Francesca Tripodi

Health-Related Characteristics and Unmet Needs of Men with Erectile Dysfunction: A Survey in Five European Countries

INTRODUCTION Data suggest that ED is still an underdiagnosed and undertreated condition. In addition, it seems that men with ED are unsatisfied about their relationship with their physician and with the available drugs. AIM The study aims to identify health-related characteristics and unmet needs of patients suffering from erectile dysfunction (ED) in big 5 European Union (EU) nations (France, Germany, Italy, Spain, and UK). METHODS Data were collected from the 2011 5EU National Health and Wellness-Survey on a population of 28,511 adult men (mean age: 47.18; SD 16.07) and was focused on men (5,184) who self-reported ED in the past 6 months. In addition, the quality of life (QoL) and work productivity/activity were explored. MAIN OUTCOME MEASURES Health-related QoL (HRQoL) and work productivity were measured with SF-12v2 and WPAI validated psychometric tools. RESULTS One in every 20 young men (age 18-39) across 5EU experienced ED in the past 6 months. About half of men (2,702/5,184; [52%]) with ED across all ages did not discuss their condition with their physician. Interestingly, among those men who did discuss their condition with their physician, 68% (1,668/2,465) do not currently use medication. These findings were more evident in the age group of 18-39 years. Only 48% (2,465/5,184) had a closer relationship with their physician, suggesting that this quality of relationship may be unsatisfactory. Compared with controls, ED patients have a significantly higher intrapsychic and relational psychopathological comorbid burden and relevant decreasing in HRQoL, with a significantly higher impairment on work productivity/activity. CONCLUSION Data suggest that there is a need for a new therapeutic paradigm in ED treatment which images the achievement of a new alliance between physician and patient. Hence, alternative drug delivery strategies may reduce the psychological and social impact of this disease.

What do men and women ask a helpline on sexual concerns? Results of an Italian telephone counselling service

Introduction:  In Europe, helplines have become a common counselling service for men and women who are seeking advice for sexual problems. Despite this, relatively few peer‐reviewed reports on this subject have been published in the last decade.

Questionnaires and scales for the evaluation of the online sexual activities: A review of 20 years of research

An increasing number of people use the Internet for Online Sexual Activities (OSA). This sexual revolution has resulted in both positive and negative aspects, enriching sexual functioning but also providing other risks for criminal, negative and harmful sexual conducts, or Online Sexual Problems (OSP). A deeper understanding of Internet sexuality is therefore important for practitioners who work in the psychological and sexological fields. Current studies on Internet sexuality span a broad spectrum with respect to data collection: interviews, questionnaires, observations, content analyses and Internet log file recordings have all been used. The aim of this paper is to offer the most complete overview of these instruments focusing on the strengths and weaknesses of different tools currently available to assess different dimensions of OSA, and to suggest a simple screener for OSP. A systematic search of published online sexual activities inventories was performed using PsychInfo and Pubmed (1993 to July 2013). Although many of them are adequate for their own purposes, our review revealed a lack of standardized, internationally (culturally) accepted tools that are epidemiologically validated in general populations and that can be used to investigate OSA and to assess OSP. The definitions of OSA and OSP continue to change and basic tools are essential to have a broader idea of the phenomenon and of the challenges and possibilities emerging from the double link between the Internet and sexuality. More accurate instruments are also necessary to help advanced clinical diagnosis and treatment for OSP.

Sexual Modes Questionnaire (SMQ): Translation and Psychometric Properties of the Italian Version of the Automatic Thought Scale

BACKGROUND The Sexual Modes Questionnaire (SMQ) is a validated and widespread used tool to assess the association among negative automatic thoughts, emotions, and sexual response during sexual activity in men and women. AIM To test the psychometric characteristics of the Italian version of the SMQ focusing on the Automatic Thoughts subscale (SMQ-AT). METHODS After linguistic translation, the psychometric properties (internal consistency, construct, and discriminant validity) were evaluated. 1,051 participants (425 men and 626 women, 776 healthy and 275 clinical groups complaining about sexual problems) participated in the present study. OUTCOMES 2 confirmatory factor analyses were conducted to test the fit of the original factor structures of the SMQ versions. In addition, 2 principal component analyses were performed to highlight 2 new factorial structures that were further validated with confirmatory factor analyses. Cronbach α and composite reliability were used as internal consistency measures and differences between clinical and control groups were run to test the discriminant validity for the male and female versions. The associations with emotions and sexual functioning measures also are reported. RESULTS Principal component analyses identified 5 factors in the male version: erection concerns thoughts, lack of erotic thoughts, age- and body-related thoughts, negative thoughts toward sex, and worries about partners evaluation and failure anticipation thoughts. In the female version 6 factors were found: sexual abuse thoughts, lack of erotic thoughts, low self-body image thoughts, failure and disengagement thoughts, sexual passivity and control, and partners lack of affection. Confirmatory factor analysis supported the adequacy of the factor structure for men and women. Moreover, the SMQ showed a strong association with emotional response and sexual functioning, differentiating between clinical and control groups. CLINICAL TRANSLATION This measure is useful to evaluate patients and design interventions focused on negative automatic thoughts during sexual activity and to develop multicultural research. STRENGTHS AND LIMITATIONS This study reports on the translation and validation of the Italian version of a clinically useful and widely used measure (assessing automatic thoughts during sexual activity). Limits regarding sampling technique and use of the Automatic Thoughts subscale are discussed in the article. CONCLUSION The present findings support the validity and the internal consistency of the Italian version of the SMQ-AT and allow the assessment of negative automatic thoughts during sexual activity for clinical and research purposes. Nimbi FM, Tripodi F, Simonelli C, Nobre P. Sexual Modes Questionnaire (SMQ): Translation and Psychometric Properties of the Italian Version of the Automatic Thought Scale. J Sex Med 2018;15:396-409.

EFS/ESSM‐Certified Psychosexologist with Mark of Excellence

*Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel; Institute of Clinical Sexology, Rome, Italy; Department of Urology, Ziekenhuis Amstelland, Amstelveen, The Netherlands; Centre for Sexual and Reproductive Health, Aristotle University, Thessaloniki, Greece; Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy; **Private urological/andrological practice, Hamburg, Germany

Quality of sex life and partnership in women affected by endometriosis

Objective This study analyses the quality of sex life and partnership in a sample of italian women affected by endometriosis verifying the hypothesis that women with endometriosis have less sexual and couple satisfaction than healthy women. Design And Method The Italian version of McCoy Female Sexuality Questionnaire (MFSQ) was administered to a total sample of 110 Italian women, 55 with endometriosis, EG, and 55 without genital disease, CG, ages 18-45 years (M=30, SD=6), grouped into 3 clusters: 18-29, 30-39 and 40-45 years. A principal component analysis was conducted to verify the two factors structure identified in previous studies. A t test was conducted on both factors scores to assess the differences between groups. Results As expected, factor analysis indentified 2 factors, sexuality (9 items) and partnership (5 items), with an adequate inter-item reliability (Cronbachs a of .84 and .71 respectively). Women with endometriosis scored significantly lower in sexuality (t=4.59, a Conclusions According to recent studies, the results indicate that women with endometriosis have less sexual and partnership satisfaction than healthy women. Moreover low sexual satisfaction maybe an indicator of the presence of dyspareunia. Further researches are required to verify these results.

Endometriosi e infertilità: impatto su sessualità, relazione di coppia, qualità della vita e benessere psicologico

L’obiettivo dello studio e stato quello di esplorare le differenze in funziona-mento sessuale, soddisfazione relazionale e sessuale, ansia e qualita della vita, tra pazienti affette da endometriosi con e senza infertilita, con l’ipotesi che quest’ul-tima fosse associata a punteggi piu critici su tutte le aree. Lo studio e stato condot-to su 71 donne che hanno compilato: un questionario socio-anagrafico, il World Health Organization Quality of Life (WHOQOL)-Bref, il McCoy Female Sexuality Questionnaire (MFS-Q), il Female Sexual Functioning Index (FSFI) e l’Hamilton Anxiety Rating Scale (HAM-A). Il gruppo senza infertilita ha ottenuto punteggi peggiori in tutte le aree analizzate, tranne nell’ansia. I risultati dello studio suggeri-scono l’importanza di un approccio BPS integrato durante la fase di diagnosi e di trattamento che coinvolga il partner per tutto il processo.

Extraversion and Neuroticism in Sexually Dysfunctional Men Suffering fromErectile Dysfunction and Premature Ejaculation: A Cross-Sectional Study

The role of personality traits in sexual complaints and dysfunctions is ever more evident. However, the literature is very scarce as to the possible relationships between such personality traits and specific sexual dysfunctions like ED, PE or both, their subtypes as to time of onset and severity levels. The main aim of the present study was to investigate if Neuroticism and Extraversion have different roles and trends in men suffering from PE and/or ED, both lifelong and acquired. Moreover, we verified if, by adopting DSM-IV-TR and DSM-5 criteria for diagnosing PE, some differences emerged in percentages of diagnosed cases. The sample consisted of 222 patients aged 18-70. The International Index of Erectile Function (IIEF-15) was used to assess erectile function, and the Premature Ejaculation Severity Index (PESI) was used to assess the severity of PE dysfunction. Neuroticism and Extraversion were measured with the Eysenck Personality Questionnaire-Revised (EPQ-R). In our results, Neuroticism and Extraversion were dependent on the kind of sexual dysfunction and its severity. These results suggest that type, time of onset and severity of sexual dysfunctions should be considered as related to specific personality characteristics and vice versa.

Oggettivazione del femminile e sessualizzazione precoce delle bambine: implicazioni sullo sviluppo psicosessuale

Nella societa attuale, i ritmi della trasformazione hanno registrato un’accelerazione tale che, per la prima volta nella nostra storia, la generazione adulta non riesce ad immaginare la societa che attende i propri figli. Per queste ragioni, emerge una domanda di comprensione del presente, prima ancora della previsione del futuro. Per il supporto della salute sessuale femminile, gli sforzi attuali sono contrapposti ad una certa pressione ad uniformarsi all’oggetto dei desideri maschili. Il continuo richiamo esercitato da uno sguardo, esterno o interno, sull’aspetto fisico interrompe la concentrazione e diminuisce la possibilita di entrare in contatto con le proprie sensazioni ed i propri bisogni. L’auspicio e quello che sempre piu si diffonda la cultura del gruppo di studio e di intervento, formato da figure professionali diverse ed integrate, che possano cogliere gli aspetti fisiologici, psicologici, relazionali e culturali, sia nelle loro peculiarita, sia nello loro interazioni reciproche.

L’approccio integrato in sessuologia Teoria e prassi clinica

Negli ultimi anni in sessuologia si e diffusa rapidamente l’integrazione di specialisti, modelli e tecniche. Questo articolo descrive l’evoluzione degli approcci nella terapia sessuale fino alla diffusione del modello biopsicosociale (BPS) nel sistema sanitario. L’approccio integrato e la diretta conseguenza e implementazione del modello BPS in sessuologia clinica. A partire dall’esperienza dell’Istituto di Sessuologia Clinica (ISC) di Roma nella clinica e nei corsi di formazione, brevemente descritta, vengono evidenziati i limiti e le risorse dell’approccio integrato, che prende idealmente in considerazione e da la stessa importanza a corpo, mente, relazioni e contesto.