Journal of Psychosexual Health

There is no dearth of web-based scientific information on sexuality and related matters, and it is shared in private social groups. Yet there appears to be a resistance on the part of psychologists in India in exploring the sexual functioning of clients. This article explores the possible reasons for the neglect that prevails and the consequences. Since, psychologists who are qualified in helping avoid addressing the sexual concerns of the people, it leads to widespread “malpractice” by the quacks. Neglect in identifying the underlying sexual problems that are manifested as various somatoform disorders and other medically unexplainable symptoms leads to emotional distress of the clients and increases the health costs. Hesitation and the “taboo” of the psychologists hinder the therapeutic contact between the therapists and the clients and, hence, people do not disclose their sexual concerns and problems. Personal discomfort of psychology trainees due to “unfinished business,” inadequate input on the role of sexual functioning and the inadequate exposure to people with sexual concerns may have contributed to this impasse. Supervised training of upcoming psychologists would help improve the quality of sexual life of people of all ages and prevent children and adolescents from sexual abuse. The need for using the ancient Indian masterpiece of sexual science, Kama Sutra, in getting over the taboo is also recommended.

There is a substantial increase in the total geriatric population worldwide. This change in demography calls for a greater, deeper, and thorough understanding of elderly and age-related issues. Even though sexuality is a basic and vital driving force, human sexuality, especially elderly sexuality, is frequently misunderstood. Many myths and misconceptions regarding elderly sexuality exist which need attention. Contrary to the popular belief, studies reveal that sexual life continues to be an important aspect in later life and is often viewed by elderly as an expression of love, passion, affection, admiration, and loyalty. Various factors play a role in elderly sexuality including that of bio-psycho-social factors, changes in the body, presence of comorbid conditions along with sexual disorders. Sexual disorders, if present, should be treated and addressed adequately.

The inseparable relationship between mind and body, though known since ages, has been acknowledged in modern medicine only in recent times. There is abundant literature about the effects of various illnesses on different organ systems, but their effect on sexuality has not been emphasized. Research on sexuality has been fore fronted by the West and data, though available, cannot be extrapolated to the Asian population due to marked differences in physical and socio-cultural aspects. The authors have reviewed articles published in Clinical Key, PubMed and Scopus.

Changing times on a global scale have seen a paradigm shift in the perception of “idealness” of body shape and construct of beauty. This has far-reaching impacts on several spheres of life from psychological, physical, as well as sexual health. The influence of attitudes, beliefs, culture, art, geography, and technological advances has been explored with the premise of body image impacting sexual health and functioning. The role body image plays in sexual health has been studied widely from the Western perspective mostly in women, but studies in the Indian context are limited to weight, body mass index, eating disorders, body dysmorphic disorders, rather the relation between body image in sexuality or sexual functioning.

In child and adolescent psychiatric practice, it is important for a clinician to be aware of contexts in which children are brought with concerns related to sexual behaviors. Johnson described a continuum of natural and healthy behaviors to sexually aggressive behaviors. Sexual development begins in fetal life and continues through infancy, childhood, and adolescence along characteristic pathways. Typically, developing children exhibit a wide range of sexual behaviors. Children and adolescents may display increased or deviant sexual behavior as a result of certain stressors, traumatic experiences, or psychiatric illnesses. This has been emerging as an important clinical issue over the past few years. It is important to distinguish between normal behaviors and disordered behaviors before planning any intervention. This article summarizes the sexuality- and gender-related issues that are encountered in child and adolescent psychiatric practice.

Dhat syndrome is known as a culture-bound syndrome of South East Asia. Its manifestations mimic the phenomenology of neurotic spectrum disorders. Myths related to semen loss are the core belief around which anxiety, depressive as well as somatic symptoms develop. Often the patients respond to psychoeducation focusing on resolving the sexual myths and misconceptions. There is an ongoing controversy regarding the nosological status of Dhat syndrome. Extensive research on Dhat syndrome may provide an answer to this controversy through understanding about the entity. This review is a synthesis of literature on Dhat syndrome from its inception till date.

Domestic violence is always discussed in relation to women. Man is always considered as the perpetrator. However, because of the socioeconomic changes affecting the family structure in recent times, domestic violence is not limited to women only. Men also are abused verbally, physically, emotionally, psychologically, and sexually. Men do not report these abusive behaviors and are silent victims of the consequences. As the laws in our society favors women as victims of violence, these hapless men do not get justice for their pitiable condition in the family and society. This article attempts to explore the extent of this problem and highlights its causes and effects. There is a need for gender neutral laws for domestic violence. Domestic violence should be considered as spousal violence.

In recent years, with increasing awareness and reports of child sexual abuse, government and nongovernment agencies working in the areas of child and adolescent health, education, welfare, and protection are increasingly looking to implement initiatives on child safety and psychosocial health, both from preventive and curative perspectives. It is critical, however, to recognize that the child sexual abuse programming needs to take into consideration the age and the developmental stage of children. Childhood encompasses the period from 0 to 18 years; however, sexuality-related issues of adolescents are vastly different from younger children. While the adolescent sexual rights’ debates (for adolescents) to engage in physical intimacy and sexual behavior or not may continue, most childcare workers unanimously agree on adolescents’ need for sexuality awareness and education. Adolescent sexual issues range from sexual abuse to mutually consenting romantic and sexual relationships and engagement in sexually inappropriate behaviors with young children; for the last-mentioned point, adolescents also come into conflict with the law. This article discusses the need for public health and community-based approaches to address this range and complexity in adolescent sexuality, also sharing concrete field-based, pilot-tested methodologies and resources to work on this issue.

Background: Chronic alcohol dependence is known to cause psychosexual dysfunction, which leads to marked psychiatric morbidity. There is a dearth of studies from India in this area.

Aim: To estimate the frequency of psychosexual dysfunction in individuals with alcohol dependence and to explore the association between psychosexual dysfunction and various socio-demographic and alcohol-related variables.

Materials and Methods: This is a cross-sectional descriptive study conducted on 50 male patients in a tertiary care center. The evaluation was conducted using a specially designed intake pro forma and tools such as the severity of alcohol dependence questionnaire, checklist for sexual dysfunction and International Classification of Disease, Tenth Revision, and diagnostic criteria for research.

Results: Sexual dysfunction was present in 66% of alcohol-dependent individuals. The most common among them was found to be aversion to sex (32%) followed by erectile dysfunction (24%). In most of the cases, patients having erectile dysfunction were also found to have aversion to sex.

Conclusion: Sexual dysfunction is highly prevalent in male patients with alcohol dependence. The study highlights the detrimental effects of alcohol on sexual function apart from other etiological factors.

Aims: The study aimed to gather the perspectives of women with schizophrenia who had sexual dysfunction (SD) and to assess their perceptions related to discussions about sexual concerns with mental health professionals (MHP).

Settings: Female patients attending the outpatient department of a tertiary care university psychiatric hospital, who were diagnosed to have schizophrenia and in remission, were recruited and assessed for SD. Those who had SD and were willing to participate were interviewed for the qualitative study.

Methods and Materials: A guided interview format was used to gather their narratives. Interviews were transcribed and translated from audio recordings on the same day. The analysis of transcript from 9 patients reached theoretical saturation.

Analysis: The data were retrieved, coded, and systematically organized according to patterns and themes. The manual inductive coding method was used to arrive at the themes.

Results: 4 themes were found for the question assessing their perspective regarding SD and 3 themes on their perspectives regarding the discussion with MHP. Many of them had misconceptions regarding their sexual lives and the relationship between sexuality and their illness. It was evident that hardly any MHP had ever inquired about their sexual functioning.

Conclusion: This qualitative research on women with schizophrenia having SD gives us in-depth knowledge regarding their snags. Results of such studies will help the clinicians pay justifiable attention to these least spoken problems.

Objectives: Online activities have influenced the expression and indulgence in sexual behavior. Sexting has become one of the modality to express sexual behavior. The present study explored sexting in the Indian context as well as its relationship with self-esteem.

Methods: 300 young adults in the age group of 17 to 20 years were assessed for sexting behaviors.

Results: Studies showed that males engaged more in sexting and that there was absence of a significant difference in self-esteem and sexting.

Conclusions: It has implications for screening sexting behavior among youth as well as for enhancing cyberliteracy among youth for sexting behaviors.

Masturbation is a normal sexual behavior; however, masturbation in childhood is less commonly addressed in research. Here we report a case of childhood masturbation in Bangladesh. A six-year-old girl was presented at a private chamber of a psychiatrist with the complaints of episodic frictions of pubic area with edges of bed, furniture, and other approachable particles for last one and half years. The average duration of episodes was about 5 minutes. After taking detailed history, and performing physical and mental state examination, the girl was labeled as a case of childhood masturbation. Adequate psychoeducation was provided to the mother regarding the disorder as well as its management such as behavior therapy. She was also ensured repeatedly regarding the diagnosis as well as the management so that she can believe and maintain the behavior therapy. However, the mother was found challenging to accept the diagnosis as well as treatment without any medication. This article is expected to raise the issue among clinical practitioners other than psychiatrists who in turn would reduce the sufferings of the patients and anxiety of the caregivers.