Profile of Patients Availing Marital and Psychosexual Clinic Services During the Pre-COVID and COVID Era: A Study From a Tertiary Care Center

Aim: To assess the profile of patients availing the marital and psychosexual clinic (MPC) services through the telemode at a tertiary care center after the imposition of lockdown and compare the same with the profile of the patients attending the outpatient services, in-person MPC services during the prelockdown period. Materials and Methods: It was a retrospective study in which comparisons were made between patients availing the MPC services from March 24, 2020 to March 23, 2021 with the profile of patients during the period of March 24, 2019 to March 23, 2020 (ie, COVID period—lockdown). Results: A total of 112 patients availed the MPC services during the COVID study period compared to 307 patients in the pre-COVID period. However, when the proportion of MPC cases among the total walk-ins was compared, during the COVID period the proportion of MPC cases increased by almost 1.75 times. During the COVID time period, there was an increase in the patients who were significantly younger ( P = .002), females ( P = .003), more from urban locality ( P = .035), and being referred by self or caregiver ( P = .001). In terms of specific diagnosis, as compared to the pre-COVID timeframe, significantly higher numbers of patients were diagnosed with premature ejaculation (PME) and PME + erectile dysfunction while the services were being provided through the telemode. Conclusion: The present study suggests an increase in the proportion of patients seeking help for marital and sexual issues while the services are being provided by telemode.

Psychiatry Disorders and Sociodemographic Profile of the Victims of Assault Attending the Teaching Hospital—Cross-Sectional Study

Background: According to World Health Organization, proportion of women experiencing either physical or sexual violence ranges between 15% and 17%. In India, one-third of women population in 15 to 49 age group experiences sexual assault at least once in their life, predisposing them to develop psychiatric disorders. Aims and Objectives: To assess prevalence of psychiatry disorders among victims of assault attending tertiary care center. Methodology: It is a retrospective, record-based study which was conducted among 216 victims of assault attending one-stop center. Study was started after obtaining Institutional Ethical Committee clearance and permissions from concerned authorities and confidentiality was maintained throughout the study. Data was analyzed by frequency, proportion, and chi-square tests using SPSS version 16. Results: Out of 216 victims, 50% were physically assaulted and 50% were sexually assaulted. Among 108 sexual assault cases, 81.5% victims were raped, 2.7% were sexually harassed, 1.9% was sexually abused, and 13.9% children were sexually abused. A total of 30.1% had adjustment disorder, 11.6% had dysthymia, 8.3% had mild depression, 5.6% had moderate depression, 0.5% had obsessive-compulsive disorder, 0.5% had psychosis, and 43.5% did not have any psychiatry disorder. Conclusion: Majority of the sexually assaulted victims belonged to age group 16 to 20 years and had adjustment disorder, whereas physically assaulted victims belonged to age group above 36 years and had dysthymia and depression. Special services like medical care, counseling, legal aid, and so on should be provided to victims free of charge. Awareness and sensitization programs should be done through active community participation for the welfare of children and women.

Adverse Effects of Plasticizers and Pesticides on Female Reproductive Health

Central neuroendocrine system regulated by hypothalamus, controls most of the body homeostasis involving processes, like metabolism, reproduction, stress responsiveness, growth, and energy balance mainly through hormonal signals. Plasticizers and pesticides interact as endocrine disruptors with endocrine hormones causing adverse effects which tend to destroy the body homeostasis. Exposures to these compounds during critical developmental stages such as puberty and pregnancy (prenatal or perinatal) influence neurodevelopment, social behavior of the growing fetus and causes sexual dimorphism. Plasticizers and pesticides systemize its effects on adulthood either by mimicking, antagonizing, or having an impact on steroidal activity also along with hormonal disruptions. The aim of this review is to address some of the effects of plasticizers and pesticides exposure on female behavior. In this review, we are discussing the remedial nutritional choice to control the plasticizers and pesticides mediated endocrine disruption.

How Inclusive Is the Transgender Persons Act? Evidence From the Ground

The transgender community of India faces numerous challenges and is struggling hard for their survival. They generally beg at signals, impart blessings at religious ceremonies, and engage in sex work for their livelihood. A majority of the individuals of this community belong to low or lower-middle socioeconomic strata. For older adults, survival becomes very hard as they do not have any biological filial relationships or access to formal, steady employment like most of the heteronormative population. It is difficult for the younger transgender women within a gharana (adoptive family) to nourish the elderly and care for all financial needs. Despite the Transgender Persons (Protection of Rights) Act, 2019, hardly any research focuses on the needs of older adults. The authors have attempted to bring the attention of academic researchers and policymakers to one of the most vulnerable communities using a case study of an elderly transgender.

It’s Time to Consider LGBTQ-Affirmative Psychology in Malaysia

International studies have revealed stark mental health inequities affecting lesbian, gay, bisexual, transgender, and queer (LGBTQ) people. While there is increasing awareness of higher prevalence of mental health difficulties among LGBTQ people in Malaysia, this issue has often been viewed through a cisheterosexist (cisgenderism and heterosexism) lens that criminalizes, pathologizes, marginalizes, and/or delegitimizes noncisgender and nonheterosexual forms of identities. Informed by LGBTQ-affirmative psychology, this viewpoint aims to scrutinize the common misconceptions surrounding the living experiences of Malaysian LGBTQ people; these include poor mental health among LGBTQ people, victim-blaming narrative of sexual violence, LGBTQ is a mental illness, and LGBTQ is a Western influence. This viewpoint draws on empirical and theoretical research, as well as international guidelines, to debunk these misconceptions. Recommendations are also provided for psychology practitioners and researchers to embark on the journey to supporting Malaysian LGBTQ people in a culturally safe manner.

Koro Presenting in the Prodromal Phase of Schizophrenia in a Patient With Klinefelter Syndrome

Klinefelter syndrome (KS), a disorder of abnormal sexual differentiation, is characterized by the presence of an excess X chromosome in males (47, XXY). KS is associated with various neuropsychiatric manifestations such as anxiety, depression, schizotypy, and frank psychosis. Psychosocial factors including stigma and poor coping or psychobiological comorbidities due to neuroendocrine mechanisms have been posited to explain these symptoms. We report the case of a young male with an anxious temperament who presented with the culture-bound neurosis of Koro, which evolved into schizophrenia. The patient also had gender dysphoria and significant social anxiety. The report highlights the implications of anxious traits leading to developing culture-bound neurosis in the prodromal phase of schizophrenia in a patient with KS and its influence on treatment strategies. Integrated psychopharmacological, psychological, and psychosocial interventions are required to promote recovery in patients with KS.

The Cyber Avatar of Sexual Harassment at the Workplace: Media Analysis of Reports During COVID-19

Background: Whether working at physical workplaces or from the seeming safety of home, women employees continue to be hounded by sexual harassment. During COVID-19, sexual harassment has taken on a cyber avatar and continues to enjoy the protections afforded by ambiguity and inept implementation. Objectives: The study explores how media reported cyber sexual harassment (CSH) during a 1-year period after COVID-19 in India. It explores the dominant discourses evident in such media reports, such as the ways in which CSH is manifested, psychosocial factors behind the same, action taken (if any), and organizational practices. Method: The present study involved content analysis of electronic print media content (newspapers and magazines) published in India, in the English language, between the period March 2020 and February 2021. A final pool of 24 articles was purposively arrived at through an Internet-based search, which was classified as news story, editorial, opinion piece, interview, column, and other. Content analysis of the articles was carried out to uncover the main themes. Within these themes, the researchers carried out open coding to identify subthemes. Results: Six broad themes emerged from the articles: manifestations of CSH, causes of CSH, outcomes of CSH, action taken by the victim, organizational practices, and barriers in seeking redressal. Manifestations included inappropriate behavior by boss/colleagues during meeting (30.6%), social media harassment (22.6%), video calls/meeting/work at odd hours (17.7%), inappropriate attire (14.5%), sexist behavior and comments (8.1%), and inappropriate jokes (6.2%). Some of the causes reported for CSH were blurring of personal and professional boundaries, lack of guidelines regarding virtual workplaces, job uncertainty, and notions of patriarchy. Only 29.2% articles highlighted any action(s) taken by the victim. Some of the barriers in seeking redressal were reported to be lack of awareness and/or clear guidelines, fear about the repercussions, difficulty in proving CSH, daunting appellate process, lack of privacy with family members around, and patriarchal culture. Conclusion: The study reiterates the need for clear and consistent communication on CSH, both in organizations and through the media. It is imperative not only to revive and modify the existing policies on CSH but also to implement them effectively. In the “new normal,” organizations need to formulate responses that are multilevel, swift, and coordinated across stakeholders, policymakers, technology specialists, and social scientists.

Quality of Marital Relationship and Sexual Interaction in Couples With Sexual Dysfunction: An Exploratory Study From India

Background: Sexual dysfunction and marital intimacy and quality are found to have a reciprocal relationship. Examining this relationship in couples seeking help for sexual dysfunctions in the cultural context of India is worthwhile. Aim: This study aims to explore the nature of sexual functioning, sexual interaction, sexual communication, and marital intimacy and quality in couples with sexual dysfunction. Further, relationship between the above variables is also examined. Methods: A cross-sectional, single-group exploratory design was adopted. A sample of 155 married heterosexual individuals, with a clinical diagnosis of sexual dysfunction in either of the spouses, was included in the study. The tools used included MINI neuropsychiatric interview, Marital Quality Scale, Marital Intimacy Questionnaire, Dyadic Sexual Communication Scale, and Sexual Interaction Inventory. Results: Erectile dysfunction and premature ejaculation in men and hypoactive sexual desire disorder in women were the most common sexual dysfunctions. Majority of the sample were young adults. About 82% of the sample had moderate-to-severe levels of marital distress. Mood disorder was the most common psychiatric disorder reported in the sample. High levels of intimacy problems were seen with no significant gender differences in the overall marital quality or intimacy. Difficulty in the overall sexual interactions was found; however, higher levels of dissatisfaction with the frequency of sex and lower self-acceptance was reported by men compared to women. Significant interrelationships were found between marital quality and intimacy, sexual interaction, and sexual communication. Conclusions: Sexual dysfunctions and marital distress are closely related. Sexual interaction and sexual communication play a significant role in marital quality and intimacy.

Psychosexual Problem in Remitted Psychiatric Patients

Background: Many patients and health literature, in general, allege that psychotropic agents cause sexual side effects. Objective: We intended to investigate this issue in a Nepalese clinical setting by estimating the prevalence of psychosexual problems among remitted psychiatric outpatients (on psychotropic medication) and by comparing it with that of a nonpsychiatric patient group (on nonpsychotropic medication). Methodology: In this hospital-based cross-sectional comparison study with purposive sampling, we collected the responses to a self-response questionnaire called “Arizona Sexual Experience Scale” from a total of 400 subjects: 100 male and 100 female consecutive consenting remitted psychiatric and dermatological outpatients, each with sex and marital status matching. We recorded pertinent information in the proforma and screened psychosexual problems with the Arizona Sexual Experience Scale after informed written consent. The problems in psychiatric and dermatological groups were compared. Results: We have more subjects of reproductive ages in both the psychiatric and dermatological groups. Depression, anxiety, and bipolar affective disorder were the most common diagnoses in the psychiatric patients, whereas eczema, fungal, immunologic, and allergic skin lesions/diseases were common in the dermatological patients. Both groups had comparable sexual dysfunction rates, both by overall and the criteria of ≥3 items with scores ≥4, whereas dermatological patients had more problems with criteria of ≥1 item with a score ≥5. Conclusions: Psychosexual dysfunction was more or less similar in frequency among both the psychiatric patients on psychotropic medication and dermatological patients on topical agents.