Sleep disorders are very common in children with neurodevelopmental disorders such as autism. Poor sleep can have detrimental effects on cognitive processes, attention, memory, language, and regulation of mood and behavior. Many people with autism have difficulty correctly processing sensory information that reaches them from both the environment and their own body. Depending on how the person with autism perceives the sensations, these can impact on sleep, causing nighttime awakenings or poor sleep conciliation. It is vitally important to evaluate nighttime rest and have knowledge of appropriate tools to improve sleep in patients with ASD.

In this work we aim to evaluate, in a child-youth population diagnosed with ASD who have been admitted to our ASD Day Hospital during the year 2024, the prevalence of sleep disorders and their characteristics. As well as generating strategies to improve sleep conciliation and factors to take into account or avoid that may be affecting our patients.

A review is carried out of the clinical history of patients admitted to the TEA Day Hospital during the year 2024. Sleep problems are analyzed, as well as their relationship with stress. Results and measures to improve the quality of night rest in these patients are presented.

From January to September 2024, a total of 26 patients with autism have been treated at the ASD Day Hospital of the University Hospital of Mutua Terrasa, in the following programs: intensive, eating problems and low functionality. Of these, 32% were women, with an average age of 11.64 and an average stay of 40 days.

More than half of the patients had sleep problems, where the majority had more than one. Among the most frequent: difficulties falling asleep (12), maintenance insomnia (8), frequent awakenings (4), night terrors (6), and the need for the presence of parents and/or sensory interventions to be able to fall asleep (12).

The main interventions carried out have consisted of: establishing adequate sleeping habits, avoiding naps, avoiding highly stimulating activities, feeling tired beforehand, adapting environmental conditions to the needs of the child and giving proprioceptive information before sleeping.

Among the most commonly used drugs we found atypical antipsychotics: olanzapine, risperidone. Some antidepressants: mirtazapine and occasionally benzodiazepines. The vast majority of children took melatonin.

Sleep disorders are highly prevalent in patients with ASD, but correct intervention can improve comorbid symptoms such as anxiety, stress and discomfort, which are largely related to poor sleep.

Sensory-perceptive interventions are essential to improve nighttime rest in children with ASD

None Declared

Many definitions have been proposed for polypharmacy, but the most common is the concurrent use of five or more medications. It is a growing concern among older adults and is associated with numerous adverse effects and drug-drug interactions. Beyond its impact on physical health, research suggests that polypharmacy may also affect mental health, which could potentially be linked to poor sleep quality.

The current study objective is to investigate the sleep quality of polypharmacy older adults and its association with depression and anxiety in this population.

A cross-sectional study was conducted in Iraq from June to August 2024. A total of 245 participants were selected from internal medicine wards in hospitals and private clinics. All participants were aged 50 years or older and had been taking five or more medications for at least 90 days. The study questionnaire comprised three main sections: demographic data, the Patient Health Questionnaire-4 (PHQ-4), and the Pittsburgh Sleep Quality Index (PSQI). A PSQI score greater than 5 was used to identify poor sleepers. The association between poor sleep and other factors was assessed by using chi-squared tests and binary logistic regression.

The sample consisted of 245 polypharmacy patients, with a mean age of 61.5 ± 12.4 years. Of the participants, 150 (61%) were female and 95 (39%) were male. Anxiety was observed in 95 (38.8%) participants, depression in 96 (39.2%), and poor sleep quality in 189 (77.1%). The study found significant associations between both anxiety (OR = 3.4 [95% CI: 1.55-7.57], p = 0.002)and depressive symptoms (OR = 2.43 [95% CI: 1.15-5.15], p = 0.020) with poor sleep quality.

Our study suggests that Iraqi polypharmacy older adults suffer from poor sleep quality, with depression and anxiety potentially exacerbating this issue. The findings suggest that mental health support is necessary for older adults with polypharmacy.

None Declared

HIV (Human Immunodeficiency Virus) is a virus that damages the immune system, weakening the body’s ability to defend against infections and certain types of cancer. If left untreated, HIV can progress to an advanced stage known as AIDS (Acquired Immunodeficiency Syndrome). HIV can be transmitted through blood, sexual contact, from mother to child during childbirth, or through breastfeeding. Today, with antiretroviral treatments, it is possible for individuals living with HIV to lead healthy and long lives. In addition to health issues, HIV-positive individuals face mental stress and societal stigmatization. Their personality traits play a significant role in determining the level of mental stress they experience and their ability to cope with stigma. We have developed a survey for HIV-positive individuals addressing these aspects.

This study, aimed to observe how HIV-positive individuals cope with societal stigmatization and the mental stress they experience based on their personality types, as well as the connection between these factors.

The study’s survey was prepared using the open-source platform ‘Google Forms’ and will be administered in person. The tests used in this study are widely accessible and have been validated for reliability and validity in Turkey. Specifically, we utilized the Enneagram, the HIV Stigma Scale developed by Berger and colleagues, and the Hospital Anxiety and Depression Scale developed by Zigmond and Snaith. The study has no commercial purpose. The analysis was conducted on a total of 63 respondents, consisting of 45 men and 18 women.

In the study, data were collected from 63 individuals, 71.4% of whom were male (n=45) and 28.6% female (n=18). The average age of participants was 39.69 years (range 20-77). It was observed that individuals with primary education were the most stigmatized, while those with middle school education experienced the least stigmatization. The most common personality type among both men and women was Type 2 (the helper). According to the data, participants had an average stigma score of 94.9.

The study did not find a significant relationship between age and stigmatization, nor between gender and stigmatization. Personality types that perceived the highest levels of stigmatization were Type 2 and Type 8, with average scores of 108. Conversely, the personality type that perceived the lowest levels of stigmatization was Type 5, with an average score of 74. These findings highlight that certain personality types may be more susceptible to experiencing or perceiving stigmatization, while others may experience it less. Further research could explore the underlying factors influencing these perceptions and their implications for support and intervention strategies.

None Declared

Sexual minority individuals face unique challenges in mental and sexual health, emotion regulation, and well-being. Although understanding the complex dynamics among these variables in the context of diverse sexual orientations and gender identities is crucial to supporting and tailoring comprehensive interventions, limited research has investigated their overlapping relationships and intersections.

The current study aims to examine the connections between mental health, sexual health, emotion regulation, and well-being among sexual minority and heterosexual individuals in Israel. The main purpose was to provide a comprehensive understanding of the unique challenges sexual minority individuals face.

The study included 465 participants, 324 (70%) were identified as heterosexual individuals and 119 (26%) as sexual minority individuals. Various variables were assessed using an online anonymous questionnaire, including mental health (anxiety, depression, suicide ideation, substance use disorder), sexual health (sex-related distress, problematic pornography use, compulsive sexual behavior disorder), emotion-regulation, and well-being. Between-group differences were analyzed using Mann-Whitney U tests. Network analysis was conducted to examine the centrality and edges of relationships between variables within each group.

Significant differences were found between the heterosexual and sexual minority groups across the measured variables. Sexual minority individuals reported higher levels of psychopathology, lower sexual health, as well as lower levels of emotion regulation and well-being compared to heterosexual individuals. Network analysis revealed that the number of diagnosed psychopathologies and depression were central nodes in the sexual minority group, while sexual functioning played a central role in the heterosexual group. The sexual minority group’s network showed less stability, suggesting distinct subpopulations within this group.

This study contributes to understanding the unique mental and sexual challenges sexual minority individuals face and the intersections between mental health, sexual health, emotion regulation, and well-being. These findings highlight the importance for mental health professionals to acknowledge and address these connections, emphasizing the need for tailored psychosocial interventions that integrate sexual health.

None Declared

Postcoital dysphoria (PCD) refers to feelings of sadness, anxiety, or irritability following sexual intercourse, even when it is consensual and satisfying. These emotions can last from minutes to hours and affect both genders.

Historically, sex was mainly viewed as a means of reproduction, with pleasure often regarded as secondary. However, during the sexual revolution of the 1960s and 70s, perceptions shifted, recognizing sex as a source of pleasure and emotional connection. Today, despite a focus on mutual satisfaction, some individuals still experience post-sexual distress, highlighting the complexity of human sexuality. As a source of important distress, PCD calls for exploration of therapeutical agents.

To examine the prevalence of postcoital dysphoria (PCD) and explore potential therapeutic agents.

A non-systematic literature review using the keywords “postcoital”, “dysphoria” and “tristesse” limited to articles published in English from the PubMed®/MEDLINE® database.

Seven relevant studies were identified regarding postcoital dysphoria (PCD). In a study of 1,208 males, 40% reported experiencing PCT at least once, with 20% experiencing symptoms in the past month, and 3–4% regularly. PCT was linked to psychological distress, childhood sexual abuse, and sexual dysfunctions.

Among women, a UK survey of female twins found that 3.7% reported recent PCT symptoms, while 7.7% had long-term symptoms. Another study indicated that nearly 50% of female university students experienced PCT at least once, with no correlation found between PCT and relationship intimacy.

In the LGBTQIA+ population, a survey of 172 adults revealed PCD prevalence of 42% among men attracted to men and 81% among bisexual/fluid individuals. Significant correlations were observed between sex life satisfaction and PCD in this group. Regarding treatment, one single case report described a patient without psychiatric comorbidities treated successfully with escitalopram (10 mg), with symptomatic relief.

The reviewed studies highlight the prevalence and factors contributing to postcoital dysphoria (PCD) across diverse populations. Among men, up to 40% experience PCD at least once, with contributing psychosocial factors. In women, PCT prevalence varies, with no clear link to relationship intimacy. In the LGBTQIA+ community, PCD is notably high, affecting 42% of MSM and 81% of bisexual/fluid individuals, with sexual dissatisfaction and perceived discrimination as key correlates. Treatment options remain unexplored, with only one case report showing positive results using escitalopram. These findings suggest PCD is a complex conditions influenced by psychological, sexual, and societal factors. More research is needed to understand the underlying mechanisms and explore effective treatments, particularly for minority populations and those without psychiatric comorbidities.

None Declared

Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) can both impact psychosexual functioning.

ASD individuals may struggle with appropriate sexual interactions due to challenges in social communication, understanding social norms, and sensory sensitivities. Restricted and repetitive behaviors may also lead to a focus on specific sexualized behaviors.

ADHD-related symptoms may impact psychosexual functioning. Impulsivity can lead to risky sexual behavior, while inattention may increase the risk of sexual dysfunction. Additionally, prescribed ADHD medication has been found to disrupt sexual functioning.

Our aim is to better understand the psychosexual profile of neurodivergent individuals.

A narrative review was carried out using various databases, including PubMed.

Literature suggests a higher prevalence of sexual ambivalence, as well as increased homosexual, bisexual, and asexual tendencies among ASD-individuals. They may also exhibit more inappropriate sexual behavior, which can put them at risk of legal consequences.

Research suggests that ADHD-individuals may have a higher frequency of homosexual experiences and females with ADHD report greater ambivalence about their gender identity. ADHD is associated with risky sexual behaviors, but ADHD-medications may have a protective effect against early pregnancy and STIs.

The literature suggests that individuals with ADHD and/or ASD can lead to different psychosexual functioning compared to neurotypical peers.

Further research is needed to understand the contributing factors.

None Declared

Vaginismus is characterized by phobic avoidance, involuntary pelvic muscle contraction, anticipation, fear, and experience of pain during vaginal penetration. In addition to anxiety and fear, vaginismus-specific cognitive and metacognitive beliefs are thought to play a role in the etiology of vaginismus. Impaired sexual functions and decreased sexual satisfaction in women with vaginismus are claimed to be associated with anxiety and depressive symptoms. However, in clinical practice, it is observed that women who do not exhibit anxiety and depressive symptoms also experience sexual dysfunction and reduced sexual satisfaction, but it is noteworthy that the causes of this deterioration have not been sufficiently investigated.

The purpose of this study is to assess the impact of metacognitive beliefs on sexual functions and satisfaction in women with vaginismus.

A total of 64 women with vaginismus and 30 healthy controls were examined through Sociodemographic Data Form (including age, education status, duration of marriage, etc), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Arizona Sexual Experiences Scale (ASEX), Golombok-Rust Inventory of Sexual Satisfaction (GRISS), and Metacognition Questionnaire-30 (MCQ-30).

The mean ASEX, GRISS, and MCQ-30 scores were significantly higher in the vaginismus group than the healthy controls. No significant difference were found between groups in terms of BDI and BAI scores. Hierarchical Regression Analysis revealed that 13% of ASEX total scores in the vaginismus group were predicted by BDI and BAI scores (F=4.59, p< 0.05), and the predictability increased significantly to 32% by the addition of MCQ-30 scores to the model (F=3.79, p<0.01). However, GRISS-Total scores were not statistically significantly predicted by BDI and BAI scores (F=1.76, p>0.05), but the predictability of variance increased significantly to %26 (F=2.87, p<0.05) with the addition of MCQ-30 scores to the model. Moreover, the metacognitive dimension of uncontrollability and danger of thoughts, and cognitive self-consciousness were found to be significant factors in predicting both ASEX (b=0.52, p=0.004 and b=-0.49, p=0.003, respectively) and GRISS (b=0.58, p=0.002 and b=-0.40, p=0.017, respectively) scores in vaginismus.

The current findings of the study indicate that metacognitive beliefs, especially dimensions of uncontrollability and danger of thoughts and cognitive self-consciousness, predict sexual functioning and sexual satisfaction in women with vaginismus. Understanding the metacognitive characteristics accompanying vaginismus and including metacognitive interventions in sexual therapy for both cognitive self-consciousness and negative beliefs about the uncontrollability of thoughts and danger, may result in increased treatment success, improved sexual functioning, and sexual satisfaction in women with vaginismus.

None Declared

Strength training has long been linked to several physical and mental health advantages, ranging from increased muscle strength and endurance to higher mood and self-esteem. However, the potential link between strength training intensity and sexual satisfaction is a relatively unexplored area of research.

This study’s objective is to evaluate the potential relationship between the intensity of strength training and an individual’s degree of sexual satisfaction among people who exercise at the gym in Tunisia.

This is a cross-sectional study, conducted from February to March 2024. Participants were recruited online through social media platforms (Tunisian facebook groups and fitness forums) using a posted survey link. We’ve included respondents who are 18 years of age or older who have been active in strength training with a gym membership for 1 month or more. The respondents were required to answer a questionnaire that included socio-demographic data and to provide strength training intensity related details (sessions frequency, duration, perceived overall intensity using likert scale)

Sexual satisfaction was measured using the Sexual Satisfaction Index (SSI), validated psychometric tool developed by Leth-Nissen et al. in 2021. The sum score of the SSI can range from 0 to 36. A higher sum score indicates a higher level of sexual satisfaction.

The total number of participants was 72, with 86% being male. The majority of responders (n=65, 90.2%) indicated that they performed strength training exercises at least three times per week, with an average session length of 45 minutes. In terms of strength training intensity, 38.8% (n= 28) of participants reported high-intensity sessions, 48.6% (n=35) moderate-intensity sessions, and the remaining participants reported low-intensity sessions.

Analysis of the Sexual Satisfaction Index scores revealed a mean score of 23.6 (SD = 6.2), indicating that individuals had moderate to high sexual satisfaction. A significant association was found between strength training intensity and sexual satisfaction scores (r = 0.42, p < 0.01), indicating that higher intensity exercises are associated with higher sexual satisfaction.

Our findings aim to shed light on the link between fitness habits and sexual well-being, emphasising the potential value of including exercise interventions in talks about sexual health and satisfaction. The findings could indicate that the benefits of strength training go beyond physical fitness, potentially contributing to improved overall well-being. More research is needed to delve deeper into the underlying mechanisms causing this link and to investigate its broader implications for overall health and quality of life.

None Declared

Persistent sexual arousal syndrome (PSAS) is characterized by unwanted and distressing genital sensations that persist for long time periods without concurrent sexual desire or fantasies. The aetiology of this remains largely enigmatic although it is likely that the condition has a diverse set of neurological, vascular, pharmacological, and psychological precipitants.

To analyze the case of a woman with schizoaffective disorder (severe depressive decompensation) and a comorbid PSAS.

We study the clinical case of a 47-year-old patient who was admitted to the acute care unit due to a major depressive condition with psychotic symptoms in the context of a schizoaffective disorder after partial abandonment and erratic taking of the medication she was previously taking.

Before the admission, the patient was hypomimic, perplexed, with psychomotor inhibition, bradypsychia, thought blockages, sadness, emotional lability, apathy, anhedonia, paranoidism, phenomena of reading and thought control, self-referentiality, delusional ideas of harm and auditory pseudohallucinations in the form of voices that urge her to harm herself. In addition, the patient presented several “sexual” crises that appeared paroxysmal throughout the day, consisting of episodes of sexual hyperarousal in the absence of desire, experienced with intense guilt. Initially, a differential diagnosis was made through an extensive history and organic screening, and she was finally diagnosed with a comorbid PSAS.

Complementary tests (complete blood, urine and imaging tests) were normal.

At the pharmacological level, several strategies were used that were ineffective: paliperidone up to 18mg/day that had to be withdrawn due to intolerable extrapyramidal effects, olanzapine up to 15mg/day with high sleepiness and finally caripracin up to 12mg/day with good tolerance and efficacy. Stabilizing treatment (valproic acid 1000mg/day with optimal blood levels (99.3 microgr/mL)) were added. However, after a month and a half of admission and given the little improvement of the depressive symptoms, even having added an SSRI for 2 weeks at full doses, it was decided together with the patient and her family to start Electroconvulsive Therapy (ECT)sessions. The patient received 12 sessions of bitemporal ECT with onset of response from the 6th session, with a complete remission of the sexual crisis and depressive symptoms.

To our knowledge, Yero et al., reported the first two cases of patients with concomitant PSAS and bipolar disorder treated with ECT. It is important to understand how sexual symptoms differ in PSAS and bipolar disorder. Remission of the mood episode could have been accompanied by resolution of the sexual symptoms. Although ECT was successful, the mechanism of action in treating PSAS is unknown, and it is premature to suggest that it should be recommended as a first line treatment of PSAS.

None Declared

Gender dysphoria is the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics. Individuals with gender dysphoria frequently face social as well as psychoaffective difficulties that can impede their well-being and quality of life.

The aim of this study were to assess the impact of gender dysphoria among young medical trainees on their psychological health in terms of stress, anxiety and depression.

A cross-sectional, descriptive, and analytical study was conducted with a Tunisian population of young medical trainees, during the period of time from October 1, 2023, to January 31, 2024. Data were collected using a questionnaire created with GOOGLE FORMS including an information sheet and two psychometric assessment tools : the Depression, Anxiety, and Stress Scale (DASS-21) and the gender identity/gender dysphoria questionnaire for adolescents and adults (GIDYQ-AA) asssessing subjective, somatic, social, and sociolegal aspects.

A total of 111 participants took part in this study. Their median age was 28 years. They were single in 56.6% of cases, with a male-to-female ratio of 0.56.

The prevalence of depression, anxiety, and stress was 53.2%, 59.5%, and 34.2%, respectively.

Median scores of depresssion, anxiety and stress were 10 (IQR =[2–18]), 8 (IQR =[4–14]) and 10 (IQR =[6–20]), respectively.

The overall median score on the GIDYQ-AA scale was 4.85 (IQR =[4.77–5.0]). The social dimension had the lowest median score at 4.88 (IQR=[4.55–5.0]) while the median score of the subjective dimension was 4.92 (IQR=[4.69-5.0]). Somatic and socio-legal median scores were 5.0 (IQR=[5.0–5.0]).

The score for the subjective dimension of the GIDYQ-AA was negatively correlated with anxiety (p=0.04) and stress (p=0.04) scores.

The psychological vulnerability of young medical trainees may be exacerbated by intrapsychic conflicts which may be related to their gender identity. It is essential to identify and consider the psychological factors associated with gender dysphoria in the care pathway of these individuals, through appropriate psychiatric evaluation and support in order to better guide therapeutic decisions regarding sex reassignment.

None Declared

Gender dysphoria (GD) is a rare entity which involves significant distress experienced by an individual due to a perceived discrepancy between his gender identity and his sex assigned at birth. In the current literature, there is little research on medical students’ knowledge and attitudes towards this entity.

The objectives of our study were to estimate the prevalence of gender dysphoria within young medical trainees and to explore their knowledge and beliefs about this entity.

It was a cross-sectional and descriptive study, carried out on GOOGLE FORMS in the period of time from October 1, 2023, to January 31, 2024, and relating to a population of Tunisian young medical trainees. We used a questionnaire including an information sheet and the gender identity/gender dysphoria questionnaire for adolescents and adults (GIDYQ-AA).

Our study involved 111 participants with a sex ratio (M/F) of 0.56. Their median age was 28 years.

The overall prevalence of gender dysphoria was 0.9%. It was 2.5% among participants assigned male at birth (95% CI=[0.06%–13.2%]) and 0% among those assigned female at birth.

Among the participants, 21.6% had received training on GD or sexual identity disorders during their medical education while 3.6% of reported being aware of specialized services for the management and support of GD.

Four-fifths of the participants (80.2%) believed that the development of GD would be due to organic factors, while 70.3% described the contribution of socio-cultural factors and 58.6% attributed it to early family interactions.

More than a third of the participants (40.6%) considered GD as an entity related to sexual development disorders, 28.8% equated it with a symptom of a more general mental pathology, while 30.6% regarded it as a distinct entity.

Regarding the suffering associated with GD, it was attributed to the internal experience of gender incongruence by 42.3% of the participants, social stigma in 29.8% of cases, and to psychiatric pathology by 27.9% of the participants. GD was mentioned as a risk factor for suicide by 84.7% of the participants.

Our study revealed a low prevalence of GD among young medical trainees, similar to that observed in the general population, which could be explained by reluctance and fear of stigma in our society where sexuality remains a taboo subject. The knowledge of young doctors about this issue, still insufficient, could be improved through sexuality training dedicated to specialists, as well as through the teaching of sexology during the medical education.

None Declared

The month of Ramadan, a sacred period in the Islamic calendar, is a time of fasting, prayer, and reflection for millions of Muslims worldwide. While the effects of fasting on physical and mental health have been extensively studied, there has been little focus on its specific impact on sexual life, particularly in the Tunisian context.

The aim of our research was to study the opinions of Tunisians regarding their sexual behavior during the month of Ramadan.

This was a retrospective, descriptive, and comparative study conducted through an online survey among Tunisian adults. Data collection was carried out via a self-administered online questionnaire during Ramadan 2024, from March 21 to April 4, 2024. Two reminders were sent and the anonymity of the responses was guaranteed.

Our study included 130 Tunisian adults with a mean age of 28.69 years. The majority of our population resided in urban areas (98.5%), 43.8% were single where 29.2% were in a relationship and both genders were equally represented (53.1% female, 46.9% male). The majority of participants identified as heterosexual (89.2%). During Ramadan, 78.5% of participants fasted, and 77.7% believed sexual activity was permissible during this period. Overall, 44.6% of participants felt that fasting had a negative impact on sexual behavior, 30.7% on sexual desire, and 26% on sexual performance. More than 70% reported that fasting influenced their sexual behavior, primarily in a negative way (44.6%). Among those who perceived an impact (n=93), changes were mostly noted in the timing (77.7%) and frequency of sexual activities (75.5%). Furthermore, 72.3% of participants reported that fasting influenced their sexual desire, with 40.9% perceiving this influence positively. Behavioral factors were identified as the most common cause of these changes (52.1%), followed by religious reasons (27.7%) and societal factors (11.7%). Significant gender differences were observed, with women being more affected by religious factors (p=0.02), while men were more influenced by behavioral factors (p=0.03). Women also reported a significantly greater impact on the frequency of sexual activity compared to men (p=0.012) and perceived a more significant negative impact of fasting on sexual performance compared to men (p=0.06).

Our study indicates that Ramadan fasting significantly affects the sexual lives of Tunisians, driven by sociocultural, religious, and physiological factors. This highlights the need for culturally sensitive sexual education and targeted health policies to ensure accessible and inclusive care during Ramadan.

None Declared

Epilepsy is a common disease that is mostly treated with antiepileptic drugs (AEDs). The sexual dysfunction (SD) side effects related to the use of AEDs have not received sufficient attention.

The aims of this study were to assess the prevalence of SD and to study the role played by the AEDs among patients with epilepsy.

A cross-sectional and analytic study was conducted from September to December 2023, among patients with epilepsy follow up in the neurology outpatients of the University Hospital in Gabes (Tunisia), received AEDs, married for at least six months and sexually active. We collected the therapeutics data including type and number of prescribed AEDs and medication adherence, using pre-established form. SD was measured using the Arizona Sexual Experience Scale (ASEX) questionnaire.

Forty-five patients were enrolled (68.9% male and 31.1% female). The average age was 46.76 years (SD=12.39). The majority of patients had a low socio-economic status (64.4%). Carbamazepine and phenobarbital were the most commonly AEDs prescribed (57.8% and 53.3% respectively), especially as monotherapy (62.3%). Poor medication adherence was observed in 13 patients (28.9%). The frequency of SD among patients, based on ASEX questionnaire, was 44.4%. The factors associated with SD included carbamazepine and phenobarbital prescription (p=0.036 and p=0.045 respectively), double or multiple drug therapies (p=0.006) and poor medication adherence (p=0.033).

SD is very common in patients with epilepsy. This seems to be related to AEDs such as using of carbamazepine and phenobarbital, polytherapy and poor medication adherence.

None Declared

This study explores sleep health disparities among adults with depressive episodes, focusing specifically on sexual and gender minorities (SGM). Given the high prevalence of sleep disturbances in this population, we aim to understand the influence of sexual orientation, alongside sociodemographic factors, on sleep health.

• - To determine the prevalence of sleep difficulties among sexual minorities with depressive episodes.

• - To assess how sociodemographic factors, including education and ethnicity, relate to sleep health in this population.

Using data from the 2020-2021 National Survey on Drug Use and Health (NSDUH), we analyzed a sample of 15,244 individuals who experienced depressive episodes. The study employed weighted estimates to accommodate the survey’s multistage sampling design. Descriptive statistics were used to assess the prevalence of various factors, including tobacco and nicotine use, age, gender, ethnicity, income, marital status, and education. To evaluate the relationships between these factors and sleep difficulties, we utilized generalized linear models with Poisson distribution and log-link function to estimate adjusted prevalence ratios for each covariate.

The study identified notable disparities in sleep health among individuals with depressive episodes based on sexual orientation and sociodemographic factors. Gay/lesbian individuals and bisexual individuals were both found to have a higher likelihood of reporting sleep difficulties compared to heterosexuals, with an increased prevalence of 1.06 times (p = 0.038 for gay/lesbian and p = 0.009 for bisexual). Educational attainment appeared to play a significant protective role; those with a college degree or higher were 0.89 times less likely to report sleep difficulties than individuals without a high school diploma (p < 0.001). Additionally, ethnicity influenced sleep health, with Hispanic individuals being 1.05 times more likely to report sleep issues than non-Hispanic Whites (p = 0.015).

Image 1:

The findings emphasize the presence of sleep health disparities among sexual and gender minorities experiencing depressive episodes. Gay/lesbian and bisexual individuals face a higher risk of sleep difficulties, highlighting the need for mental health interventions that are sensitive to sexual orientation. The protective effect of higher educational attainment suggests that enhancing access to education and related resources may improve sleep health outcomes. The increased prevalence of sleep difficulties among Hispanic individuals points to the need for culturally tailored approaches in mental health care. Addressing these disparities through individualized and culturally sensitive therapeutic strategies can contribute to better sleep health and overall well-being for these populations, underlining the importance of integrated, comprehensive care in managing depressive disorders.

None Declared

Sexual functioning is an essential aspect of human existence. Sexual dysfunctions are prevalent and negatively affect the quality of life in the general population. Little attention has been paid to the sexual function of health workers.

The aim of our work was to evaluate sexual dysfunction among Tunisian doctors and to determine associated underlying factors.

A cross-sectional study was conducted online, from January to March 2024, via a pre-established questionnaire. Tunisian doctors, who had finished their medical studies, working in the public or private sector and who agreed to anonymously respond to the questionnaire were included. Sociodemographic, economic, clinical data and those related to the medical profession were collected. Sexual function was evaluated with the Arizona Sexual Experience Scale (ASEX).

A total of 80 individuals had fully responded to the questionnaire. The mean age of participants was 36.81 ± 7.49 years and 68,7 % (n=55) of them were male. Ninety five percent (n=76) were married and 77.5 % (n=62) had children. The mean working hours per week was 34.32 ± 5.32. A regular physical activity was practiced by 35 % (n=28) of individuals. The mean monthly income was 3592.5 ± 596 Tunisian Dinars. The results of the ASEX showed that 23,8 % (n=19) of participants, 23,6 % (n=13) of male participants and 24 % of female (n=6) participants had sexual dysfunction. Ten per cent of individuals (n=8) have previously consulted a sexologist. Longer working hours, lower monthly income, less physical exercise were significantly associated with increased risk for sexual dysfunction.

Sexual dysfunctions seem to be common among Tunisian doctors. Knowledge about their sexual functioning is important to promote their physical and mental health and to improve the care delivered.

None Declared

The use of recreational drugs for sexual intercourse (chemsex) is a widespread practice in certain subgroups of the population in recent years. There is documentation of chemsex in men who have sex with men (MSM) but less data on its use in other populations (men who have sex with women, women, transgender women, transgender men) and its effects on mental health.

Evaluate the use of chemsex in the population attended in a sexually transmitted infection (STI) consultation.

To evaluate the use of chemsex in the population attended in a sexually transmitted infection (STI) consultation, a survey was carried out on all patients who attended the STI consultation of the U. Ramón y Cajal Hospital between January and April 2022. The degree of anxiety and depression was assessed using the HADS scale.

A total of 148 surveys were distributed, with 82 being completed. Among those surveyed, 56% had used drugs at some time in their lives, the vast majority of times associated with sexual relations. The most consumed drugs were alcohol, cannabis and poppers. There were no differences between MSM and non-MSM in this consumption (p= 0.073), but there were in the substances consumed: MSM consumed more gamma hydroxy-butyrate acid (GHB/GBL) (p= 0.031), mephedrone (p= 0.031) and poppers (p= 0.019). Using the HADS Scale, 34 patients suffered from anxious (41%) and 11 depressive symptoms (13%), with no significant differences between MSM and non-MSM.

Chemsex is a frequent phenomenon among patients attending in an STI consultation, both in the MSM and non-MSM population. It negatively impacts mental health, being associated with anxiety and depression. It is necessary to improve information to reduce drug use in this context.

None Declared

The COVID-19 pandemic has significantly altered daily life and affected the sexual dynamics of couples across various contexts. Enforced lockdowns and pervasive social isolation, coupled with heightened anxiety associated with the pandemic, have profoundly affected mental health and intimate relationships, affecting sexual satisfaction among couples. This narrative review examines the psychosocial effects of these changes on couples’ sexuality, focusing on the challenges and coping strategies adopted by couples to mitigate the adverse effects and enhance intimate relationship quality.

This review systematically analyzes the psychosocial impacts of the pandemic on couples’ sexuality, using post-2020 literature to better understand these dynamics and enhance psychosexual support.

An extensive literature review was conducted across PubMed, Scopus, and Google Scholar, focusing on keywords such as “COVID-19,” “sexual health,” “intimacy,” “divorce,” and “coping strategies.” Ten high-quality studies published after 2020 were selected based on their methodological rigor and relevance to couples’ dynamics. These studies include a mix of quantitative and qualitative research and systematic reviews, providing a broad yet detailed perspective on the topic.

The findings reveal that the pandemic has significantly diminished couples’ sexual desire and relationship satisfaction. Notable psychosocial effects include increased anxiety, stress, depression, and relational conflicts. Modifications in sexual frequency and quality were noted, yet many couples have adopted effective coping strategies such as enhanced communication, couples therapy, shared stress management activities, and the utilization of online psychological support resources, which have helped strengthen relationships during the pandemic.

The pandemic has profoundly influenced couples’ sexual and relational health, introducing psychosocial stressors. Despite these challenges, the resilience displayed by couples through diverse coping strategies highlights their adaptive capacity. This review emphasizes the need for mental health professionals to integrate targeted interventions to support couples’ well-being and prepare them for potential future crises.

None Declared

Reproduction in mammals relies on complex interactions involving the genital and olfactory systems, which can be influenced by environmental factors, such as manganese (Mn). Although essential for survival, Mn is potentially toxic over long periods, potentially affecting sexual and reproductive behaviors.

This study aims to assess the long-term effects of Mn exposure on sexual and reproductive functions in male Wistar rats, focusing on Mn-induced neuroaffective and olfactory dysfunctions.

Male Wistar rats received intraperitoneal injections of Mn at doses of 6 mg/kg, 25 mg/kg, and 30 mg/kg for 12 weeks. Each experimental group consisted of one Mn-intoxicated male and four non-intoxicated females. After six days of cohabitation, the females were isolated to evaluate fertility outcomes. The study also monitored weight changes and conducted behavioral assessments for anxiety, depression, and olfactory functions in males.

Higher Mn doses (25 mg/kg and 30 mg/kg) resulted in significant behavioral changes in males, including anxiety, depression, and olfactory dysfunctions, which were associated with decreased reproductive success. Specifically, pregnancy rates were 33% (4 out of 12) at 25 mg/kg and zero at 30 mg/kg. In contrast, males treated with 6 mg/kg Mn exhibited no significant neuroaffective or olfactory impairments, maintaining fertility rates comparable to those of the control groups.

Chronic Mn exposure adversely affects sexual behavior and reproductive success in male Wistar rats, probably due to olfactory and neuroaffective disruptions. Further research is recommended to elucidate the mechanisms underlying these effects.

None Declared

Infertility can have a profound impact on couples, causing emotional distress and negatively affecting sexual well-being. In Tunisia, it contributes to over 20% of divorce cases due to relationship strain. Despite its significance, research on the influence of infertility on sexual experiences, particularly gender differences, remains limited.

This study aims to evaluate the effects of infertility on sexual health of Tunisian infertile couples and to compare these effects between men and women.

We conducted a cross-sectional study involving sexually active infertile couples who had been under follow-up for at least one year at a specialized Assisted Reproductive Technology center in Tunis. Each participant completed closed-ended questions regarding their sexual experiences following the infertility diagnosis, including the frequency of sexual intercourse, preferred types of sexual activities, sexual positions believed to enhance conception, and overall sexual rhythm. The Arizona Sexual Experiences Scale (ASEX) was used in Arabic to assess sexual function.

A total of 60 infertile couples participated in the study. The average age of women was 35.07 ± 4 years while the average age of men 41.1 ± 6 years. Regarding sexual intercourse frequency, 35% of women (n=21) and 27% of men (n=16) reported a decrease, with no significant gender difference (p=0.426).

Infertility did not significantly alter preferences for sexual practices, as 78% of women (n=47) and 85% of men (n=51) reported no changes. Vaginal penetration was the predominant activity for both sexes (100%), while mutual masturbation was engaged in by 68% of women and 72% of men. Oral sex was reported by 57% of women and 53% of men, with no significant gender differences (p>0.05).

In terms of sexual positions, 48% of women and 50% of men favored specific positions to enhance conception, with no significant differences (p=0.995). However, 48% of women and 64% of men adhered to a calendar-based rhythm, with women perceiving this regimen as more detrimental to spontaneity (p=0.038 and p=0.041).

Sexual dysfunctions were significantly more common in women, with a prevalence of 28% compared to only 5% in men. Desire disorders were the most commonly reported sexual dysfunction for both genders. Women exhibited significantly higher rates of physical and psychological arousal problems, as well as orgasmic disorders (p<0.05).

Screening for sexual dysfunction in infertile couples is essential not only for improving sexual health but also for providing tailored psychological support that considers gender differences. By identifying and addressing these issues, healthcare providers can enhance the overall well-being of couples dealing with infertility challenges.

None Declared

The postpartum period can significantly affect sexual life, particularly for women who have undergone an episiotomy. This study examines the impact of episiotomy on sexual activity during the postpartum period.

To evaluate the sexual life of Tunisian women following episiotomy in the postpartum period.

We conducted a prospective cohort study at the Gynecology and Obstetrics Department of Farhat Hached University Hospital in Sousse. The study included women who delivered vaginally with an episiotomy in 2020. Data were collected from medical records and delivery reports. Nine months postpartum, participants were contacted by phone to complete a questionnaire assessing their experiences with episiotomy and sexual satisfaction.

The final sample comprised 66 women with a mean age of 27 ± 2.8 years (range: 20-34 years).

Regarding sexual function, 84% of women were very or moderately satisfied with their sexual life before pregnancy, and 74% were satisfied during pregnancy. Most women resumed sexual activity between 7 and 8 weeks postpartum (78%), with 22% resuming before 8 weeks. Compared to pre-birth satisfaction, 54% of women reported no change in sexual satisfaction after childbirth, while 29% reported a decrease and 17% an increase.

Sexual satisfaction was statistically related to the mode of delivery, with 55% of women who had forceps delivery being dissatisfied or equally satisfied as dissatisfied (p=0.01).

Factors affecting postpartum sexual activity included fear of pain (32%), fear of another pregnancy (13%), perceived loss of body desirability (37%), body changes (31%), and excessive fatigue (24%).

This study demonstrates that episiotomy can have a notable impact on postpartum sexual life. Several factors, including the type of suture used during delivery and the mode of delivery, influence women’s sexual satisfaction. These findings underline the importance of considering both physical and emotional aspects of postpartum recovery to improve the overall sexual health and well-being of women after childbirth.

None Declared