How to Deal with the Issues of Fertility, Malignancies, and the Postfinasteride Syndrome while Prescribing Finasteride for Male Pattern Hair Loss

Oral finasteride represented a breakthrough for treatment of male pattern hair loss (MPHL), with clinical studies having demonstrated high efficacy of treatment and a favorable safety profile. And yet, fertility issues, malignancy, and postfinasteride syndrome have been concerns of users and prescribers of the drug. Pre-existing mental health disorder may put patients at an increased risk of nocebo, while the prevalence of personality disorders in subjects with MPHL is known to be higher than in the general population, specifically histrionic personality disorder. We devised a system for patient selection and risk assessment, including fertility issues, regular PSA determinations, and specific mental health assessment. For those who choose regular prostate cancer screening, the use of finasteride meaningfully reduces the risk of prostate cancer. While gynecomastia is a known, rare adverse effect of finasteride, so far, studies support the view that exposure to finasteride is not associated with male breast cancer risk. Patient understanding and involvement are central to optimal treatment selection and active patient role in treatment.

The Evolution of Social Media and the Impact on Modern Therapeutic Relationships

Combining the most popular social networking sites (SNS), Facebook, Twitter, Instagram, Linkedin, and Pinterest, the number of social networking users has exceeded two billion ( Jain, 2013 ). The average American spends on average 37 min to 2 h and 16 min on SNS each day, which surpasses any other internet activity, including email ( Adler, 2014 ; Batastini & Vitacco, 2020 ; Kemp, 2019 ). The high number of users and the amount of time people spend social networking has given rise to an increased interest of research on social medical and mental health. For example, several studies have shown that extended social media use increases depression ( Coyne et al., 2020 ; Veretilo & Billick, 2012 ), symptoms of bipolar mania, narcissism, and histrionic personality disorder in adults 18–35 ( Rosen et al., 2013 ) and decreases self-esteem among adolescents ( Coyne et al., 2020 ; Shapiro & Margolin, 2014 ).

Sexual Aversion and Lack of Sexual Desire in Woman: a Case from Clinical Practice

The article presents a clinical case with a 25-year-old female patient A., who has been married for 1 year, but before she was in a commonlaw marriage during 5 years with her present spouse, who is 30. They have not got any children. When she sought medical advice the patient informed that during 1.5 years she had been feeling sexual aversion to her husband (when he tried to take her in his arms, she had creeping sensations on her arms and back, a feeling of lump in her throat, and a desire to cry). She attributed it to the fact that her husband “does not pay enough attention to me”, he did not defend her against accusations from the side of his relatives and stood with his mother, faulting the patient for causing conflictual relations between the women. She did not feel any sexual desire toward her husband. Their sexual life was once a week. She let her husband loose with her only after she drank alcohol. A month before it was the end of their 8-month period, when she did not let her husband loose with her at all. Her husband put up with restrictions in their sexual life; he did not have any lover. Four months before she parted with her lover, with whom she was going 3-4 months. She did not feel any aversion to him. With time, by means of long conversations she succeeded in making her husband completely take her part in the conflict with his parents, and the spouses even severed any contacts with them. Our additional examination succeeded in revealing a number of the patient’s characterological peculiarities, particularly histrionic personality disorder, this fact confirming our clinical observations. The following diagnosis was made: sexual aversion, absence of sexual desire (selective variants) with development by the conversion (hysterical) mechanism. Treatment was provided with help of cognitive effects and hypnosuggestive therapy (its seven sessions were given). The cognitive effects were targeted at the patient’s complete acceptance of the belief that her husband fully supported her at that time and was entirely reliable. It was explained that in some cases disorders might base on the mechanism of conditioned pleasantness/desirability (conversion mechanism). But it was done in a very nuanced and kind way, since a straight-line explanation of this mechanism (“it is in your interests”) may cause a negative response and the treatment may be discontinued by patients. It was pointed out that sexual dysfunctions could result from influence of psychological factors: her bad relationships with her husband’s parents and with him. Suggestion in the hypnotic state was particularly targeted at elimination of sexual aversion, appearance of sexual desire toward her husband, generation of pleasant sensations during his caresses and kisses, presence of voluptuous (lascivious) sensations in frictions during coitus. Sexual intercourses were modeled too. It was also suggested that her husband was her defender, he stood with her and was entirely reliable. As the result of the given treatment, sexual aversion to the patient’s husband was nullified and her sexual desire toward him was completely restored.

The Utility of Clinical Psychology Concepts for Judgment and Decision-Making Research: The Case of Histrionic Features

This research was conducted to highlight the utility of considering clinical psychology concepts in judgment and decision research. Our overarching thesis is that the judgments and choices people make may often be influenced by clinically relevant phenomena, and that understanding these relationships can, in a reciprocal fashion, help advance our understanding of judgment and decision making as well as specific clinical diagnoses and proclivities. We focused on histrionic personality disorder and conducted four studies that show that histrionic symptomology predicts preferences and choices that facilitate grabbing others’ attention, even when such choices cost more money, and are at the expense of giving up more tangible features. In addition to demonstrating a new implication of the histrionic personality, we provide insight into the process underlying this tendency and discuss implications for mental health service providers.

Freud by Numbers? – Hysteria and Transgenerational Haunting in Patrick McGrath’s Constance (2013)

This article investigates the literary technique with which Patrick McGrath opposes two narrators and illustrates how the subtle story of one of them, Constance, deconstructs the apparently dominant discourse of the second narrator, Sidney. This article furthermore refutes the current critical interpretation of Constance as a hysteric and demonstrates that it is Sidney who deliberately constructs this notion of hysteria and who himself – paradoxically – can be linked to Histrionic Personality Disorder. This article finally explores how Constance experiences what Abraham and Torok called transgenerational haunting and how this psychoanalytic theory is reinforced and commented upon by a series of metaphors.

Gender Identity Disorder Arising as a Part of Nonpsychotic Forms of Endogenous Diseases and Personality Disorders (Clinical and Psychopathological Aspects)

Purpose: psychopathological differentiation of gender identity disorder (GID) that occurs as part of depressive episode; creating a typology for developing diagnostic and prognostic criteria. Material and methods: 63 patients (46 women and 17 men) who applied to the FSBRI MHRC from 2016 to 2019 were examined by a clinical psychopathological method. All patients were diagnosed with a depression being part of schizotypal disorder or histrionic personality disorder or mixed histrionic and schizoid personality disorder. Results: Clinical and psychopathological analysis of gender identity disorder occurring as a part of depressive episode showed its heterogeneity, varying severity, as well as a diverse relationship with other psychopathological disorders, which required an in-depth and detailed study. We have identified the following typological varieties: type 1 — GID as a part of depersonalization disorders, type 2 — GID as a part of dysmorphophobic disorders, type 3 — GID as a part of histrionic disorders. Conclusions: The obtained results give us the opportunity to suggest that the diagnosis of the disease, in which the gender identity disorder is detected, can help predict its further course and possible outcomes.