Bremelanotide for Treatment of Female Hypoactive Sexual Desire

Hypoactive sexual desire disorder (HSDD) is a persistent deficiency or absence of sexual fantasies and desire resulting in significant distress or interpersonal difficulty. Women with this disorder may display a lack of motivation for sexual activity, reduced responsiveness to erotic cues, a loss of interest during sexual activity, and avoidance of situations that could lead to sexual activity. The pathophysiology of HSDD is thought to be centered around inhibitory and excitatory hormones, neurotransmitters, and specific brain anatomy. Due to the multifactorial nature of HSDD, treatment can be complex and must attempt to target the biological and psychosocial aspects of the disorder. Bremelanotide is a melanocortin receptor agonist and has been recently approved by the FDA to treat HSDD. Bremelanotide is administered intranasally or as a subcutaneous injection. The recommended dosage of bremelanotide is 1.75 mg injected subcutaneously in the abdomen or thigh at least 45 min before sexual activity. Studies showed improvements in desire, arousal, and orgasm scores when 1.75 mg of bremelanotide was administered before sexual activity compared to a placebo. Bremelanotide is a promising way to treat HSDD.

A-118 Efficacy of Computerized Cognitive Rehabilitation Programs in Treating Warfighters with a History of Mild Traumatic Brain Injury

Background Computerized cognitive rehabilitation programs (CCRP) have gained popularity in recent years. The objective of this study was to investigate the efficacy of CCRP in military personnel with a prior mTBI. Methods 21 active-duty service members with a history of mTBI were enrolled in the randomized clinical trial. Participants completed one of two CCRPs (Lumosity or the University of California Riverside Brain Game Center). Primary dependent variable was the Key Behavioral Change Inventory (KBCI) with eight scales: Inattention, Impulsivity, Unawareness of problems, Apathy, Interpersonal difficulty, Communication problems, Somatic difficulties, and Emotional adjustment. Other variables included age, education, number of mTBIs, years since last mTBI, total lifetime years of repetitive head injury (RHI). Results There was a significant reduction in Somatic Difficulties post-treatment (p = 0.029) with trends towards reductions on Inattention (p = 0.077) and Apathy (p = 0.064). 19/21 (90%) of participants had improvement in at least one KBCI scale (i.e., at least one point change), 14/21 (66%) had 3 or more scales improved, and 7/21 (67%) had 5 or more scales improved. Total number of scales improved was correlated with years since TBI (rho = 0.38, p = 0.044) and years of RHI (rho = 0.459, p = 0.018). Conclusions CCRP had modest efficacy in improving persistent symptoms following a mTBI. Fewer years since mTBI and fewer number of years of RHI were associated with better treatment response.

Arousal disorder in women

Recurrent / persistent inability to attain/ maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual arousal. Recurrent inability to get aroused. Your response to stimulation is physiologically / somatically maladaptive. And your perceptions about your inability to get aroused are distorted. The disturbance causes distress. The disturbance causes marked distress or interpersonal difficulty. Worldwide prevalence of arousal disorder in women is 26-43% and can be maintained depending on partner, stimulation, situation or regardless partner, stimulation, situation etc. The disorder may emerge from the beginning of the sexual life or begin after a period of relatively normal sexual function. Keywords: arousal disorder in women, s-on, therapy, testing, evaluation, sexual disorders.

Addiction, Stress, and Relational Disorder: A Neuro-Informed Approach to Intervention

Substance use disorders are immensely costly economically and socially, but also in relational terms. The helping fields have struggled to arrive at consensus about substance use disorders and to endorse effective treatment approaches. We suggest that counselors will find it useful to frame substance use disorders as a type of relational disorder, a cycle wherein early nurturance disruption leads to brain function vulnerability and subsequent interpersonal difficulty. This difficulty in establishing and maintaining connections with others, in turn, can lead to susceptibility to substance use disorders. This article discusses basic neurophysiology surrounding substance use and relational disorders that can be used to inform efficacious counseling approaches for working with individuals facing substance use disorders. Such approaches explore the connection between substance use and relational disorders in terms of long-term exposure to nonnurturing environments. Our hope is that conceptualizing substance use disorders as relational disorder will assist clinicians in building more informed conceptualizations of their clients and reconsidering how they may work to rebuild this relational capacity, drawing on the brain's adaptive nature and potential for healing.

Psychiatric features in perpetrators of homicide-unsuccessful-suicide at Weskoppies Hospital in a 5-year period

<p><strong>Background.</strong> In the absence of medical literature reporting on homicide-unsuccessful-suicide (HUS) cases in which the perpetrator is referred for forensic psychiatric observation present an opportunity to explore psychiatric features pertaining to the event.</p><p><strong>Objective.</strong> To identify possible contributing psychiatric features in HUS cases.</p><p><strong>Method.</strong> A retrospective, single-centre, descriptive study was conducted, in which were reviewed clinical records of HUS subjects referred for observation to Weskoppies Hospital from December 2005 to January 2011. Socio-demographic and psychiatric information was obtained.</p><p><strong> Results.</strong> Nine cases were reviewed. The median age of the subjects was 29 years and 7 subjects were male. Five cases involved family members. Cases involving couples demonstrated male subjects and cases involving filicide demonstrated female subjects. Only 1 case involved the use of a firearm. At the time of the incident, 4 of the cases had no psychiatric diagnosis but notable interpersonal difficulties. Psychotic disorders were diagnosed in 3 subjects, a depressive disorder in 1 subject and a depressive and anxiety disorder in 1 subject.</p><p><strong>Conclusion.</strong> Subjects commonly used less lethal methods than shooting. The high rate of psychiatric disorders diagnosed is in keeping with court referrals occurring when a mental illness is suspected. Some cases may require specialised probing before psychosis becomes apparent. Identification of psychosocial stressors and failure of coping mechanisms during periods of strife within an intimate relationship may be a focus of future research in homicide-suicide cases. Separation should possibly be investigated as an independent factor which promotes the interpersonal difficulty associated with homicide-suicide.</p>

Maternal Drug Use, Personality, Child-Rearing Practices, and Toddlers' Sadness

We investigated the influence of maternal drug use/personality attributes and child-rearing on 2-yr.-olds' sadness. The sample consisted of 62 girls and 53 boys and their mothers. Analysis showed maternal parenting practices served as a mediator for the effect of the mothers' personalities on the children's feelings of sadness. Moreover, the mothers' personality traits of low interpersonal difficulty, anxiety, and depression were important in enhancing low maternal alcohol or illegal drug use, leading to less sadness in the children.