Navegando por Palavras-chave "disfunção sexual"
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- ItemAcesso aberto (Open Access)A acurácia da Escala de Experiência Sexual do Arizona (ASEX) para identificar disfunção sexual em pacientes do espectro da esquizofrenia(Faculdade de Medicina da Universidade de São Paulo, 2009-01-01) Nunes, Luciana Vargas Alves [UNIFESP]; Dieckmann, Luiz Henrique Junqueira [UNIFESP]; Lacaz, Fernando Sargo [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Matsuo, Tiemi; Mari, Jair de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Londrina Departamento de Estatística; University of London King's College Instituto de PsiquiatriaBACKGROUND: Sexual dysfunction is frequent in patients with schizophrenia, it is reported as one of the most distressing antipsychotic's adverse effects and it is directly related to treatment compliance. OBJECTIVES: a) to evaluate the accuracy of the Arizona Sexual Experience Scale (ASEX) to identify sexual dysfunction; b) to assess the frequency of sexual dysfunction in a sample of outpatients with schizophrenia and schizoaffective disorder under antipsychotic therapy; and c) to investigate the effect of different antipsychotics on sexual function. METHOD: Outpatients with schizophrenia or schizoaffective disorder were asked to fulfill both the ASEX and the Dickson Glazer Scale for the Assessment of Sexual Functioning Inventory (DGSFi) at a single interview. RESULTS: 137 patients were interwied. The sensitivity and specificity of the ASEX in relation to DGSFi were: 80.8%, (95% CI = 70.0%-88.5%) and 88.1% (95% CI = 76.5%-94.7%), and the misclassification rate was 9.5%. The ROC curve comparing the ASEX and the DGSFi scores revealed a value of 0.93 (CI = 0.879-0.970), with the optimum cut-off point of ASEX being 14/15. Sexual dysfunction measured was higher in females (79.2%) than in males (33.3%) (χ2 = 27.41, d.f. = 1, p < 0.001). DISCUSSION: Patients under antipsychotic treatment showed a high level of sexual complaints, and the ASEX proved to be an accurate instrument to identify sexual dysfunction in an outpatient sample of patients with schizophrenia spectrum. Females showed a higher frequency of sexual dysfunctions and sexual drive and ability to reach orgasm were the most affected areas. The use of antipsychotics, especially the combinations, was more likely to impair sexual functioning.
- ItemAcesso aberto (Open Access)Estudo comparativo dos tratamentos fisioterapêuticos e psicológicos em pacientes atendidas no setor de sexualidade feminina - Projeto Afrodite da Disciplina de Ginecologia endocrinológica da Universidade Federal de São Paulo(Universidade Federal de São Paulo (UNIFESP), 2013-04-24) Alcides, Maria Angelica [UNIFESP]; Silva, Ivaldo da [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objetive: To evaluate and compare the proposed physiotherapeutic and psychotherapeutic interventions in patients with the diagnosis of vaginismus. Methods: We evaluated and compared in a descriptive study with 24 women, two groups: physiotherapy treatment (G1) and psychological treatment and physiotherapy (G2). Both groups underwent screening and were assessed through evaluation form by the multidisciplinary team (Doctors, Psychologists, Physiotherapists) sector of female sexuality Unifesp. To evaluate the physical therapy evaluation was performed bodily and physical assessment of pelvic floor muscle using palpation method and perineal body (subjective) so we could see any changes involuntary spastic contraction. We evaluated the physical and functional integrity of the pelvic floor in order to assess possible changes in muscle through digital examination and/or bidigital (objective evaluation). Were also collected during the evaluation questionnaires Sexual Quality of Life ? Female Sexual Quotient and Inventory and Beck ? BDI (psychological evaluation) for both the G1 Group as well as for the Group G2. Only underwent the treatment, patients with diagnosis of vaginismus. After signing the consent form, the same was referred for treatment with physical therapy and psychology individualized treatments. The number of sessions for therapy (physiotherapy and psychological) were 10 initial sessions the treatment may be extended for 10 more sessions if the multidisciplinary team thought very necessary. The treatment group G1 and G2 were started by working sex education (through the mirror technique and illustrative booklet (anatomy of the internal and external genitalia). Treatment Group G1 was accomplished through relaxation techniques and perineal body, respiratory training, normalization of body tone and perineal massage performed with and desensitization and perineal body and application of specific exercises (body awareness ? and acceptance verbalization through visualization and perineal body in the mirror) (mirror technique ? visualization body) and (autofocus ? visual and tactile perception of the body in the mirror). Results: The study included 15 patients in Group G1 and 9 patients in Group G2. With respect to gynecological assessment, initially seventeen (70.83%) failed to perform evaluation at the end of treatment the twenty-for (100.0%) have done it. In assessing physiotherapy, seven (46.67%) and nine in Group G1 (100.0%) in Group G2 conducted subjective evaluation and eight (53.33%) underwent objective evaluation the end of treatment the twenty-four (100.0%) of the patients began to perform objective evaluation. There was also improvement in relation to the scores of QSF (Female Sexual Quotient) and BDI (Beck Inventory of Psychological Assessment) and regarding the Partial and Total Penetration. Conclusions: physiotherapy should be an integral part of the multidisciplinary team treating sexual dysfunctions, we conclude also that the resources physiotherapeutic help produce physical changes in the body and perineal muscle, central nervous system, altering the mechanism of pain through the reeducation sensory motor.
- ItemSomente MetadadadosO impacto da incontinência urinária na sexualidade feminina(Universidade Federal de São Paulo (UNIFESP), 2015-06-30) Felippe, Mariana Rhein [UNIFESP]; Almeida, Fernando Goncalves de Almeida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To determine the impact of urinary incontinence (UI) on female sexuality. Methods: From August, 2011 to September, 2012 incontinent women were evaluated in the Women's Voiding dysfunction clinic of the Hospital São Paulo Urology sector (HSP) and asymptomatic women in the outpatient hypertension and Ophthalmology of the same institution. Women with UI were evaluated using validated questionnaires ICIQ -SF (International Consultationon Incontinence Questionnaire - Short Form), OAB-q (Overactive Bladder- questionnaire), WHOOQol (World health organization for quality of life), QS-F (Quotient sexuality- Female Version), clinical and physical evaluation, and pad test. The asymptomatic women were applied only questionnaires. Results: 356 women with an average of 56.9±10.9 years were inclued, 243 women with urinary incontinence (UI group) and 113 asymptomatic women (control group - CG). In the UI group, 129 patients (52.2%) reported being sexually inactive. The presence of UI has proven to be an independent risk factor for sexual abstinence in those women. In sexually active women, although both groups had the same sexual frequency (p=0.675), all data on sexuality were significantly worse in the IU group. Urinary Incontinent women have a QS-F significantly lower score (58.02 -73.35 p <0.001) and a higher prevalence of sexual dysfunction (52%, p <0.001). Women with UI showed overall quality of life lower than the asymptomatic women. 46% of women with UI reported losing urine during intercourse and 49% state that the UI interfers negatively in their sexual life. Women with more severe urinary incontinence had significantly worse scores on the QS-F. Despite the higher proportion of patients with mixed symptoms (68%), there wasn?t any relationship between the type of symptom (SUI, BH, IUM) and the presence of sexual dysfunction. (P = 0.251). Conclusion: Women with urinary incontinence have a higher chance of leaving the sex life and the ones who remain sexually active have a global damage on sexual function.