Background Sexual dysfunction may be a side effect of treatment with antipsychotics, antidepressants, and other psychotropic drugs. Aim To review the evidence concerning male sexual dysfunctions in patients taking psychotropic drugs to provide specific information to nonpsychiatric physicians for the management of these dysfunctions. Methods A systematic search of Medline and Embase databases was performed up to October 15th, 2020. We included randomized controlled trials comparing the effects of psychotropic drugs versus placebo or versus another drug of the same class, for at least 5 weeks. Outcomes We considered studies whose male population could be evaluated separately from the female population and with a separate analysis of the different phases of the male sex cycle. RESULTS We included 41 studies in the final review. There was a significant association between sexual dysfunction and antidepressant drug therapy, compared to placebo (decreased libido OR 1.89, 95% CI:1.40 to 2.56, 22 series, 11 trials, 7706 participants; erectile dysfunction OR = 2.28, 95% CI: 1.31 to 3.97; 11 trials, 3008 participants; ejaculatory dysfunction OR = 7.31, 95% CI: 4.38 to 12.20,19 trials, 3973 participants). When the effects of selective serotonin reuptake inhibitors (SSRIs) were evaluated separately from those of serotonin/norepinephrine reuptake inhibitors (SNRIs), the use of SNRIs but not that of SSRIs was characterized by significantly higher odds of erectile dysfunction compared to placebo. Only limited data were found regarding the effects of antipsychotics on the phases of the male sexual cycle, as it was shown that aripiprazole and risperidone showed lower and higher odds for erectile or ejaculatory dysfunction, respectively, compared to other atypical antipsychotics. Clinical Implications Treatment of male sexual dysfunction in patients taking psychotropics requires a basic knowledge of the different drugs that affect sexual function with different mechanisms. Strengths & Limitations The effects of psychotropic drugs on erectile function and ejaculation were evaluated separately. The great variability of the mechanisms of action makes it difficult to make comparisons between the effects of the different classes of psychotropic drugs. CONCLUSIONS Administration of antipsychotics affects male sexual function with different mechanisms, although the increase in prolactin values associated with the administration of first-generation antipsychotics and some atypical, such as risperidone, seems to play a primary role in determining male sexual dysfunction. Most antidepressants cause decreased libido, ejaculatory and erectile dysfunction, however the administration of SNRIs appears to be possibly associated with a specific risk of erectile dysfunction.

No abstract

It’s becoming even more widely recognized from neurosciences, epigenetics, and clinical research on observation of infant-caregiver interaction that daily cumulated micro-traumatic experiences cause damages not only to one’s mental health and identity, but also to immune system, leading to metabolic, eating, sleeping, affective, behavioural, cognitive and linguistic, and social disorders in adults as well as in children and infants. Relational Psychoanalytic treatment argues that the therapeutic change is related to expanding levels of consciousness and exploring new ways of being in the world. Clinical examples are provided.

Introduction/Aim: A spectrum of psychological problems is commonly found in CP/CPPS patients, though it is not yet clear whether, a priori, psychological dysfunctions are the cause of these pain syndromes, or whether these pain conditions are themselves causing psychological disturbances. In this article we present the current perspective on the impact of psychological problems in chronic prostatitis syndromes and we discuss the implications thereof from a clinical perspective. Materials and Methods: A database and a manual search were conducted in the MEDLINE database of the National Library of Medicine, EMBASE, and other libraries using the key words “prostatitis syndromes”, “chronic bacterial prostatitis”, “chronic pelvic pain”, in various combinations with the terms “psychological issues”, “depression” “anxiety”, “stress”, “unhappiness”, “cognitive status” and “personality”. Two independent reviewers performed data extraction. We included clinical studies with available information on chronic prostatitis and related psychological conditions. We considered full-text written papers. We excluded reviews and case reports. In order to reduce the risk of bias we analyzed only studies including patients with confirmed CBP or CP/CPPS. Bibliographic information in the selected publications was checked for relevant records not included in the initial search. Results: Database search allowed us to retrieve 638 studies to which we added to 16 additional studies retrieved by hand-searching. After screening, 34 relevant papers were identified for thorough review. Most studies included patients with chronic pelvic pain and prostatitis-like symptoms, whereas a smaller number of studies included patients with methodologically con- firmed CP/CPPS including studies with a microbiologically confirmed diagnosis of CBP. The psychosocial factors examined in the selected studies include pain, catastrophizing, stress, personality factors and social aspects. Comorbid psychiatric disorders evidenced in the studies included depression, anxiety and trauma-related disorders, somatization disorders, and substance abuse. Some studies investigated the association of pain with each individual psychological disturbance, while others examined the impact of pain in association with the overall quality of life. Sample size, study design and diagnostic measures varied among studies. Conclusions: Despite limitations and variations in sample size, study design and diagnostic measures in all included studies, a relation between chronic prostatitis and psychological problems is a consistent finding. The existing evidence does not permit to definitely conclude whether psychological problems are a risk factor for CP/CPPS or whether they represent an array of symptoms that are associated with the exacerbation of this disease.

L’articolo tratta il fenomeno della migrazione dal punto di vista psicoanalitico insieme alle tematiche dell’interculturalità e della genitorialità. Tale lavoro vuol fare emergere la condizione di particolare vulnerabilità che caratterizza i soggetti migranti, nel loro confrontarsi con il complesso passaggio alla genitorialità. Le autrici intendono presentare le potenziali difficoltà connesse ai processi migratori, in particolare per quanto riguarda la sofferenza che molte donne vivono lasciando il loro paese d’origine e le violenze fisiche e psicologiche che spesso sono costrette a subire. Il complesso tema della migrazione viene affrontato con riguardo agli aspetti dell’integrazione e alle relative dinamiche che la caratterizzano, all’interno di una visione epistemica dell’essere umano, in cui ciascun soggetto mette a disposizione le proprie fragilità, risorse e competenze in un’ottica di crescita umana. Attraverso il viaggio terapeutico, il viaggio migratorio assume dignità e consistenza permettendo così ad entrambi di esistere.