Advertisement

Mental Health and Sexual Medicine: An Update

  • Kevan R. Wylie
  • T. S. Sathyanarayana Rao
  • Abhinav Tandon
  • Shivanand Manohar
  • António Pacheco Palha
  • F. Navarro-Cremades
  • R. Hernández-Serrano
  • F. Bianco Colmenares
  • A. L. Montejo
Chapter

Abstract

In this chapter of the WPA Section on Psychiatry and Human Sexuality are presented two interesting articles on sexual dysfunctions, a crucial clinical concern in Sexology – one deals with female sexuality and its dimensions and the other on the adequate and efficient treatments offered in these days. One other concerns the important matter of sexual violence.

Kevan Wylie, sexologist and president of the World Association for Sexual Health presents a very actual reflection on female sexuality on different dimensions, namely women, sexual well-being, mental health, religion and sex and sexual diversity.

A revision on the treatment of sexual dysfunction is done by T. S. Rao and et al. Navarro Cremades et al. the authors of the last article present an overview of the dramatic problem of sexuality violence against women starting in the definition and in sexual rights. This theme of sexual violence and PTSD is another dimension considered in what concerns to prevalence, genetic and epigenetic classifications and sexuality. The last point treated in this paper is the dimension of public health, prevention and public policies.

The authors intended to follow a clinical orientation since the important issue of sexual history and how to do it in different treatments that can be prescribed, psychological and biological treatments.

The human sexuality section believes in the importance of sexuality dimension in Psychiatry and Mental Health.

António Palha

Chair of the P.H.S. Section of WPA

References

  1. 1.
    Mitchell KR, Mercer CH, Ploubidis GB, Jones KG, Datta J, Field N, Copas AJ, Tanton C, Erens B, Sonnenberg P, Clifton S, Macdowall W, Phelps A, Johnson AM, Wellings K. Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet. 2013;382(9907):1817–29.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    World Association for sexual Health. Declaration of sexual rights. www.worldsexology.org/wp-content/uploads/2013/08/Declaration-of-Sexual-Rights-2014-plain-text.pdf. Accessed 19 Jan 2017.
  3. 3.
    Basson R. The female sexual response: a different model. J Sex Marital Ther. 2000;26:51–65.CrossRefPubMedGoogle Scholar
  4. 4.
    Wylie K, Silvain M. Sexual response models in women. Maturitas. 2009;63:112–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Parish SJ, Hahn SR. Hypoactive sexual desire disorder: a review of epidemiology, biopsychology, diagnosis and treatment. Sex Med Rev. 2016;4:103–20.CrossRefPubMedGoogle Scholar
  6. 6.
    Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, Graham C, Nobre P, Wylie K. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2016;13:538–71.CrossRefPubMedGoogle Scholar
  7. 7.
    Worsley R, Santoro N, Miller KK, Parish SJ, Davis SR. Hormones and female sexual dysfunction: beyond estrogens and androgens-findings from the fourth international consultation on sexual medicine. J Sex Med. 2016;2016(13):283–90.CrossRefGoogle Scholar
  8. 8.
    Sungur MZ, Bez Y. Cultural factors in the treatment of sexual dysfunction in Muslim clients. Curr Sex Health Rep. 2016;8:57–63.CrossRefGoogle Scholar
  9. 9.
    Pandor A, Kaltenthaler E, Higgins A, Lorimer K, Smith S, Wylie K, Wong R. Sexual health risk reduction interventions for people with severe mental illness: a systematic review. BMC Public Health. 2015;15:138.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Varney J. Rainbow medicine – supporting the needs of lesbian, gay, bisexual and trans patients. Clin Med. 2016;16:405–6.CrossRefGoogle Scholar
  11. 11.
    Wylie K, Knudson G, Khan SI, Bonierbale M, Watanyusakul S, Baral S. Serving transgender people: clinical care considerations and service delivery models in transgender health. Lancet. 2016;388(10042):401–11.CrossRefPubMedGoogle Scholar
  12. 12.
    McManus MA, Hargreaves P, Rainbow L, Alison LJ. Paraphilias: definition, diagnosis and treatment. F1000prime Rep. 2013;5:36.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Masters WH, Johnson V. Human sexual response. Boston: Little Brown & Co; 1966.Google Scholar
  14. 14.
    Bhavsar V, Bhugra D. Cultural factors and sexual dysfunction in clinical practice. Adv Psychiatr Treat. 2013;19:144–52.CrossRefGoogle Scholar
  15. 15.
    Hengeveld MW. Erectile disorder: a psychosexological review. In: Jonas U, Thon WF, Stief CG, editors. Erectile dysfunction. Berlin: Springer; 1991. p. 14–22.Google Scholar
  16. 16.
    Tomlinson J. ABC of sexual health: taking a sexual history. BMJ. 1998;317(7172):1573–6.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Sadock VA. Normal human sexuality and sexual and gender identity disorders. In: Sadock BJ, Sadock VA, Ruiz P, editors. Kaplan and Sadock’s comprehensive textbook of psychiatry, vol. 1(Ch.18). 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2009. p. 2027–41.Google Scholar
  18. 18.
    Avasthi A, Rao TSS, Grover S, Biswas P, Kumar S. Clinical practice guidelines for management of sexual dysfunctions. In: Gautham S, Avasthi A, editors. Clinical practice guidelines for management of substance abuse disorders, sexual dysfunctions and sleep disorders. Gurgaon: Indian Psychiatric Society; 2006. p. 144–32.Google Scholar
  19. 19.
    Butcher J. ABC of sexual health female sexual problems I: loss of desire—what about the fun? BMJ. 1999;318:41–3.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Lue TF, Giuliano F, Montorsi F, Rosen RC, Andersson KE, Althof S, Christ G, Hatzichristou D, Hirsch M, Kimoto Y, Lewis R, McKenna K, MacMahon C, Morales A, Mulcahy J, Padma-Nathan H, Pryor J, Tejada IS, Shabsigh R, Wagner G. Summary of the recommendations on sexual dysfunctions in men. J Sex Med. 2004;1:1–23.Google Scholar
  21. 21.
    Basson R, Althof S, Davis S, Fugl-Meyer K, Goldstein I, Leiblum S, Meston C, Rosen R, Wagner G. Summary of the recommendations on sexual dysfunctions in women. J Sex Med. 2004;1:24–34.CrossRefGoogle Scholar
  22. 22.
    Gregoire A. ABC of sexual health: assessing and managing male sexual problems. BMJ. 1999;318:315–7.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Kandeel FR, Koussa VKT, Swerdloff RS. Male sexual function and its disorders: physiology, pathophysiology, clinical investigation, and treatment. Endocr Rev. 2001;22(3):342–88.CrossRefPubMedGoogle Scholar
  24. 24.
    Prakash O, Rao TSS. Sexuality research in India: an update. Indian J Psychiatry. 2010;52:S260–3.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Butcher J. ABC of sexual health female sexual problems II: sexual pain and sexualfears Josie Butcher. BMJ. 1999;318:110–2.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Hatzichristou D, Rosen RC, Broderick G, Clayton A, Cuzin B, Derogatis L, Litwin M, Meuleman E, O’Leary M, Quirk F, Sadovsky R, Seftel A. Clinical evaluation and management strategy for sexual dysfunction in men and women. J Sex Med. 2004;1:49–57.CrossRefPubMedGoogle Scholar
  27. 27.
    Hatzichristou DG, Hatzimouratidis K, Bekas M, Apostolidis A, Tzortzis V, Yannakoyorgos K. The diagnostic steps in the evaluation of patients with erectile dysfunction. J Urol. 2002;168:615–20.CrossRefPubMedGoogle Scholar
  28. 28.
    Anastasiadis AG, Salomon L, Ghafar MA, Burchardt M, Shabsigh R. Female sexual dysfunction: state of the art. Curr Urol Rep. 2002;3:484–91.CrossRefPubMedGoogle Scholar
  29. 29.
    Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol. 1994;151:54–61.CrossRefPubMedGoogle Scholar
  30. 30.
    Runciman A. Sexual therapy of masters and Johnson. In: Herink R, Herink PR, editors. The psychotherapy guidebook e-book. USA: International Psychotherapy Institute; 2016.Google Scholar
  31. 31.
    American Urological Association. Erectile Dysfunction Clinical Guidelines Panel. Treatment of Organic Clinical Practice Guidelines. 1996.Google Scholar
  32. 32.
    Avasthi A, Banerjee ST. Guidebook on sex education marital and psychosexual clinic. Chandigarh: PGIMER; 2002.Google Scholar
  33. 33.
    Hawton K. Sexual dysfunctions. In: Hawton K, Salkovskis PM, Kirk J, Clerk DM, editors. Cognitive behaviour therapy for psychiatric problems. A practical guide. New York: Oxford University Press; 1989.Google Scholar
  34. 34.
    Power PW. The psychological and social impact of illness and disability. New York: Springer; 2007. ISBN 9780826103093. Retrieved December 15, 2013Google Scholar
  35. 35.
    Annon J. Behavioral treatment of sexual problems, vol. 2. New York: Harper & Row; 1976.Google Scholar
  36. 36.
    Seidl A, Bullough B, Haughey B, Scherer Y, Rhodes M, Brown G. Understanding the effects of a myocardial infarction on sexual functioning: a basis for sexual counselling. Rehabil Nurs. 1991;16(5):255–64.CrossRefPubMedGoogle Scholar
  37. 37.
    Guiliano F, Jardin A, Gingell CJ. Sildenafil (VIAGRA), an oral treatment for erectile dysfunction: a 1-year, open label extension study. Br J Urol. 1997;80:93.Google Scholar
  38. 38.
    Melnik T, Soares BG, Nasselo AG. Psychosocial interventions for erectile dysfunction. Cochrane Database Syst Rev. 2007;3:CD004825.Google Scholar
  39. 39.
    Lue TF. Erectile dysfunction. N Engl J Med. 2000;342(24):1802–13. http://www.ncbi.nlm.nih.gov/pubmed/10853004 CrossRefPubMedGoogle Scholar
  40. 40.
    Moncada I, Jara J, Subira D, et al. Efficacy of sildenafil citrate at 12 hours after dosing: re-exploring the therapeutic window. Eur Urol. 2004;46(3):357–60. discussion 360-1. http://www.ncbi.nlm.nih.gov/pubmed/15306108 CrossRefPubMedGoogle Scholar
  41. 41.
    Hatzimouratidis K, Eardley I, Giuliano F, Hatzichristou D, Moncada I, Salonia A, Vardi Y, Wespes E. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. 2014;57(5):804–14.CrossRefGoogle Scholar
  42. 42.
    Porst H, Padma-Nathan H, Giuliano F, et al. Efficacy of tadalafil for the treatment of erectile dysfunction at 24 and 36 hours after dosing: a randomized controlled trial. Urology. 2003;62(1):121–5. discussion 125-6CrossRefPubMedGoogle Scholar
  43. 43.
    Rosano GM, Aversa A, Vitale C, et al. Chronic treatment with tadalafil improves endothelial function in men with increased cardiovascular risk. Eur Urol. 2005;47(2):214–20. http://www.ncbi.nlm.nih.gov/pubmed/15661417 CrossRefPubMedGoogle Scholar
  44. 44.
    Aversa A, Greco E, Bruzziches R, et al. Relationship between chronic tadalafil administration and improvement of endothelial function in men with erectile dysfunction: a pilot study. Int J Impot Res. 2007;19(2):200–7. http://www.ncbi.nlm.nih.gov/ CrossRefPubMedGoogle Scholar
  45. 45.
    Dula E, Keating W, Siami RF, Edmonds A, O’Neil J, Buttler S. Efficacy and safety of fixed-dose and dose optimization regimens of sublingual Apomorphine versus placebo in men with erectile dysfunction. The Apomorphine Study Group. Urology. 2000;56:130–5.CrossRefPubMedGoogle Scholar
  46. 46.
    Van Ahlen H, Piechota HJ, Kias HJ, Brennemann W, Klingmuller D. Opiate antagonists in erectile dysfunction: a possible new treatment option? Results of a pilot study with naltrexone. Eur Urol. 1995;28:246–50.CrossRefPubMedGoogle Scholar
  47. 47.
    Linet OI, Ogrinc FG. Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. The Alprostadil Study Group. N Engl J Med. 1996;334:873–7.CrossRefPubMedGoogle Scholar
  48. 48.
    World Health Organization. ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: World Health Organization; 1993.Google Scholar
  49. 49.
    Derby CA, Mohr BA, Goldstein I, et al. Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology. 2000;56(2):302–6. http://www.ncbi.nlm.nih.gov/pubmed/10925098 CrossRefPubMedGoogle Scholar
  50. 50.
    World Health Organization. World report on violence and health. 2002. Available at: http://www.who.int/violence_injury_prevention/violence/world_report/en/. Accessed 2 Jan 2017.
  51. 51.
    Council of Europe Istanbul Convention. Available at: http://www.coe.int/en/web/istanbul-convention/. Accessed 3 Jan 2017.
  52. 52.
    Navarro Cremades F, Hernández Serrano R, Navarro Sánchez F. Sexología médica y derecho. Derechos sexuales y reproductivos y conexos (Medical and sexology and law. Sexual and reproductive rights; and related ones). In: Bianco F, editor. Avances en Sexología Médica (Advances in medical sexology, being translated to English). Madrid: Síntesis; 2015. p. 549–72. (ISBN 978-84-9077-215-7).Google Scholar
  53. 53.
    United Nations. The universal declaration of human rights. Available at: http://www.un.org/en/universal-declaration-human-rights/. Accessed 03 Jan 2017.
  54. 54.
    European Union (EU) Charter for Fundamental Rights. Available at: http://ec.europa.eu/justice/fundamental-rights/charter/index_en.htm. Accessed 03 Jan 2017.
  55. 55.
    World Health Organization. Available at: http://www.who.int/reproductivehealth/topics/gender_rights/sexual_health/en/. Accessed 4 Jan 2017.
  56. 56.
  57. 57.
    IPPF & WAS. Guidance document for the implementation of young people’s sexual rights. 2016. Available at: http://www.worldsexology.org/wp-content/uploads/2016/09/Fulfil-Guidance-document-for-the-implementation-of-young-people27s-sexual-rights-IPPF-WAS.pdf, Accessed 5 Jan 2017.
  58. 58.
    European Union (EU) Directive 2012/29/EU. Available at: http://data.europa.eu/eli/dir/2012/29/oj. Accessed 03 Jan 2017.
  59. 59.
  60. 60.
    World Health Organization. Prevention of child maltreatment. Available at: http://www.who.int/violence_injury_prevention/violence/activities/child_maltreatment/en/. Accessed 3 Jan 2017.
  61. 61.
    Yoona SA, Weiericha MR. Salivary biomarkers of neural hypervigilance in trauma-exposed women. Psychoneuroendocrinology. 2016;63:17–25.CrossRefGoogle Scholar
  62. 62.
    Unternaehrer E, Meinlschmidt G. Psychosocial stress and DNA methylation. In: Spengler D, Binder E, editors. Epigenetics and neuroendocrinology. Clinical focus on psychiatry, vol. 2. Switzerland: Springer; 2016.Google Scholar
  63. 63.
    Violence against women: an EU-wide survey Main results. Available at: http://fra.europa.eu/sites/default/files/fra-2014-vaw-survey-main-results-apr14_en.pdf. Accessed 7 Jan 2017.
  64. 64.
    Sexual violence in USA. MMWR/September 5, 2014/Vol. 63/No. 8:1–18. Available at: https://stacks.cdc.gov/view/cdc/24861. Accessed 5 Jan 2017.
  65. 65.
    McLaughlin KA, Koenen KC, Hill E, Petukhova M, Sampson NA, Zaslavsky A, Kessler RC. Trauma exposure and posttraumatic stress disorder in a US national sample of adolescents. J Am Acad Child Adolesc Psychiatry. 2013;52:815–30.CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    McLaughlin KA, Lambert HK. Child trauma exposure and psychopathology: mechanisms of risk and resilience. Curr Opin Psychol. 2017;14:29–34.CrossRefPubMedPubMedCentralGoogle Scholar
  67. 67.
    Ryan J, Chaudieu I, Ancelin ML, Saffery R. Biological underpinnings of trauma and post-traumatic stress disorder: focusing on genetics and epigenetics. Epigenomics. 2016;8(11):1553–69.CrossRefPubMedGoogle Scholar
  68. 68.
    Gilbert SG. Ethical implications of epigenetics, epigenetics, the environment, and Children’s health across lifespans. In: Spengler D, Binder E, editors. Epigenetics and neuroendocrinology. clinical focus on psychiatry, vol. 1. Switzerland: Springer; 2016. p. 327–34.Google Scholar
  69. 69.
    Sheerin CM, Lind ML, Bountress KE, Nugent NR, Amstadter AB. The genetics and epigenetics of PTSD: overview, recent advances, and future directions. Curr Opin Psychol. 2017;14:5–11.CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Praharsoa NF, Morgan J, Teara MJ, Cruwysa T. Stressful life transitions and wellbeing: a comparison of the stress buffering. Psychiatry Res. 2017;247:265–75.CrossRefGoogle Scholar
  71. 71.
    Pineles SL, Kimberly A, Arditte Hall KAA, Rasmusson AM. Gender and PTSD: different pathways to a similar phenotype. Curr Opin Psychol. 2017;14:44–8.CrossRefPubMedGoogle Scholar
  72. 72.
    Taft CT, Creech SK, Murphy CM. Anger and aggression in PTSD. Curr Opin Psychol. 2017;14:67–71.CrossRefPubMedGoogle Scholar
  73. 73.
    Tiihonen Möller A, Bäckström T, Söndergaard HP, Helström L. Identifying risk factors for PTSD in women seeking medical help after rape. PLoS One. 2014;9(10):e111136.CrossRefPubMedPubMedCentralGoogle Scholar
  74. 74.
    Martinson A, Craner J, Sigmon S. Differences in HPA axis reactivity to intimacy in women with and without histories of sexual trauma. Psychoneuroendocrinology. 2016;65:118–26.CrossRefPubMedGoogle Scholar
  75. 75.
    Shors TJ, Tobόn K, DiFeo G, Durham DM, Chang HY. Sexual conspecific aggressive response (SCAR): a model of sexual trauma that disrupts maternal learning and plasticity in the female brain. Sci Rep. 2016;6:18960.  https://doi.org/10.1038/srep18960.CrossRefPubMedPubMedCentralGoogle Scholar
  76. 76.
    Welch J, Mason F. Rape and sexual assault. BMJ. 2007;334(7604):1154–8.CrossRefPubMedPubMedCentralGoogle Scholar
  77. 77.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.CrossRefGoogle Scholar
  78. 78.
    American Psychiatric Association. DSM-5 PTSD. Available at: https://www.psychiatry.org/psychiatrists/practice/dsm. Accessed 3 Jan 2017.
  79. 79.
    World Health Organization ICD-10. Available at: http://apps.who.int/classifications/icd10/browse/2016/en#/V. Accessed 3 Jan 2017.
  80. 80.
    Friedman MJ. Literature on DSM-5 and ICD-11. PTSD Res Q. 2014;25(2):1–6.Google Scholar
  81. 81.
    Keeley JW. Disorders specifically associated with stress: a case-controlled field study for ICD-11 mental and behavioural disorders. Int J Clin Health Psychol. 2016;16(2):109–27.  https://doi.org/10.1016/j.ijchp.2015.09.0021697-2600/ CrossRefGoogle Scholar
  82. 82.
    Bianco FJ, editor. Manual Diagnóstico en Sexología/diagnostic manual in sexology: MDS III. 3rd ed. Caracas: Ediciones CIPV; 2012. ISBN, 9801253118Google Scholar
  83. 83.
    Steven Betts K, Williams GM, Najman JM, Alati R. Exploring the female specific risk to partial and full PTSD following physical assault. J Trauma Stress. 2013;26(1):86–93.  https://doi.org/10.1002/jts.21776.CrossRefPubMedGoogle Scholar
  84. 84.
    McGuire J, Clark S. PTSD and the law: an update. PTSD Res Q. 2011;22(1):1–6. Available at: http://www.ptsd.va.gov/professional/newsletters/research-quarterly/v22n1.pdf. Accessed 7 Jan 2017.Google Scholar
  85. 85.
    Mangelsdorf J, Eid M. What makes a thriver? Unifying the concepts of posttraumatic and postecstatic growth. Front Psychol. 2015;6:813.  https://doi.org/10.3389/fpsyg.2015.00813 CrossRefPubMedPubMedCentralGoogle Scholar
  86. 86.
    DiGangi JA, Gomez D, Mendoza L, Jason LA, Keys CB, Koenen KC. Pretrauma risk factors for posttraumatic stress disorder: a systematic review of the literature. Clin Psychol Rev. 2013;33(6):728–44.CrossRefPubMedGoogle Scholar
  87. 87.
    Navarro-Cremades F, Hernández-Serrano R, Luri-Prieto P, Bianco-Colmenares F, Hurtado-Murillo F, Montejo-González AL. Sexual violence against women. Posttraumatic Stress Disorder (PTSD) and Posttraumatic Sexual Stress (PTSS, MDS III). (Spanish: Violencia sexual sobre la mujer. Trastorno de Estrés Postraumático (TEPT) y Estrés Postraumático Sexual (EPTS, MDS III). Propuesta). PRO. 2016;5(2):4–8. http://desexologia.com/. ISSN 2174-4068Google Scholar
  88. 88.
    World Health Organization. Available at: http://apps.who.int/iris/bitstream/10665/82753/1/WHO_NMH_VIP_PVL_13.1_eng.pdf?ua=1. Accessed 5 Jan 2017.
  89. 89.
    World Health Organization/London School of Hygiene and Tropical Medicine. Preventing intimate partner and sexual violence against women: taking action and generating evidence. Geneva: World Health Organization; 2010. Available at: http://www.who.int/violence_injury_prevention/publications/violence/9789241564007_eng.pdf. Accessed 7 Jan 2017.Google Scholar
  90. 90.
    Tabachnick J, McCartan K, Panaro R. Changing course: from a victim/offender duality to a public health perspective. In: Laws RD, O’Donohue W, editors. Treatment of sex offenders. Strengths and weaknesses in assessment and intervention. Switzerland: Springer; 2016. p. 323–42.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Kevan R. Wylie
    • 1
    • 2
    • 3
  • T. S. Sathyanarayana Rao
    • 4
  • Abhinav Tandon
    • 5
  • Shivanand Manohar
    • 4
  • António Pacheco Palha
    • 6
    • 7
  • F. Navarro-Cremades
    • 6
    • 8
  • R. Hernández-Serrano
    • 6
    • 8
  • F. Bianco Colmenares
    • 6
    • 8
  • A. L. Montejo
    • 9
    • 8
  1. 1.Department of NeurosciencesUniversity of SheffieldSheffieldUK
  2. 2.European Federation of SexologyRomeItaly
  3. 3.World Association for Sexual HealthRomeItaly
  4. 4.Department of PsychiatryJSS Medical College and Hospital, JSS UniversityMysoreIndia
  5. 5.Indian Journal of PsychiatryDr AK Tandon Neuropsychiatric CentreAllahabadIndia
  6. 6.Psychiatry of Faculty of MedicinePorto University (FMUP)PortoPortugal
  7. 7.International Academy of Medical Sexology (IASM)MedellinColombia
  8. 8.Miguel Hernandez University (UMH)ElcheSpain
  9. 9.University of Salamanca (USAL)SalamancaSpain

Personalised recommendations