to identify the health outcomes of women and girls with a coded FGM/C diagnose who had been admitted to Swiss university hospitals between 2016 and 2018. Four of the five Swiss university hospitals provided anonymized data on primary and secondary diagnoses coded with the International Classification of Diseases (ICD) and interventions coded in their medical files. RESULTS: Between 2016 and 2018, 207 inpatients had a condition/diagnosis of FGM/C. The majority (96%) were admitted either to gynaecology or obstetrics divisions with few genito-urinary and psychosexual conditions coded. CONCLUSIONS: FGM/C coding capacities in Swiss university hospitals are low, and some complications of FGM/C are probably not diagnosed. Pregnancy and delivery represent key moments to identify and offer medical care to women and girls who live with FGM/C. TRIAL REGISTRATION: This cross-sectional study (protocol number 2018-01851) was conducted in 2019, and approved by the Swiss ethics committee

Results of a World Health Organization scoping of sexual dysfunction-related guidelines: what exists and what is needed

BACKGROUND: Sexual dysfunction has long been overlooked in the broader context of sexual and reproductive health services. As a result, and in the absence of international sexual dysfunction treatment guidelines, recommendations have instead been developed by a variety of professional associations, worldwide. AIM: We conducted a mapping of existing recommendations addressing a wide array of conditions related to sexual function/dysfunction. METHODS: We contacted 25 professional associations from around the world and held an online open call for guidelines. OUTCOMES: Eligible submissions had to provide recommendations on treatment related to male or female sexual dysfunction. RESULTS: Twelve guidelines from 11 associations were included. Of the 195 recommendations extracted, 61% were related to men, 53% were related specifically to treatment, and 48% did some form of evidence assessment. CONCLUSION: Recommendations from this exercise are provided for WHO, international and national research institutions, ministries of health, and professional associations. Gonsalves L, Cottler-Casanova S, VanTreeck K, et al. Results of a World Health Organization Scoping of Sexual Dysfunction-Related Guidelines: What Exists and What Is Needed. J Sex Med 2020;XX:XXX-XXX

The evolution of the female sexual disorder/dysfunction definitions, nomenclature, and classifications: a review of DSM, ICSM, ISSWSH, and ICD

INTRODUCTION: The 2 most well-known classification systems that include sexual medicine diagnoses are the International Classification of Diseases and Statistics (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM). Sexual medicine experts from international societies representing an array of disciplines have revised and redefined female sexual dysfunctions (FSDs) to reflect current scientific evidence and the state of the art. AIM: To summarize the evidence and interactive and chronological process by which sexual medicine societies' consensus groups developed the current nomenclature, classifications, and definitions for FSDs. METHODS: We review the contributions and collaborations of the Fourth International Consultation in Sexual Medicine (ICSM), the International Society for the Study of Women's Sexual Health (ISSWSH), and the World Association of Sexual Health in conjunction with the World Health Organization. MAIN OUTCOME MEASURES: The ICSM and ISSWSH diagnostic systems are contrasted with the DSM classification. We discuss innovations and strengths; relevant evidence regarding epidemiology, etiology, and risk factors; and key differences. We describe how sexual medicine expertise informed FSD codes in the ICD-11 classification. RESULTS: ICSM and ISSWSH published evidence-based guidelines on the definitions, nomenclature, and diagnostic criteria for FSD that diverge from the DSM psychiatric compendia. These definitions and nomenclature recommend the separation of female sexual desire and arousal disorders, elaborate on subtypes of arousal problems, broaden the scope of sexual pain definitions, and provide a greater understanding of etiologies and risk factors for FSDs. CONCLUSIONS: These collaborations among sexual medicine experts and their role in the ICD-11 development process provide confidence that the ICD-11 Sexual Dysfunction codes are based on current scientific evidence for diagnosing and coding FSDs in clinical settings worldwide, can serve as endpoints in clinical trials, and will provide specificity for treatment outcomes for FSD therapies. Parish SJ, Cottler-Casanova S, Clayton AH, et al. The Evolution of the Female Sexual Disorder/Dysfunction Definitions, Nomenclature, and Classifications: A Review of DSM, ICSM, ISSWSH, and ICD. J Sex Med 2020;XX:XXX-XXX

Transtorno de estresse pós-traumático em uma unidade de saúde de atenção primária Trastorno de estrés postraumático en una unidad de salud de atención primaria Posttraumatic stress disorder in a primary health care service

INTRODUÇÃO: O transtorno de estresse pós-traumático (TEPT) caracteriza-se pelo desenvolvimento de sintomas como a re-experienciação do evento traumático (pesadelos, idéias intrusivas, sintomas somáticos relacionados ao momento do trauma), evitação e embotamento (evitar situações, pessoas ou comportamentos que relembrem o trauma e ter dificuldade para lidar com novas situações ou sentimentos) e excitabilidade aumentada (insônia, irritação, dificuldade de concentração e um estado permanente de alerta e sobressalto). É importante saber a freqüência do transtorno numa comunidade pobre. OBJETIVO: Identificar a freqüência de TEPT e a presença de sintomas depressivos e alcoolismo em um serviço de atenção primária. METODOLOGIA: O estudo ocorreu na Unidade de Saúde Divina Providência, do Serviço de Saúde Comunitária do Grupo Hospitalar Conceição. Realizou-se uma amostragem aleatória dos pacientes que consultaram no posto. Foram aplicados instrumentos para a identificação de TEPT, sintomas depressivos, alcoolismo e perfil sociodemográfico. RESULTADOS: Dos 54 pacientes entrevistados, 83,3% eram mulheres, e a média da idade foi de 39 anos. Os sintomas depressivos severos foram identificados em 28% dos pacientes; 59% tinham o critério de TEPT e 12,5% apresentavam problemas com álcool. CONCLUSÕES: A amostra do sexo feminino foi predominante e houve uma elevada prevalência de TEPT.<br>INTRODUCCÍON: El trastorno de estrés postraumático (TEP) se caracteriza por el desarrollo de síntomas como la retomada de la experimentación del evento traumático (pesadilla, ideas de intrusión, síntomas somáticos relacionados a la ocasión del trauma); evitación y embotamiento (evitar situaciones, personas o comportamientos que recuerden el trauma y tener dificultad para convivir con nuevas situaciones o sentimientos) y excitabilidad ampliada (insomnio, irritación, dificultad de concentración y un estado permanente de alerta y sobresalto). Es importante saber la frecuencia en una comunidad pobre. OBJETIVO: Identificar la frecuencia del TEP, la presencia de síntomas de depresión y alcoholismo en un servicio de atención primaria. METODOLOGÍA: El análisis se realizó en la Unidade de Saúde Divina Providência del Servicio de Salud Comunitaria del Grupo Hospitalar Conceição. Se hizo una muestra aleatoria de los pacientes que consultaron en el Servicio. Se utilizaron los síntomas depresivos, el alcoholismo y el perfil sociodemográfico como instrumentos de la identificación del TEP. RESULTADOS: De los 54 pacientes entrevistados 83,3% eran mujeres y el promedio de edad fue de 39 años. Se identificó síntomas depresivos severos en 28% de los pacientes, el 59% tenían el criterio de TEP y el 12,5% presentaban problemas con el alcohol. CONCLUSIÓN: La mayoría de los pacientes entrevistados era del sexo femenino y hubo una alta prevalencia de TEP.<br>INTRODUCTION: Posttraumatic stress disorder (PTSD) is characterized by the development of symptoms such as the reexperience of traumatic events (nightmares, intrusive thoughts, somatic symptoms associated with the trauma), avoidance (trying to avoid situations, people or behaviors associated with the trauma and having difficulty in dealing with new situations and feelings) and increased arousal (insomnia, irritability, difficulty in concentrating, hypervigilance and exaggerated startle response). Being aware of the frequency of PTSD in poor communities is of paramount importance. OBJECTIVE: To identify the frequency of PTSD and the presence of depressive symptoms andalcohol abuse in a primary health care service. METHODS: The study was carried out at the Divina Providência Health Care Service, Grupo Hospitalar Conceição. Patients seen at the service were selected randomly. PTSD, depression, alcohol abuse and the sociodemographic profile of the patients were determined. RESULTS: Of the 54 patients included in the study, 83.3% were female; mean age was 39 years. Severe depressive symptoms were found in 28% of the patients; 59% fulfilled the criteria for PTSD diagnosis, and 12.5% had problems with alcohol. CONCLUSIONS: The majority of patients were female, and the prevalence of PTSD was high