Bibliotherapeutic tools: An adjunct to promote our patients’ sexual health?

peer reviewedIt’s known that sexual health of people with psychiatric and psychological disorders is often highly impoverished. Mental health professionals may feel helpless against these sexual difficulties, because of being poorly trained to treat them and lacking the means to do it. In this context, it seems important to inform patients about sexual difficulties and treatment options. Although it’s impossible to assign a sex therapist to each mental health service, it could be very useful to use bibliotherapeutic documentation to guide people with sexual difficulties in finding solutions. This mode of treatment which consists in putting information and therapeutic guidelines on writing is called « bibliotherapy ». Some bibliotherapies have already been developed and tested in the field of sexual disorders. Others, experimental, are nowadays under clinical evaluation, notably by three of the authors of the present paper. Bibliotherapy could be a helpful adjunct in improving the sexual health of dayhospital patients.Il est connu que la santé sexuelle des personnes souffrant d’affections psychiatriques et psychologiques est souvent fortement appauvrie. Les intervenants en santé mentale se sentent parfois désarmés face à ces difficultés sexuelles, peu formés qu’ils sont pour les prendre en charge, manquant de moyens pour y répondre. Dans ce contexte, l’information des patients sur les difficultés sexuelles et leurs possibilités de traitement semble indispensable. S’il est inenvisageable d’affecter un sexologue à chaque service de santé mentale, il pourrait être en revanche bien utile de recourir à des documents bibliothérapeutiques afin d’aiguiller les personnes en souffrance à ce niveau dans la recherche de solutions. On appelle « bibliothérapie » ce mode de traitement qui consiste à diffuser par écrit des informations et des consignes thérapeutiques. Certaines bibliothérapies ont déjà été élaborées et testées dans le domaine des troubles sexuels ; d’autres, expérimentales, sont en cours d’évaluation clinique notamment par les soins de trois des auteurs du présent article. Il pourrait s’agir d’adjuvants appréciables s’agissant d’améliorer la santé sexuelle des patients des hôpitaux de jour

Clinical outcomes of a new cognitive-behaviour bibliotherapy for premature ejaculation

INTRODUCTION. Premature ejaculation (PE) is a common sexual disorder. However, only few affected people consult clinicians in order to overcome this problem. Although no definitive consensus about its aetiology emerges, some mechanisms of PE are now well known. This allows more precise and efficient treatments, both at pharmacological as well as cognitive-behavioural levels. Further, studies have shown that reading didactical documents about their PE problem might be useful to men. Such approach is called “bibliotherapy”. AIM. The aim of the present study was to improve the bibliotherapy approach on the basis of up to date knowledge and techniques. The expected benefits were: (1) an efficient manual shorter than previous ones, (2) therapeutic principles easier to assimilate and (3) a method thereby made accessible to a large public which usually does not consult for this type of sexual problem. METHOD. A short bibliotherapy named Practical Guide of PE [in French] was tested among 421 PE subjects (DSM-IV diagnosis criteria). Self-reported anxiety, sexual satisfaction, ejaculatory latency time, feeling of control and distress were measured: (1) at baseline, (2) at 4-8 months and (3) at 10-14 months after reading the Practical guide of PE. A control condition was composed by 67 subjects left on a waiting-list for two months after baseline. RESULTS. Significant improvements were found for all the self-reported parameters, either at 4-8 and at 10-14 months after the bibliotherapy. The improvements were associated with an adjustment of sexual cognitions (SIQ, McCormick & Jordan). The response to treatment seemed better when the severity of PE was moderate, but did not seem related to variables such as age, educational level and personality traits (TCI-R, Cloninger; STAI Y-B, Spielberger.) CONCLUSION: Its cost/benefit ratio makes the Practical Guide an ideal first line therapeutic tool. Its large diffusion might be useful in order to improve sexual health in population

Patient Satisfaction and Retrospective Evaluation of Benefits of Penile Prosthetic Implantation Surgery: the OEDIPUS Study

peer reviewedIntroduction: Penile Prosthetic Implantation (PPI) is the method of choice for patients not responding to or contra indicated for conservative treatment of Erectile Dysfunction (ED). Complete satisfaction has not been expressed in all cases. Aim: Using validated questionnaires, this study sought to assess the satisfaction of patients who underwent PPI and of their partners, along with potential determinants of satisfaction. It also assessed the benefits afforded by PPI on the subjects’ and their partners' sexual satisfaction, general mood, and quality of life. Methods: This was a retrospective, single-center, open label study, including patients who had undergone PPI between 2009 and 2012 at our center. Main outcome measures: Patient/partner satisfaction with PPI was assessed using the EDITS scale. Patient and partner attitude towards PPI were evaluated using the API and AAPPI scales, respectively. Each subject’s satisfaction with PPI size was assessed with answer grades ranging from 1 to 5. Patient and partner personal, sexual, and relationship well-beings were evaluated using an answer scoring system. Results: Study questionnaire responses were received from 96 patients who underwent PPI at our center, and from 56 partners. The mean EDITS scores of patients and partners were 82.78 (± 15.58) and 83.30 (± 15.41), respectively, suggesting high satisfaction. The mean attitude score towards PPI of patients and partners were 18.87 (± 8.42) and 14.45 (± 5.06), on the API and AAPI scales, respectively. EDITS scores significantly correlated with the patients' satisfaction with the implanted penis size, and patients' and partners' attitudes towards PPI, on the API and AAPIP scores, respectively. Conclusions: PPI exerts an excellent impact on patient and partner satisfaction, sex-life, and overall quality of life.OEDIPU

BibliothEP : a study evaluating the effectiveness of bibliotherapy for premature ejaculation

Objective. The BibliothEP study aimed to assess the efficacy of a bibliotherapy for premature ejaculation (PE) Design and method. The study was conducted in two phases. First, a sample of 120 participants suffering from PE read a concise cognitive behavioural self-help manual for PE (51 A5 pages including illustrations) and were compared after treatment to 66 waiting list controls. Second, 36 subjects received and read the self-help manual and were compared after treatment to 32 subjects having received the same manual plus a complementary brief guidance (45-90 minutes) from a coach not specialised in sex therapy, but who had been specifically trained to support the bibliotherapy intervention (by attending a 5-hour training module). The main outcome measures were selfdetermined latency time to ejaculation, feelings of control, sexual satisfaction, PErelated distress and subjective impression of improvement. Results. At 6-month posttreatment, all participants showed significant improvements as compared to waiting list condition. The improvements were maintained at 12 month. They were slightly greater in the case of complementary therapist support. Improvements were demonstrated for all forms of PE, but the intervention appeared to be slightly more effective when the problem was of moderate severity. In all cases, improvements in sexual functioning were accompanied by improvements in sexual cognitions. Conclusions. The cost-effectiveness of the self-help manual makes it a valuable first-line treatment for any form of PE. Moreover, the outcome of the bibliotherapy process might be increased by coaching from a health worker specifically trained to this aim

BibliothEP: a study evaluating the effectiveness of bibliotherapy for premature ejaculation

Objective. The BibliothEP study aimed to assess the efficacy of a bibliotherapy for premature ejaculation (PE) Design and method. The study was conducted in two phases. First, a sample of 120 participants suffering from PE read a concise cognitive behavioural self-help manual for PE (51 A5 pages including illustrations) and were compared after treatment to 66 waiting list controls. Second, 36 subjects received and read the self-help manual and were compared after treatment to 32 subjects having received the same manual plus a complementary brief guidance (45-90 minutes) from a coach not specialised in sex therapy, but who had been specifically trained to support the bibliotherapy intervention (by attending a 5-hour training module). The main outcome measures were self-determined latency time to ejaculation, feelings of control, sexual satisfaction, PE-related distress and subjective impression of improvement. Results. At 6-month posttreatment, all participants showed significant improvements as compared to waiting list condition. The improvements were maintained at 12 month. They were slightly greater in the case of complementary therapist support. Improvements were demonstrated for all forms of PE, but the intervention appeared to be slightly more effective when the problem was of moderate severity. In all cases, improvements in sexual functioning were accompanied by improvements in sexual cognitions. Conclusions. The cost-effectiveness of the self-help manual makes it a valuable first-line treatment for any form of PE. Moreover, the outcome of the bibliotherapy process might be increased by coaching from a health worker specifically trained to this aim

The BibliothEP project: Development and validation of a bibliotherapy for premature ejaculation (PE) for use alone or in a therapeutic relationship

BbibliothEP: étude d'efficacité clinique d'une bibliothérapie de l'éjaculation précoce (EP

Clinical outcomes of a new self-help booklet for premature ejaculation

INTRODUCTION. Premature ejaculation (PE) is quite common. Although effective treatments do exist, only a few affected people consult a practitioner in order to overcome their problem. At the same time, studies have shown that reading didactical documents about their PE problem (bibliotherapy) can be useful to men. AIM. The aim of this study was to improve the bibliotherapy approach using up to date knowledge and techniques. The expected benefits were: (1) an effective manual shorter than previous ones, (2) easier to assimilate therapeutic principles and (3) a method thereby made accessible to a broad population most of whom usually do not consult for this type of sexual problem. METHOD. A short bibliotherapy titled The Practical Guide of PE [in French] was tested among PE subjects who were diagnosed with PE according to DSM-IV-TR criteria. Assessments were made at baseline (N = 421), at 4-8 months (N = 120) and at 10-14 months (N = 79) after they read The Practical Guide. A control group of 66 subjects was left on a waiting list and was assessed two months after baseline. MAIN OUTCOME MEASURES. Self-reported ejaculatory latency time, feeling of control upon ejaculation, sexual satisfaction, distress related to PE, anxiety experienced during sexual intercourse and sexual cognitions (SIQ). RESULTS. Significant improvements were found for all the self-reported parameters, both at 4-8 and at 10-14 months after the bibliotherapy. The improvements were associated with an adjustment of sexual cognitions. The response to treatment seemed better for those subjects with moderate PE. Although the severity criteria used in this study did not precisely meet the ISSM criteria for lifelong PE, they were likely related. The response did not seem to be affected by variables such as age, education or personality. CONCLUSION. Its cost/benefit ratio makes The Practical Guide a valuable therapeutic tool.BibliothE

Functional and Psychological Characteristics of Belgian Men with Premature Ejaculation and Their Partners

Physiological, behavioral, cognitive, and emotional factors are generally acknowledged to play a role in premature ejaculation (PE). However, the nature and the extent of their etiological impact remain largely imprecise. The present study examined functional and psychometric dynamics at work in a PE population. A total of 461 men with PE and 80 partners completed an online questionnaire. The main outcome measures were self-reported ejaculatory latency time, the feeling of control upon ejaculation, sexual satisfaction, distress related to PE, trait anxiety (STAI-B), sexual cognitions (SIQ), social anxiety (LSAS and SISST), and personality traits (TCI-R). In our sample, the median latency time to ejaculation was between 1 and 2 minutes. Sexual satisfaction and distress correlated more strongly with the feeling of control than with the self-reported latency time. Men experienced more distress and dissatisfaction related to PE than did their partners while overestimating their partners’ distress and dissatisfaction. PE participants’ scores differed significantly, albeit slightly, from STAI-B, SIQ, LSAS, and SISST norms. The differences were negligible on TCI-R. Some differences became stronger when subtypes were considered. Participants combining generalized and lifelong PE with self-reported latency times of < 30 sec reported lower sexual satisfaction and control, higher distress, higher social anxiety, and harm avoidance (TCI-R/HA) scores. By contrast, the situational subtype of PE was found to be characterized by a higher level of satisfaction, a greater feeling of control, less distress, and higher trait anxiety scores. However, the trends remained statistically discrete.BibliothE