L’objet de cette etude est d’evaluer, a travers la litterature scientifique internationale, le de... more L’objet de cette etude est d’evaluer, a travers la litterature scientifique internationale, le devenir des transsexuels operes et les consequences du traitement hormonochirurgical (THC). Les transsexuels se disent satisfaits de leur transformation dans plus de trois quarts des cas et, en definitive, tres peu la regrettent. Il apparait assez clairement que le THC engendre des effets largement plus positifs que ceux que prevoyaient jadis les medecins et, plus encore, les psychologues. Sur cette base, et dans la mesure ou la prise en charge peut etre assumee de facon correcte, les facteurs de vulnerabilite psychologique etant pris en compte — de la phase diagnostique a la phase postoperatoire — il ne semble pas qu’il y ait des raisons empiriques de refuser la demande de changement de sexe (les criteres diagnostiques etant respectes, aucune contre-indication ne peut lui etre opposee). Des recherches sur les « profils a risque psychologique » sont a promouvoir pour mieux apprecier les fa...
L'objet de cette etude est d'evaluer, a travers la litterature scientifique international... more L'objet de cette etude est d'evaluer, a travers la litterature scientifique internationale, le devenir des transsexuels operes et les consequences du traitement hormonochirurgical (THC). Les transsexuels se disent satisfaits de leur transformation dans plus de trois quarts des cas et, en definitive, tres peu la regrettent. Il apparait assez clairement que le THC engendre des effets largement plus positifs que ceux que prevoyaient jadis les medecins et, plus encore, les psychologues. Sur cette base, et dans la mesure ou la prise en charge peut etre assumee de facon correcte, les facteurs de vulnerabilite psychologique etant pris en compte - de la phase diagnostique a la phase postoperatoire - il ne semble pas qu'il y ait des raisons empiriques de refuser la demande de changement de sexe (les criteres diagnostiques etant respectes, aucune contre-indication ne peut lui etre opposee). Des recherches sur les « profils a risque psychologique » sont a promouvoir pour mieux appr...
Il existe actuellement des debats portant sur le caractere irreversible de l’hormonotherapie chez... more Il existe actuellement des debats portant sur le caractere irreversible de l’hormonotherapie chez les personnes transsexuelles. Si, en ce qui concerne les FtM (femme vers homme), Il est connu que les androgenes ont une action sur les organes genitaux, il existe peu d’informations sur la reversibilite de ces effets. Objectif Determiner si un traitement androgenique au long cours entraine des modifications irreversibles sur l’appareil genital des patients transsexuels FtM. Methode Analyse retrospective des resultats anatomopathologiques des uterus et ovaires de 44 FtM ayant beneficie d’une chirurgie de reassignation sexuelle entre 2005 et 2015 au CHU de Marseille. Resultats L’âge median au debut du traitement hormonal est de 25 ans (20–29). Apres un traitement par testosterone injectable pendant 1,9 ans (1,5–2,3), une hysterectomie avec ovariectomie bilaterale est pratiquee apres un arret d’androgenotherapie d’environ 15 jours a un âge median de 27 ans (23–32). Le taux de testosterone median avant l’intervention est de 4570 pg/mL (3940–5790). La majorite des ovaires presentent des kystes (70 %) dont 25 (56,8 %) multiples. Des corps jaunes sont presents chez 20 % des patientes, une proliferation et/ou impregnation endometriale chez 43 % et un endometre quiescent chez 20 %. Il n’existe aucune neoplasie ovarienne ou endometriale. Conclusion Ces donnees temoignent d’un effet de la testosterone sur l’appareil genital des FtM, qui, malgre un traitement prolonge et correctement adapte par androgenes, semble etre a l’origine de modifications non irreversibles comme en temoignent les stigmates d’ovulation et l’activite endometriale persistantes chez une majorite de ces transsexuels.
The current aim of the fight against the HIV epidemic is to reduce the proportion of missed oppor... more The current aim of the fight against the HIV epidemic is to reduce the proportion of missed opportunities for HIV diagnosis. Erotic industry Shows (ES) were deemed to be appropriate events to organize awareness campaigns and to propose HIV Rapid Diagnostic Test (HIV-RDT) to people who are sexually active and likely to engage in unsafe sex practices. In 2015, a cross-sectional study in 4 ES was conducted to document the sexual risk factors associated with HIV-screening test approach and the proportion of positive HIV-RDT. Prevention booths were set up to offer HIV-screening to individuals ≥18 years volunteers for HIV-RDT and to respond to a validated anonymous self-reported questionnaire. In 4 ES, 943 participants were questioned and tested, mainly men (64%), young (mean age 30 years old), living as a couple (63.7%). A large majority (95.1%) reported sexual intercourse over the last year. The mean number of partners was 4.8. About 2/3 had unprotected sex. 37.5% had never been tested ...
The World Professional Association for Transgender Health (WPATH) standards of care for transsexu... more The World Professional Association for Transgender Health (WPATH) standards of care for transsexual, transgender, and gender non-conforming people (version 7) represent international normative standards for clinical care for these populations. Standards for optimal individual clinical care are consistent around the world, although the implementation of services for transgender populations will depend on health system infrastructure and sociocultural contexts. Some clinical services for transgender people, including gender-affirming surgery, are best delivered in the context of more specialised facilities; however, the majority of health-care needs can be delivered by a primary care practitioner. Across high-income and low-income settings alike, there often remains a dearth of educational programming for health-care professionals in transgender health, although the best evidence supports introducing modules on transgender health early during clinical education of clinicians and allied health professionals. While these challenges remain, we review the increasing evidence and examples of the defined roles of the mental health professional in transgender health-care decisions, effective models of health service provision, and available surgical interventions for transgender people.
ABSTRACT Objectif L’objectif principal de ce travail est d’évaluer l’impact de la transformation ... more ABSTRACT Objectif L’objectif principal de ce travail est d’évaluer l’impact de la transformation hormonochirurgicale sur les différents domaines importants de la vie quotidienne des transsexuels. Le second objectif est de rechercher l’influence de différents facteurs susceptibles d’influencer la qualité de vie tels que le sexe et la personnalité des sujets. Méthode Une étude de la personnalité sera ainsi effectuée grâce à l’inventaire de personnalité d’Eysenck (EPI) afin d’analyser deux dimensions de la personnalité (l’extraversion et le névrosisme). Trente-huit sujets ayant suivi une transformation hormonochirurgicale sont inclus dans cette étude. Résultats Les résultats montrent que l’opération de changement de sexe améliore la qualité de vie des transsexuels dans différents domaines pertinents (les transsexuels sont tous satisfaits de leur conversion sexuelle, [28/30] satisfaits et [2/30] moyennement satisfaits, leur qualité de vie s’améliore après chirurgie sur le plan social [21/30] et sexuel [25/30]). Cependant, il existe des différences entre les transsexuels masculins et féminins en ce qui concerne la qualité de vie (les transsexuels FM ont une meilleure vie sociale, professionnelle, amicale et un bien-être psychologique plus important que les transsexuels MF). Enfin, les résultats de cette étude ne mettent pas en évidence l’influence de certains facteurs de personnalité tels que l’extraversion et le névrosisme sur le niveau de qualité de vie des sujets transsexuels opérés.
ABSTRACT Aim The main objective of this work is to provide a more detailed assessment of the impa... more ABSTRACT Aim The main objective of this work is to provide a more detailed assessment of the impact of surgical reassignment on the most important aspects of daily life for these patients. Our secondary objective was to establish the influence of various factors likely to have an impact on the quality of life (QoL), such as biological gender and the subject's personality. Methods A personality study was conducted using Eysenck Personality Inventory (EPI) so as to analyze two aspects of the personality (extraversion and neuroticism). Thirty-eight subjects who had undergone hormonal surgical reassignment were included in the study. Results The results show that gender reassignment surgery improves the QoL for transsexuals in several different important areas: most are satisfied of their sexual reassignment (28/30), their social (21/30) and sexual QoL (25/30) are improved. However, there are differences between male-to-female (MtF) and female-to-male (FtM) transsexuals in terms of QoL: FtM have a better social, professional, friendly lifestyles than MtF. Finally, the results of this study did not evidence any influence by certain aspects of the personality, such as extraversion and neuroticism, on the QoL for reassigned subjects.
The development of sex-active drugs justifies the use of scales for evaluating changes induced by... more The development of sex-active drugs justifies the use of scales for evaluating changes induced by such forms of therapy. Among the tools available for evaluating erectile dysfunction (ED), the International Index of Erectile Function is the most widely used. Analysis of the scientific literature shows that these instruments remain primarily focused on functional aspects of ED. The vulnerability factors involved in ED are mainly based upon organic characteristics, e.g., age, cardiovascular diseases, or diabetes, but the psychological factors involved in the occurrence and maintenance of ED are less studied. This conclusion led us to develop a French self-administered instrument, based on patients' subjective sexual experiences, to evaluate "male sexual anticipating cognitions," using Apter's reversal theory as a framework. We present here the first stages of the development of this new instrument. We carried out semistructured, one-to-one interviews with patients with psychogenic ED and patients with mixed ED. Eighteen one-to-one interviews were held in several urologic/andrologic and psychiatric sexologist services. Interviews were continued until the required information was obtained. Analyses of the content were performed to generate items for the new instrument. Dimensions isolated were those of (a) sexual beliefs; (b) metamotivational modes; and (c) dysfunctional coping. Pools of items are currently being analyzed by 108 experts (psychologists, sexologists, andrologists, urologists) to determine if additional items are required. The acceptability and the comprehensiveness of this preliminary questionnaire will be tested by 320 patients in a multicentric study, to produce a shorter questionnaire featuring the most relevant items. Once validated, this multidimensional instrument could be used to assess treatment efficacy of the mixed and psychogenic components of ED.
The development of sex-active drugs justifies the use of scales for evaluating changes induced by... more The development of sex-active drugs justifies the use of scales for evaluating changes induced by such forms of therapy. Among the tools available for evaluating erectile dysfunction (ED), the International Index of Erectile Function is the most widely used. Analysis of the scientific literature shows that these instruments remain primarily focused on functional aspects of ED. The vulnerability factors involved in ED are mainly based upon organic characteristics, e.g., age, cardiovascular diseases, or diabetes, but the psychological factors involved in the occurrence and maintenance of ED are less studied. This conclusion led us to develop a French self-administered instrument, based on patients' subjective sexual experiences, to evaluate "male sexual anticipating cognitions," using Apter's reversal theory as a framework. We present here the first stages of the development of this new instrument. We carried out semistructured, one-to-one interviews with patients with psychogenic ED and patients with mixed ED. Eighteen one-to-one interviews were held in several urologic/andrologic and psychiatric sexologist services. Interviews were continued until the required information was obtained. Analyses of the content were performed to generate items for the new instrument. Dimensions isolated were those of (a) sexual beliefs; (b) metamotivational modes; and (c) dysfunctional coping. Pools of items are currently being analyzed by 108 experts (psychologists, sexologists, andrologists, urologists) to determine if additional items are required. The acceptability and the comprehensiveness of this preliminary questionnaire will be tested by 320 patients in a multicentric study, to produce a shorter questionnaire featuring the most relevant items. Once validated, this multidimensional instrument could be used to assess treatment efficacy of the mixed and psychogenic components of ED.
The development of sex-active drugs justifies the use of scales for evaluating changes induced by... more The development of sex-active drugs justifies the use of scales for evaluating changes induced by such forms of therapy. Among the tools available for evaluating erectile dysfunction (ED), the International Index of Erectile Function is the most widely used. Analysis of the scientific literature shows that these instruments remain primarily focused on functional aspects of ED. The vulnerability factors involved in ED are mainly based upon organic characteristics, e.g., age, cardiovascular diseases, or diabetes, but the psychological factors involved in the occurrence and maintenance of ED are less studied. This conclusion led us to develop a French self-administered instrument, based on patients' subjective sexual experiences, to evaluate "male sexual anticipating cognitions," using Apter's reversal theory as a framework. We present here the first stages of the development of this new instrument. We carried out semistructured, one-to-one interviews with patients with psychogenic ED and patients with mixed ED. Eighteen one-to-one interviews were held in several urologic/andrologic and psychiatric sexologist services. Interviews were continued until the required information was obtained. Analyses of the content were performed to generate items for the new instrument. Dimensions isolated were those of (a) sexual beliefs; (b) metamotivational modes; and (c) dysfunctional coping. Pools of items are currently being analyzed by 108 experts (psychologists, sexologists, andrologists, urologists) to determine if additional items are required. The acceptability and the comprehensiveness of this preliminary questionnaire will be tested by 320 patients in a multicentric study, to produce a shorter questionnaire featuring the most relevant items. Once validated, this multidimensional instrument could be used to assess treatment efficacy of the mixed and psychogenic components of ED.
The assessment of co-existing psychological and psychiatric disorders is advocated in the Standar... more The assessment of co-existing psychological and psychiatric disorders is advocated in the Standards of Care for the health of transsexual people. This study aimed to determine the psychopathological characteristics of transsexuals based on a large sample of French individuals and to identify whether these characteristics differed according to the individual's sociodemographic or clinical characteristics. The aim of this study was to determine the psychopathological characteristics of transsexuals from a large sample of French individuals and whether these differed by sociodemographic or clinical characteristics. This cross-sectional study was conducted in a French public university hospital. The inclusion criteria were 18 years or older, diagnosis of gender dysphoria, and eligibility for a standardized sex reassignment procedure. Personality characteristics were assessed using the Minnesota Multiphasic Personality Inventory 2 (MMPI-2). A total of 108 individuals provided a valid...
Malgré la fréquence des troubles sexuels chez le patient schizophrène, peu d’études ont été réali... more Malgré la fréquence des troubles sexuels chez le patient schizophrène, peu d’études ont été réalisées sur le sujet. Le lien entre schizophrénie et sexualité est variable et complexe, différent entre les hommes et les femmes. Peu de méthodes d’évaluation ont été proposées et encore moins validées. Les antipsychotiques peuvent améliorer certains aspects du comportement sexuel des patients schizophrènes. Cependant, des dysfonctionnements sexuels sont également un possible effet secondaire de ce type de molécules. L’évaluation des antipsychotiques sur la sexualité a été souvent limitée au dosage de la prolactine, alors que le lien entre taux de prolactine et troubles sexuels n’est pas totalement clair. Des données préliminaires suggèrent que tous les antipsychotiques n’ont pas les mêmes effets sur la sexualité des patients schizophrènes. Cette revue présente les données disponibles sur le mécanisme des dysfonctions sexuelles, le profil pharmacologique et les effets sexuels des neuroleptiques classiques (halopéridol, thioridazine) et des antipsychotiques de seconde génération (amisulpride, clozapine, rispéridone, olanzapine).In spite of the frequency of sexual dysfunction in schizophrenic patients and antipsychotic-treated schizophrenic patients, few studies have been performed. The relationship of schizophrenia to sexual pathology is variable and complex, and of course different between men and women. Few evaluation methods have been proposed or validated. Antipsychotics may improve some aspects of sexual behaviour in schizophrenic patients. However, sexual dysfunction is also a possible side effect of these drugs. The evaluation of antipsychotics is often restricted to prolactin measurement, the relationship with sexual disorders of which has not been fully established. Preliminary data suggest that the capacity to induce sexual disorders differs from one antipsychotic to another. The available data on the mechanisms of sexual dysfunction, the pharmacological profile and the sexual effects of classical neuroleptics (haloperidol and thioridazine) and second generation antipsychotics available in France (amisulpride, clozapine, risperidone, olanzapine) are reviewed.
L’objet de cette etude est d’evaluer, a travers la litterature scientifique internationale, le de... more L’objet de cette etude est d’evaluer, a travers la litterature scientifique internationale, le devenir des transsexuels operes et les consequences du traitement hormonochirurgical (THC). Les transsexuels se disent satisfaits de leur transformation dans plus de trois quarts des cas et, en definitive, tres peu la regrettent. Il apparait assez clairement que le THC engendre des effets largement plus positifs que ceux que prevoyaient jadis les medecins et, plus encore, les psychologues. Sur cette base, et dans la mesure ou la prise en charge peut etre assumee de facon correcte, les facteurs de vulnerabilite psychologique etant pris en compte — de la phase diagnostique a la phase postoperatoire — il ne semble pas qu’il y ait des raisons empiriques de refuser la demande de changement de sexe (les criteres diagnostiques etant respectes, aucune contre-indication ne peut lui etre opposee). Des recherches sur les « profils a risque psychologique » sont a promouvoir pour mieux apprecier les fa...
L'objet de cette etude est d'evaluer, a travers la litterature scientifique international... more L'objet de cette etude est d'evaluer, a travers la litterature scientifique internationale, le devenir des transsexuels operes et les consequences du traitement hormonochirurgical (THC). Les transsexuels se disent satisfaits de leur transformation dans plus de trois quarts des cas et, en definitive, tres peu la regrettent. Il apparait assez clairement que le THC engendre des effets largement plus positifs que ceux que prevoyaient jadis les medecins et, plus encore, les psychologues. Sur cette base, et dans la mesure ou la prise en charge peut etre assumee de facon correcte, les facteurs de vulnerabilite psychologique etant pris en compte - de la phase diagnostique a la phase postoperatoire - il ne semble pas qu'il y ait des raisons empiriques de refuser la demande de changement de sexe (les criteres diagnostiques etant respectes, aucune contre-indication ne peut lui etre opposee). Des recherches sur les « profils a risque psychologique » sont a promouvoir pour mieux appr...
Il existe actuellement des debats portant sur le caractere irreversible de l’hormonotherapie chez... more Il existe actuellement des debats portant sur le caractere irreversible de l’hormonotherapie chez les personnes transsexuelles. Si, en ce qui concerne les FtM (femme vers homme), Il est connu que les androgenes ont une action sur les organes genitaux, il existe peu d’informations sur la reversibilite de ces effets. Objectif Determiner si un traitement androgenique au long cours entraine des modifications irreversibles sur l’appareil genital des patients transsexuels FtM. Methode Analyse retrospective des resultats anatomopathologiques des uterus et ovaires de 44 FtM ayant beneficie d’une chirurgie de reassignation sexuelle entre 2005 et 2015 au CHU de Marseille. Resultats L’âge median au debut du traitement hormonal est de 25 ans (20–29). Apres un traitement par testosterone injectable pendant 1,9 ans (1,5–2,3), une hysterectomie avec ovariectomie bilaterale est pratiquee apres un arret d’androgenotherapie d’environ 15 jours a un âge median de 27 ans (23–32). Le taux de testosterone median avant l’intervention est de 4570 pg/mL (3940–5790). La majorite des ovaires presentent des kystes (70 %) dont 25 (56,8 %) multiples. Des corps jaunes sont presents chez 20 % des patientes, une proliferation et/ou impregnation endometriale chez 43 % et un endometre quiescent chez 20 %. Il n’existe aucune neoplasie ovarienne ou endometriale. Conclusion Ces donnees temoignent d’un effet de la testosterone sur l’appareil genital des FtM, qui, malgre un traitement prolonge et correctement adapte par androgenes, semble etre a l’origine de modifications non irreversibles comme en temoignent les stigmates d’ovulation et l’activite endometriale persistantes chez une majorite de ces transsexuels.
The current aim of the fight against the HIV epidemic is to reduce the proportion of missed oppor... more The current aim of the fight against the HIV epidemic is to reduce the proportion of missed opportunities for HIV diagnosis. Erotic industry Shows (ES) were deemed to be appropriate events to organize awareness campaigns and to propose HIV Rapid Diagnostic Test (HIV-RDT) to people who are sexually active and likely to engage in unsafe sex practices. In 2015, a cross-sectional study in 4 ES was conducted to document the sexual risk factors associated with HIV-screening test approach and the proportion of positive HIV-RDT. Prevention booths were set up to offer HIV-screening to individuals ≥18 years volunteers for HIV-RDT and to respond to a validated anonymous self-reported questionnaire. In 4 ES, 943 participants were questioned and tested, mainly men (64%), young (mean age 30 years old), living as a couple (63.7%). A large majority (95.1%) reported sexual intercourse over the last year. The mean number of partners was 4.8. About 2/3 had unprotected sex. 37.5% had never been tested ...
The World Professional Association for Transgender Health (WPATH) standards of care for transsexu... more The World Professional Association for Transgender Health (WPATH) standards of care for transsexual, transgender, and gender non-conforming people (version 7) represent international normative standards for clinical care for these populations. Standards for optimal individual clinical care are consistent around the world, although the implementation of services for transgender populations will depend on health system infrastructure and sociocultural contexts. Some clinical services for transgender people, including gender-affirming surgery, are best delivered in the context of more specialised facilities; however, the majority of health-care needs can be delivered by a primary care practitioner. Across high-income and low-income settings alike, there often remains a dearth of educational programming for health-care professionals in transgender health, although the best evidence supports introducing modules on transgender health early during clinical education of clinicians and allied health professionals. While these challenges remain, we review the increasing evidence and examples of the defined roles of the mental health professional in transgender health-care decisions, effective models of health service provision, and available surgical interventions for transgender people.
ABSTRACT Objectif L’objectif principal de ce travail est d’évaluer l’impact de la transformation ... more ABSTRACT Objectif L’objectif principal de ce travail est d’évaluer l’impact de la transformation hormonochirurgicale sur les différents domaines importants de la vie quotidienne des transsexuels. Le second objectif est de rechercher l’influence de différents facteurs susceptibles d’influencer la qualité de vie tels que le sexe et la personnalité des sujets. Méthode Une étude de la personnalité sera ainsi effectuée grâce à l’inventaire de personnalité d’Eysenck (EPI) afin d’analyser deux dimensions de la personnalité (l’extraversion et le névrosisme). Trente-huit sujets ayant suivi une transformation hormonochirurgicale sont inclus dans cette étude. Résultats Les résultats montrent que l’opération de changement de sexe améliore la qualité de vie des transsexuels dans différents domaines pertinents (les transsexuels sont tous satisfaits de leur conversion sexuelle, [28/30] satisfaits et [2/30] moyennement satisfaits, leur qualité de vie s’améliore après chirurgie sur le plan social [21/30] et sexuel [25/30]). Cependant, il existe des différences entre les transsexuels masculins et féminins en ce qui concerne la qualité de vie (les transsexuels FM ont une meilleure vie sociale, professionnelle, amicale et un bien-être psychologique plus important que les transsexuels MF). Enfin, les résultats de cette étude ne mettent pas en évidence l’influence de certains facteurs de personnalité tels que l’extraversion et le névrosisme sur le niveau de qualité de vie des sujets transsexuels opérés.
ABSTRACT Aim The main objective of this work is to provide a more detailed assessment of the impa... more ABSTRACT Aim The main objective of this work is to provide a more detailed assessment of the impact of surgical reassignment on the most important aspects of daily life for these patients. Our secondary objective was to establish the influence of various factors likely to have an impact on the quality of life (QoL), such as biological gender and the subject's personality. Methods A personality study was conducted using Eysenck Personality Inventory (EPI) so as to analyze two aspects of the personality (extraversion and neuroticism). Thirty-eight subjects who had undergone hormonal surgical reassignment were included in the study. Results The results show that gender reassignment surgery improves the QoL for transsexuals in several different important areas: most are satisfied of their sexual reassignment (28/30), their social (21/30) and sexual QoL (25/30) are improved. However, there are differences between male-to-female (MtF) and female-to-male (FtM) transsexuals in terms of QoL: FtM have a better social, professional, friendly lifestyles than MtF. Finally, the results of this study did not evidence any influence by certain aspects of the personality, such as extraversion and neuroticism, on the QoL for reassigned subjects.
The development of sex-active drugs justifies the use of scales for evaluating changes induced by... more The development of sex-active drugs justifies the use of scales for evaluating changes induced by such forms of therapy. Among the tools available for evaluating erectile dysfunction (ED), the International Index of Erectile Function is the most widely used. Analysis of the scientific literature shows that these instruments remain primarily focused on functional aspects of ED. The vulnerability factors involved in ED are mainly based upon organic characteristics, e.g., age, cardiovascular diseases, or diabetes, but the psychological factors involved in the occurrence and maintenance of ED are less studied. This conclusion led us to develop a French self-administered instrument, based on patients' subjective sexual experiences, to evaluate "male sexual anticipating cognitions," using Apter's reversal theory as a framework. We present here the first stages of the development of this new instrument. We carried out semistructured, one-to-one interviews with patients with psychogenic ED and patients with mixed ED. Eighteen one-to-one interviews were held in several urologic/andrologic and psychiatric sexologist services. Interviews were continued until the required information was obtained. Analyses of the content were performed to generate items for the new instrument. Dimensions isolated were those of (a) sexual beliefs; (b) metamotivational modes; and (c) dysfunctional coping. Pools of items are currently being analyzed by 108 experts (psychologists, sexologists, andrologists, urologists) to determine if additional items are required. The acceptability and the comprehensiveness of this preliminary questionnaire will be tested by 320 patients in a multicentric study, to produce a shorter questionnaire featuring the most relevant items. Once validated, this multidimensional instrument could be used to assess treatment efficacy of the mixed and psychogenic components of ED.
The development of sex-active drugs justifies the use of scales for evaluating changes induced by... more The development of sex-active drugs justifies the use of scales for evaluating changes induced by such forms of therapy. Among the tools available for evaluating erectile dysfunction (ED), the International Index of Erectile Function is the most widely used. Analysis of the scientific literature shows that these instruments remain primarily focused on functional aspects of ED. The vulnerability factors involved in ED are mainly based upon organic characteristics, e.g., age, cardiovascular diseases, or diabetes, but the psychological factors involved in the occurrence and maintenance of ED are less studied. This conclusion led us to develop a French self-administered instrument, based on patients' subjective sexual experiences, to evaluate "male sexual anticipating cognitions," using Apter's reversal theory as a framework. We present here the first stages of the development of this new instrument. We carried out semistructured, one-to-one interviews with patients with psychogenic ED and patients with mixed ED. Eighteen one-to-one interviews were held in several urologic/andrologic and psychiatric sexologist services. Interviews were continued until the required information was obtained. Analyses of the content were performed to generate items for the new instrument. Dimensions isolated were those of (a) sexual beliefs; (b) metamotivational modes; and (c) dysfunctional coping. Pools of items are currently being analyzed by 108 experts (psychologists, sexologists, andrologists, urologists) to determine if additional items are required. The acceptability and the comprehensiveness of this preliminary questionnaire will be tested by 320 patients in a multicentric study, to produce a shorter questionnaire featuring the most relevant items. Once validated, this multidimensional instrument could be used to assess treatment efficacy of the mixed and psychogenic components of ED.
The development of sex-active drugs justifies the use of scales for evaluating changes induced by... more The development of sex-active drugs justifies the use of scales for evaluating changes induced by such forms of therapy. Among the tools available for evaluating erectile dysfunction (ED), the International Index of Erectile Function is the most widely used. Analysis of the scientific literature shows that these instruments remain primarily focused on functional aspects of ED. The vulnerability factors involved in ED are mainly based upon organic characteristics, e.g., age, cardiovascular diseases, or diabetes, but the psychological factors involved in the occurrence and maintenance of ED are less studied. This conclusion led us to develop a French self-administered instrument, based on patients' subjective sexual experiences, to evaluate "male sexual anticipating cognitions," using Apter's reversal theory as a framework. We present here the first stages of the development of this new instrument. We carried out semistructured, one-to-one interviews with patients with psychogenic ED and patients with mixed ED. Eighteen one-to-one interviews were held in several urologic/andrologic and psychiatric sexologist services. Interviews were continued until the required information was obtained. Analyses of the content were performed to generate items for the new instrument. Dimensions isolated were those of (a) sexual beliefs; (b) metamotivational modes; and (c) dysfunctional coping. Pools of items are currently being analyzed by 108 experts (psychologists, sexologists, andrologists, urologists) to determine if additional items are required. The acceptability and the comprehensiveness of this preliminary questionnaire will be tested by 320 patients in a multicentric study, to produce a shorter questionnaire featuring the most relevant items. Once validated, this multidimensional instrument could be used to assess treatment efficacy of the mixed and psychogenic components of ED.
The assessment of co-existing psychological and psychiatric disorders is advocated in the Standar... more The assessment of co-existing psychological and psychiatric disorders is advocated in the Standards of Care for the health of transsexual people. This study aimed to determine the psychopathological characteristics of transsexuals based on a large sample of French individuals and to identify whether these characteristics differed according to the individual's sociodemographic or clinical characteristics. The aim of this study was to determine the psychopathological characteristics of transsexuals from a large sample of French individuals and whether these differed by sociodemographic or clinical characteristics. This cross-sectional study was conducted in a French public university hospital. The inclusion criteria were 18 years or older, diagnosis of gender dysphoria, and eligibility for a standardized sex reassignment procedure. Personality characteristics were assessed using the Minnesota Multiphasic Personality Inventory 2 (MMPI-2). A total of 108 individuals provided a valid...
Malgré la fréquence des troubles sexuels chez le patient schizophrène, peu d’études ont été réali... more Malgré la fréquence des troubles sexuels chez le patient schizophrène, peu d’études ont été réalisées sur le sujet. Le lien entre schizophrénie et sexualité est variable et complexe, différent entre les hommes et les femmes. Peu de méthodes d’évaluation ont été proposées et encore moins validées. Les antipsychotiques peuvent améliorer certains aspects du comportement sexuel des patients schizophrènes. Cependant, des dysfonctionnements sexuels sont également un possible effet secondaire de ce type de molécules. L’évaluation des antipsychotiques sur la sexualité a été souvent limitée au dosage de la prolactine, alors que le lien entre taux de prolactine et troubles sexuels n’est pas totalement clair. Des données préliminaires suggèrent que tous les antipsychotiques n’ont pas les mêmes effets sur la sexualité des patients schizophrènes. Cette revue présente les données disponibles sur le mécanisme des dysfonctions sexuelles, le profil pharmacologique et les effets sexuels des neuroleptiques classiques (halopéridol, thioridazine) et des antipsychotiques de seconde génération (amisulpride, clozapine, rispéridone, olanzapine).In spite of the frequency of sexual dysfunction in schizophrenic patients and antipsychotic-treated schizophrenic patients, few studies have been performed. The relationship of schizophrenia to sexual pathology is variable and complex, and of course different between men and women. Few evaluation methods have been proposed or validated. Antipsychotics may improve some aspects of sexual behaviour in schizophrenic patients. However, sexual dysfunction is also a possible side effect of these drugs. The evaluation of antipsychotics is often restricted to prolactin measurement, the relationship with sexual disorders of which has not been fully established. Preliminary data suggest that the capacity to induce sexual disorders differs from one antipsychotic to another. The available data on the mechanisms of sexual dysfunction, the pharmacological profile and the sexual effects of classical neuroleptics (haloperidol and thioridazine) and second generation antipsychotics available in France (amisulpride, clozapine, risperidone, olanzapine) are reviewed.
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Papers by Mireille Bonierbale