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Introduction:Female Sexual dysfunction is an important health concern caused by several factors. This study aimed to compare the sexual function of women who have primary headaches in order to investigate the relationship between sexual dysfunction and the features of headaches.Materials and Methods:95 consecutive patients aged 18 to 65 years with a history of headache for at least 1 month and sexually active in the last 6 months presenting to Psychiatry OPD of a tertiary care hospital in New Delhi giving informed consent were taken. The diagnosis of headache type was confirmed according to the 2nd edition of International Headache Society (IHS) International Classification of Headache Disorders (ICHD-II) in 2004. The Female Sexual Function Index (FSFI), visual analog scale (VAS) score and Migraine disability assessment scale score (MIDAS) were applied.Results:Those with migraines reported a greater intensity of pain than those with tension headaches. Individuals with tension headaches reported more frequent headaches. The mean MIDAS score in the migraine group was 14.64 (±2.59); 30% of the migraine group fell into the most severe category in MIDAS. Women with headaches had lower scores (indicating impaired sexual functioning) on all FSFI subscales, as well as on the total score when the prescribed cutoffs were applied as compared to controls (66.3% vs. 30% in controls).Conclusion:The present study showed that patients with either type of primary headache experience problems in several aspects of sexuality compared with controls.

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AimsThe Tony Hillis Unit (THU) is a locked rehabilitation unit for men aged 18–65 years with Treatment Resistant Psychosis, with or without mild personality disorders; drug and alcohol misuse; and challenging behaviour. The multi-disciplinary team including psychiatrists, psychologists, nurses, occupational therapists and specialist pharmacists offer service-users a holistic, personalised and pragmatic management plan to facilitate an improvement in their level of functioning. This service evaluation aimed to review the effectiveness of our intervention as a unit as defined by functional outcome at six months pre- and post- admission.MethodsA retrospective, mirror-image study design was used to collect data. Data were obtained from South London & Maudsley's Electronic Patient Journey System (ePJS) records. All patients discharged from THU over a two-year period, from May 2019 to May 2021, were considered in the study (n = 25 patients). Two service users died during the evaluation period and were excluded. A further service user was excluded as he had an admission length less than 28 days. Variables recorded included patient demographics and the presence of biopsychosocial interventions at THU including Clozapine initiation, engagement in weekly 1:1 occupational therapy (OT) and 1:1 psychology sessions. The functional status at six months pre-admission and post-discharge was defined by placement type, graded in terms of level of support; 1 = Psychiatric Intensive Care Unit, 2 = Acute ward, 3 = Rehabilitation service/Prison, 4 = Care home, 5 = Supported accommodation and 6 = Independent living. The change in patient acuity pre- and post- THU was compared using Wilcoxon-signed rank test.Results23 service users were included in this evaluation. The average admission length was 365 days, and average age at admission was 38 years. The difference in patient acuity before and after THU intervention was statistically significant (P < 0.005), with an overall reduction in level of placement support required. The most common placement prior to admission was an acute ward, compared to a rehabilitation service six months after discharge. 60% of patients (n = 13) were newly initiated or re-titrated on Clozapine during their admission, with a further 4 patients already on Clozapine. 82% of patients engaged with 1:1 weekly OT and 72% engaged with 1:1 weekly psychology sessions.ConclusionThis study demonstrates the effectiveness of our role as a locked rehabilitation unit. It outlines some of the key biopsychosocial interventions likely contributing to this, including initiation of Clozapine.