Within psychiatry, sexology is a very particular area of expertise both by the nature and specificity of its diagnosis, as by the various difficulties and challenges their patients place. Sexology is a sub-specialty niche, but also a vast universe that covers such diverse conditions as paraphilia, gender dysphoria or sexual dysfunction. The sexology consultation of Santa Maria Hospital (HSM) is one of the biggest centers specialized in sexual disorders in the country. Consultations depend on the collaboration of a sexologist psychiatrist and psychiatry residents in close connection with endocrinology, urology and plastic surgery services.

We intend to conduct a characterization of the population observed in the HSM sexology consultation, in a period of 2 years, from the analyses of different general and diagnosis-specific relevant variables.

We intent to make a descriptive analysis of the population that attended the sexology consultation over the last 2 years. The sample study refers to all patients who have been specifically referred to sexology department or that directly requested access to this consultation. Data will be collected from medical computer records.

Through systematic evaluation of different variables we can possibly conclude by some putative associations. A comprehensive characterization of this particular population is a possible method for a better and deeper insight on the diagnosis itself.

The purpose of this work is to increase peers’ sensitivity both to sexology and to the patients sexology serves.

The authors have not supplied their declaration of competing interest.

Addiction refers to a pattern of:

– loss of control, as shown by unsuccessful efforts to stop the behaviour;

– continuation of the behaviour despite adverse consequences – such as marriage breakdown;

– an obsession with obtaining, using or recovering from the behaviour.

To date, DSM-5 does not recognize sex addiction as a disorder, however when problematic sexual behaviours fulfil these same three criteria, the process is considered to be an addiction.

This case report describes the development of problematic addictive sexual behaviour, possibly as a result of other psychiatric comorbidities including obsessive-compulsive disorder (OCD), alvinophilia, and obsessional fetishism. The presence of the Madonna-Puttana syndrome is also explored.

To use the biopsychosocial model to investigate the aetiology of addictive problematic sexual behaviour. To explore the role of psychiatric comorbidities in the expression of such behaviour. To examine the holistic impact of sexual addictions. To examine the treatment modalities of addictive problematic sexual behaviour.

A 25 year old happily-married nurse who confessed to serial extramarital affairs was interviewed. Underlying psychiatric comorbidities were identified. Family members were also interviewed for a collateral history. The above objectives were explored and the response to various treatment modalities were evaluated. Literature reviews were carried out.

This case illustrates a form of OCD which manifested as addictive problematic sexual behaviour. The message portrayed is that hope exists for such couples once various treatment modalities are put into action.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Cancer of the uterine cervix represents 10% of malignant tumors affecting women. Despite occupying fifth place in the global mortality rate it is described with the highest healing potential. One of the most used treatments is radiotherapy, which has a particularly significant impact on women's quality of life, especially in their sexuality. Biological and psychic factors are suggested as possible etiologies for sexual dysfunction situations. Changes in body image may arouse feelings of shame and low self-esteem. In what concerns biology, vaginal stenosis is referred as a cause of vaginism and vaginal bleeding, with consequent decrease in libido and pleasure.

Describe the implications in the sexuality of women with cancer of the uterine cervix after radiotherapy.

A literature search using the PubMed and Scielo databases of scientific articles published in the last 10 years.

In the literature, there are significant changes in sexual behavior in women with cervical cancer in the period after radiotherapy. A large percentage reveals sexual abstinence and an equally significant part presents sexual dysfunction caused by lack of lubrication, arousal and orgasm. Moreover, it is reported decreased libido and sexual pleasure, vaginal bleeding and vaginism. On the other hand, there is a small account of cases in which it is mentioned increase libido and pleasure.

Despite the high probability of healing this disease, the patients’ quality of life after advanced stages of radiotherapy, should be a source of concern, especially with regard to sexuality.

The authors have not supplied their declaration of competing interest.

Premature ejaculation (PE) corresponds to “a persistent or recurring ejaculation pattern that occurs during sexual activity with a partner approximately 1 minute after vaginal penetration and before the person wishes to”. It affects 5–20% of men, having its origin in psychological factors and with important biological contribution. It is considered generalised, when not confined to certain patterns of stimulation, situations, or partners, or may be situational. It may occur soon after the onset of sexual activity (primary) or after a normal sexual functioning (acquired). Primary EP is associated with the hyposensitivity 5-HT2C receptors and/or hypersensitivity 5-HT1A receptors. High performance anxiety levels are related to acquired EP. Increasing this physiological knowledge has enabled significant advances in treatment.

Approach the therapeutic options of EP and its peculiarities.

Literature review of articles published in the last five years, using the PubMed and Scielo databases.

At present, the approaches include psychosexual counseling, behavioral and pharmacotherapy. Among the most popular drugs, antidepressants stand out, particularly dapoxetine, the first medication specifically approved. Local anesthetics, phosphodiesterase-5 inhibitors and tramadol are also used. Acupuncture is suggested as a useful therapeutic, but needs more research.

The behavioral therapies are referred to as first-line treatment in the long-term, associated or not with medication. Dapoxetine is the preferred symptomatic treatment. However, a holistic approach, including psychotherapy and sex therapy, is the most beneficial modality for sexual and marital relationship.

The authors have not supplied their declaration of competing interest.

To asses the effect of oral capsule of mixed Tribulus Terrestris, Zingiber Officinale, Crocus Sativus and Cinnamomum Verum on postmenopausal women's sexual satisfaction.

In this triple blind randomized control clinical trial, 80 healthy volunteer postmenopause women with age 50–60 years old in one of clinics of west of Tehran had been involved (year 2013–2014). Participants were randomly assigned to intervention and placebo group and received one month same shape capsules two times in a day. Tools of this study had two main parts of personal characteristics and sexual satisfaction. All ethical points were considered and approved by Ethics committee of Research Institute for Islamic & Complementary Medicine (RICM, IUMS).

After a month intervention, there is significant increase in the mean score of sexual satisfaction between two groups (P = 0.01), but when sexual satisfaction compared with pre-menopausal time in two groups, t-test results showed no significant difference (P = 0.16).

Use of oral capsule of mixed Tribulus Terrestris, Zingiber Officinale, Crocus Sativus and Cinnamomum Verum two times a day for a month could improve sexual satisfaction in postmenopausal women. Referring to no significant change with comparing premenopause time, it sounds they have same satisfaction as premenopause time. There were no side effects during study and one month follow-up. It is suggested to do same research on sexual satisfaction and function with more month intervention.

The authors have not supplied their declaration of competing interest.

Exhibitionistic disorder may be present when there is sexual arousal from the exposure of one's genitals to an unsuspecting and nonconsenting person. This disorder prevalence is unknown but we know it is highly unusual in females. It generally starts at adolescence and its course is likely to vary with age. There are temperamental and environmental risk factors.

Most of what we know about exhibitionistic disorder is largely based on research with individuals convicted for criminal acts involving genital exposure, and this may represent an important bias. From a clinical case of exhibitionism, the authors intend to review this type of paraphilia from an historical, conceptual and etiologic point of view.

To review the concept behind this diagnosis and its evolution, the comprehensive theories that attempt to justify and frame it, as well as the type of intervention currently considered to be the state of the art.

Patient's observation and assessment, along with an extensive review of the relevant literature.

Starting from a real clinical case, the authors present a general theoretical review on the subject.

The authors have not supplied their declaration of competing interest.

Narcolepsy is a neurological disorder characterized by disturbances in REM sleep. The symptoms that the patient could present are excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations and disrupted nocturnal sleep. Its etiology is unknown. Currently, there is established pharmacotherapy for symptomatic treatment, which are often unsatisfactory.

Review of new treatments for narcolepsy based on recent advances about its ethiopathogenesis.

Seventy-five year-old female with a personal history of arterial hypertension and obstructive sleep apnea syndrome. The patient presented several episodes of abrupt muscular weakness, nightmares, sleep paralysis and excessive daytime sleepiness. Diagnosed of narcolepsy and treated with methylphenidate immediate-release (IR) 10 mg, alprazolam 1 mg, and trazodone 100 mg with good response.

Due to persistent symptoms, treatment was modified to osmotic-release oral system (OROS) – methylphenidate resulting on a substantial weight loss (12 kg) and persistence of symptoms. Another methylphenidate preparations were unsuccessfully tested. Currently she continues treatment based on methylphenidate release-release and she improved significantly though she sometimes presented daytime sleepiness.

Recent studies have shown that a loss of the hypothalamic neuropeptide hypocretin causes Narcolepsy with cataplexy and that an autoimmune mechanism may be responsible for this loss (related to HLA DQB*0602). Pathophysiology of narcolepsy without cataplexy is less understood.

Although amphetamines and its derivatives are the mainstay of management, therapies that involve hypocretine seems to be hopeful (intranasal, peripherical or hipocretin cell transplantation). Monotherapy with GHB, H3 antagonist receptors, TRH analogs and immunotherapy are also being studied.

The authors have not supplied their declaration of competing interest.

College students seem to be a population group that is increasingly recognized to be at risk of having sleep difficulties. Some studies revealed that medical students, in particular, are believed to be more stressed and sleep deprived than their non-medical peers.

The present work aimed at investigating the quality of sleep among medical students at the University College of Medicine in Sfax, Tunisia.

The study consisted of an anonymous, voluntary survey for a sample of 74 students. A two-part questionnaire was used, including demographic criteria and the Pittsburgh Sleep Quality Index (PSQI), a self-rated instrument that measures sleep habits for a month (a total score of 5 or greater is indicative of poor sleep quality).

The average age was 24 years (range 19–33) with a sex ratio almost equal to 1. In 47.3% of cases, students were married. These latter had at least one child in 34.2% of cases. A total of 39.4% of the students reported being smokers, while 25.6% of them admitted having regular alcohol consumption.

Poor sleep quality was reported by 63.5% of students with a PSQI average score of 9.32 ± 3.64.

The most correlated factors with poor sleep quality were parenthood (P = 0.031), alcohol consumption (P = 0.004) and stressful studies (P = 0.02).

Poor sleep quality was pervasive among surveyed medical students and this seemed to be in relationship with some factors. This study points to the need for further evaluation of medical students’ sleep problems in order to improve their performance and their quality of life as well.

The authors have not supplied their declaration of competing interest.

This research examined gender variations in depressive mood for high school students affected by emotional upset and how such depressive mood affect their sleep quality.

Research was conducted from September 2015 to October 2015. Both males and females were divided into normal group and depressive group by Zung Self-rating Depression Scale (ZSDS). Each group adopted the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality.

Analysis was made on a total of 155 students, which were 83 male students and 72 female. The average ZSDS for all high school students was 43.38 and the average PSQI was 5.39. The number of male students in the normal and depressive group who were diagnosed with sleep disorder were 2 (3.8%) and 9 (29.0%), respectively (P < 0.05). But the number of female students in the normal and depressive group who were diagnosed with sleep disorder were 11 (32.4%) and 33 (86.8%), respectively (P < 0.05). Both males and females shared a meaningful result over sleep latency, sleep disturbance, use of sleep medication, and daytime functional disturbance among 7 items of PSQI for sleep quality, and female students had a significantly meaningful result over sleep duration, habitual sleep effects (P < 0.05).

This research showed that sleep quality of all high school students was not too bad but it can be problematic for those with depressive mood. Especially, female students were diagnosed with sleep disorder more than male students.

The authors have not supplied their declaration of competing interest.

Kleine-Levin syndrome was first described by Kleine in 1925 and elaborated on by Levi in 1936. It is an infrequent syndrome that predominantly affects to teenagers, and boys are four times more likely to be affected than girls. It is rare for patients over 30 years although some cases have been reported. Kleine-Levin syndrome is a recurrent hypersomnia characterized by episodes of hypersomnia lasting for 2 days to 4 weeks associated with symptoms of hyperphagia, hypersexuality and cognitive impairment. It can be accompanied by other abnormal behavior such as aggression, personality changes and irritability. Deficits are resolved between episodes.

It is presented the case report of a patient that suffers from recurrent episodes of hypersomnia associated with hyperphagia and abnormal behavior.

EEG demonstrates slowing of drowsiness and a decrease in REM sleep. The test of multiple sleep latency is abnormal and the rest of complementary test are normal.

F51.1 Recurrent hypersomnia (Kleine-Levin syndrome) [307.44].

Kleine-Levin syndrome is an intriguing, severe and homogenous disease with no obvious cause or treatment. Treatment is generally supportive. It should be considered in any teenager presenting with recurrent episodes of hypersomnia concurrent with cognitive changes or disinhibition.

The authors have not supplied their declaration of competing interest.

Medical students have higher levels of depressive symptoms than the general population. Additionally, depressed students are more likely to commit suicide. Recent studies find up to 10% of medical students experiment depression and suicidal ideation, which is meaningfully higher than general population of similar age (5–8%). However, little is known about depression and suicidal ideation in medical students in Spain.

This study aims to create a self-administered questionnaire to investigate the prevalence and factors involved in depression and suicidal behaviour in medical students from a Spanish University.

We evaluated the main risk factors leaning to suicide in students. In addition, we selected an appropriate scale to assess depression among the existing ones. The evaluated items included demographic reports, academic information (academic course, unfinished subjects and accomplishment) and sanitary data (psychiatric family history, psychiatric personal history, psychotropic drug consumption, distress emotional events in the last twelve months and drugs consumption). Furthermore, we selected the 9-item Patient Health Questionnaire (PHQ-9) because of its rapidly implementation and proven efficacy.

Rates of depression and suicidal ideation are high in medical students. Currently, there is no program to detect and prevent depression neither suicide in students. For that reason, we consider that creating a new instrument to evaluate mental health in student is useful in order to offer early detection and treatment at medical school.

The authors have not supplied their declaration of competing interest.

The objective of the study is the analysis and the description of patients who committed autolitic acts and were attended in a mental health hospital unit in 2014.

We analyze the patient registry for the attended emergencies in our mental health hospital unit, extracting the following variables: gender distribution, age range, type of method applied in the attempt and diagnosis based on DSM-IV TR.

The study reveals a larger share of autolitic acts in the feminine population between 14 and 69 years old. A total of 31 patients needed to be attended in an emergency hospital unit (11.74%). The most common method is the medical substance abuse (23 patients, 74.19% from the admitted patients in our Mental Health Hospitalary Unit). The diagnoses in order of frequency were; affective disorders (13 patients, 41.93%), personality disorders (8 patients, 25.80%), adaptative disorders (7 patients, 22.58%) and psychotics disorders (3 patients, 9.68%).

Our population-based sample confirms the epidemiologic data found in the consulted literature as well as in other population groups.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Scientific research indicates that accessibility of suicide means has a significant influence on the choice of method. Since the choice of suicide method largely depends on availability of suicide means, the lethality of method at hand plays a crucial role in a period of suicidal crisis.

We aimed to reveal the associations between accessibility and availability of medications and toxic substances and suicidal behavior of teenage girls in Armenia.

Our objectives were to determine whether accessibility and availability of medications and toxic substances have any impact on development of suicidal behavior among teenage girls in Armenia and whether toxicity and quantity of medications and toxic substances at hand or purchased by attempters are associated with severity of outcome.

A qualitative analysis of patient histories of 26 teenage girls, hospitalized in the ICU, Toxicology Center “Muratsan”, Yerevan, RA, diagnosed as having acute deliberate self-poisoning was performed.

In majority of cases, conflict situation preceded suicidal behavior and decision on attempting suicide was impulsive. Being emotionally distressed teenage girls reached for medications and toxic substances readily available in the household or bought medications from a pharmacy.

The vast majority of teenage girls attempted suicide by medications and toxic substances at hand. Admittedly, both, type of medication and quantity of pills or amount of toxic substances utilized, affected the severity of outcome. Hence, the availability and accessibility of medications and toxic substances played a crucial role in development of suicidal behavior and severity of outcome.

The authors have not supplied their declaration of competing interest.

Nowadays, the lesbian, gay and bisexual (LGB) community still suffers from prejudice and social stigma, including from medical professionals.

Thus, it is urgent to draw attention to this population since these individuals have an increased risk of mental disorders, substance abuse and dependence, suicidal ideation and suicide attempt or complete suicide.

To underline the prevalence of mental disorders and increased suicide risk in the LGB population.

To summarize the latest literature about this field.

A brief review of the latest literature was performed on PubMed using the keywords “mental health”, “suicidal risk”, “LGB population”.

LGB individuals appear to be at increased risk of mental disorders and suicidal behavior than heterosexuals. According to Meyer, they are exposed to what is called the minority stress: proximal, depending on the subject and related to fear of rejection and internalized homophobia and distal, regardless of the individual including prejudice, social stress, social exclusion (including their own families) and violence.

The odds of attempting suicide are approximately 2 to 7 times higher for lesbians, gay men and bisexuals (LGBs) than for heterosexuals.

Minority stress related to prejudice and stigma against LGB people has a significant risk that can be related to suicide ideation and attempt.

The higher rate of many psychiatric conditions noted in this community underscores the need for clinicians to provide nonjudgmental care and approachable environment.

The authors have not supplied their declaration of competing interest.

The association between suicide ideation, depression, and hopelessness is relatively ignored in the literature of the Arab World, particularly using suicide ideation, Beck Depression, and hopelessness inventories.

The specific research questions related to this model are as follows: does the relationship between suicide ideation, depression, and hopelessness, postulate the latent factor?

The participants were 200 girls, first year Kuwait University students. The mean age (18.18 ± 0.38) and BMI (23.50 ± 4.85). The Arabic versions of the Beck Scale for Suicide Ideation (BSI), Beck Depression Inventory-II (BDI-II), the Beck Hopelessness Scale (BHS), and demographic surveys were administered to participants in the class. All participants read and signed a consent form before test administration. The correlation matrices, exploratory factor analysis, and reliability analysis are used in this study.

Internal consistency of scores were satisfactory for the BSI, BDI-II, & BHS inventories respectively (Cronbach's alpha = .91, .89, .85). A correlation of (r = .53) between the BSI and BDI-II and (r = .43) with BHS. Meanwhile, a correlation of (r = .58) between BDI-II & BHS. A principal-axis factor analysis with oblique rotation suggested one factor accounting for 67.73% of the common variance.

This trend indicates there is a strong relationship of suicide ideation with depression and hopelessness. The results of the present study suggest that targeting depression may be as important in adolescents as in adults to reduce suicidal ideation and prevent suicidal attempts.

The authors have not supplied their declaration of competing interest.

The Beck Scale for Suicide ideation (BSS) has consistently been regarded as a strong tool for measuring cognitive and somatic aspects of suicide ideation symptomatology in both clinical and non-clinical population. There is no study until this date that examines the BSS within Kuwaiti College students.

The present study aims at identifying impact of gender (male/female) on suicide ideation.

The sample was consisted of (584) undergraduates students (284 of males and 300 females). The study applies Beck Scale for Suicide ideation (BSS) and suicide Ideation Questionnaire (SIQ).

Table 1 descriptive statistics for two standardized self-report measures means and standard deviations for these measures were within the expected ranges for college samples. The mean (BSS) score was 5.2 for males and 7.0 for females. The mean (SIQ) score was 11.3 for males and 13.7 for females.

BSS revealed significant gender differences in score indicated that females obtained higher scores than males on suicide Ideation although the magnitude of the difference was small.

Table not available.

The author has not supplied his declaration of competing interest.

In the dawn of increasing interest in climate changes, including extreme weather events, e.g. the Foehn winds, and their influence on public health, it is of great importance to understand their role in suicide.

The association between suicides in the Tatra Mountains, Poland from 1999 to 2014 and the Foehn wind (called Halny in this region) was examined. The belief that suicides are affected by Halny seems to be firmly rooted in local language and culture.

The purpose of the study was to assess the Halny wind as a suicide risk factor.

Data concerning all suicides in the region were included. Meteorological data were derived every three hours during the period of the study. Halny was defined as a complex of interacting meteorological conditions. The two days preceding and following the wind were recognized as the period of the Foehn influence (FI). The probability of suicide in the presence of Halny and during the FI period was calculated.

From 1st January 1999 to 31 December 2014 (5844 days), 210 consecutive suicides were registered. The number of suicides in men was markedly higher than in women. Halny did not change the overall probability of suicide. However, the presence of Halny modified the suicide risk according to the season (P = 0.00095, two-way ANOVA test). The FI periods appeared to increase suicide risk in summer and autumn.

Halny may contribute to the increased suicide risk in summer and autumn. It should be taken into account in suicide preventive interventions in this region.

The authors have not supplied their declaration of competing interest.

According to Durkheim's theory, suicide attempts increase during periods of rapid economic changes and decrease again when stability is achieved, due to the social integration in the community guaranteed by occupational status. Since 2009 in Europe, it was observed an increase in the suicide rates, in line with the increase of unemployment. Although unemployment is considered a risk factor for suicide, it was observed a noticeable increase in suicide rates among Italian employed men during the last years, probably related to the specific economic scenario and to emerging difficulties in keeping an income to adequately maintain one's own family standard of living.

To study attempted suicides with a specific focus and attention on the current Italian economic scenario.

Determinants of emergency room visits for psychiatric reasons in patients aged > 16 years were studied prospectively from 2008 to 2015 at the AOU Maggiore della Carità Hospital, Novara, Italy. Each patient was assessed by an experienced psychiatrist with a clinical interview and socio-demographic and clinical features were gathered. Statistical significance was set at P ≤ 0.05.

Preliminary results suggest an increase in suicide attempts according to the rise of the unemployment rate in Novara. Although in absolute figures most attempters are unemployed, it seems that suicide attempts are more frequent in the group of employed subjects, which includes also people under redundancy fund. This subgroup may be considered halfway between employed and unemployed attempters.

Data collection and statistical analyses are still ongoing. Implications for clinical practice will be discussed.

The authors have not supplied their declaration of competing interest.