Psychosomatic Abnormalities And Sexual Dysfunction Ⅱ

3 Sexual function abnormalities and psychiatric disorders

According to some studies, about 90% of people with chronic psychiatric disorders have 90% of people with chronic psychiatric disorders have a combination of sexual dysfunction. Possible causative factors include barriers to achieving and maintaining intimate gender relationships, and The use of psychotropic drugs may also contribute to abnormal sexual function [17]. Related studies Studies have also confirmed the use of most psychotropic prescriptions (antidepressants and benzodiazepines). diazepines, etc.) are independent risk factors for sexual dysfunction [18]. The use of most psychotropic prescriptions (antidepressants and benzodiazepines, etc.) is an independent risk factor for sexual dysfunction [18]. In patients with bipolar disorder, there is often low sexual desire, impaired arousal, and difficulty reaching orgasm, and this group of patients in patients with bipolar disorder are more likely to engage in high-risk sexual behavior and to change sexual partners [18]. They are also more likely to change partners [2]. In general, these patients with psychopathological abnormalities are more likely to engage in high-risk sexual behaviors and to change partners [2]. In general, these patients with psychopathological abnormalities are likely to have abnormalities in all aspects of their sexual behavior. In general, these patients with psychosomatic abnormalities are more likely to have abnormalities in all aspects of sexual behavior and are more likely to have painful intercourse than the general population [2]. This makes their self-assessment through sexual life often a negative and psychological burden, thus affecting the progression of psychiatric abnormalities [19]. This may affect the progression of psychiatric disorders [19]. On the other hand, previous studies have confirmed that some patients discontinuation of psychotropic medications solely because of sexual dysfunction after their application [20]. This requires the clinician to be aware of the need for a more effective approach in dealing with similar cases. This requires the clinician, when dealing with similar cases, to during the history taking process to inquire about the patient's current and previous sexual function If the patient has no history of abnormal sexual function, it is strongly recommended to If the patient has no history of sexual abnormalities, it is strongly recommended to describe in detail the possible sexual abnormalities, i.e., the possible complications of drugs in the management of psychiatric abnormalities. In the process of psychological abnormalities, drug-related dysfunction may be complicated.

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4 Assessment of Sexual Dysfunction in Patients with Psychosomatic Abnormalities

Sexual dysfunction and psychosomatic health status are inextricably linked and influence each other. On the one hand, psychosomatic abnormalities can lead to sexual function abnormalities, and as mentioned above, drug-related sexual dysfunction may also occur during the treatment of psychiatric disorders. drug-related sexual dysfunction may also occur during psychiatric treatment. On the other hand, sexual dysfunction may affect the individual's mental health status, which may may affect an individual's mental health, making them more likely to develop abnormalities including vaginal cramps and genital-pelvic pain. This can lead to a variety of abnormalities, including vaginismus and genital-pelvic pain. Therefore, it is recommended that both male and female patients It is therefore recommended that both male and female patients be routinely evaluated for sexual functioning and that clinicians include detailed assessments of sexual functioning in their psychiatric consultations. It is also recommended that clinicians collect detailed information on past medications, lifestyle, and the presence of comorbid chronic diseases during the psychiatric consultation. It is also recommended that clinicians take a detailed history of past medications, lifestyle, and the presence of co-morbid chronic diseases during the psychiatric consultation.
It is important to note that in the management of psychiatric abnormalities, it is important to distinguish the severity of the illness. It is important to note that in the management of psychiatric abnormalities, differentiating the severity of the disease will facilitate the rational allocation of clinical resources. According to WILSON et al [21], if patients have insomnia, fatigue, irritability, or difficulty concentrating or difficulty concentrating suggests that the patient may require only a basic level of medical attention, as the patient may have difficulty concentrating.
medical attention at a basic level, as this group of patients is relatively unlikely to present with significant sexual function The likelihood of significant sexual function abnormalities in these patients is relatively low. In the case of more severe The more severe psychiatric abnormalities are usually accompanied by more pronounced sexual abnormalities. For example, patients with schizophrenia often exhibit emotional unresponsiveness and apathy, which can lead to erectile dysfunction in men. For example, schizophrenic patients often show emotional unresponsiveness and indifference, which leads to erectile and ejaculatory disorders in males [22] and decreased libido and sexual in men [22], and hypoactive sexual desire and orgasmic disorder in women [23]; patients with depression often present with Depressed patients often show a lack of sexual pleasure, and patients with panic disorder have relatively little active sexual contact [24].

5 Possible mechanisms by which antipsychotic drugs affect sexual function
Previous studies have been done on the mechanisms of the effects of antipsychotic drugs on sexual function, and the following possible mechanisms are currently being considered.

5.1 Dopamine system
The dopamine system plays an important role in the maintenance of sexual desire and the generation of sexual impulses, so any mechanism that affects the action of the dopamine system (receptor sensitivity modulation and dopamine sensitivity modulation) is likely to have an impact on sexual function.
（Therefore, any drug that affects the action of the dopamine system (receptor sensitivity regulation and dopamine transmitter release, etc.) can affect sexual function. Decreased dopamine release leads to decreased libido and poor erectile function in men, while increased serum prolactin levels due to dopamine blockade further inhibits testosterone synthesis and inhibits the positive feedback of estrogen to the hypothalamus, which not only affects ovulation, but can also lead to sexual dysfunction in women, mainly due to decreased libido, by inhibiting progesterone synthesis [7].

5.2 Antipsychotics
The sedative and activating effects of antipsychotics are often effective in the short term in response to acute psychiatric disorders, but there is still a risk of excessive sedation or activation during long-term use, which on the one hand can impair the quality of life of patients and may even cause serious adverse consequences, including an increased risk of suicide, and at the same time, the sedative effect is actually contradictory to the maintenance of sexual impulses and sexual arousal, so that patients who rely on antipsychotics to Patients who rely on antipsychotics for sedation may be at risk of reduced sexual desire.

5.3 5-Hydroxytryptamine
5-Hydroxytryptamine is an important signaling molecule that regulates peripheral vasoconstriction and diastole, as well as an important central
It is also an important central neurotransmitter, so any drug that alters peripheral 5-HT activity has the potential to affect sexual function [25].

5.4 Others
Antagonism of peripheral cholinergic receptors, α-adrenergic receptor blockade can cause orgasmic disorders in both male and female patients, as well as affects ejaculatory function in male patients [26]. In addition, the first generation of antipsychotics drugs are prone to excessive sedation, tachycardia, cardiovascular response, and upright hypotension due to the large number of targets. The risk of extrapyramidal reactions is relatively high. The risk of extrapyramidal reactions is relatively high, resulting in the inability of patients to successfully complete sexual activities [26].

6 Disposition of psychopathic abnormalities combined with abnormal sexual function
The clinical assessment and management of sexual function in patients with psychosomatic abnormalities should be in accordance with the following protocols: first, a detailed clinical data collection should be performed to understand the possible risk factors, including high-quality psychological scales and laboratory tests, as well as to understand the patient's current treatment, including medication prescriptions, dietary supplements, and lifestyle modification plans. The patient's current treatment, including medication prescriptions, dietary supplements, and lifestyle modification plans, should also be identified. Secondly, treatment modifications that may predispose to sexual dysfunction should be targeted, including changes in medication prescriptions or reductions in medication dosages. Finally, the patient's sexual function should be monitored before, during, and after treatment, and the common assessment tools include the International Index of Erectile Function, the Female Sexual Function Index, and the Quality of Sexual Life Scale [27].

In conclusion, physicians should be cautious about prescribing psychotropic medications until the patient's prevailing sexual function status is adequately clarified. It needs to be recognized that the disposition of abnormal sexual function in patients with psychosomatic abnormalities is not only about the regression of the patient's sexual function, but is also important for improving the patient's mental condition and maintaining the patient's physical and mental health. Data show that the sexual health level of psychopathic patients is significantly lower than that of the general population. The incidence of sexually transmitted diseases is higher [28], and the probability of unwanted pregnancy and sexual assault is higher. The probability of unwanted pregnancy and sexual assault is higher. This group of patients has a higher incidence of alcohol and substance abuse, as well as unprotected and high-risk sexual attempts. This group of patients has a higher likelihood of alcohol and drug abuse, and of trying unprotected, high-risk sexual behavior [29]. Therefore, it is important to increase The management of female patients is, to some extent, a matter of concern. The management of female patients is to some extent more specific. Compared to the current research on male sexual dysfunction, the current national The attention to female sexual dysfunction is relatively weak in China, and people tend to focus more on female sexual dysfunction. The focus of attention has often been more on the maintenance and improvement of female fertility. In the future, more research focusing on female psychosexual and physiological health is needed to scientifically guide clinical work.

In the future, more research on women's psychosexual and physiological health is needed to scientifically guide clinical work. In the process of history taking and disease management, attention should be paid In the process of history taking and disease management, attention should be paid to maintaining the privacy of female patients, and individualized In the process of history taking and disease management, attention should be paid to maintaining the privacy of female patients and developing individualized programs based on the mental health characteristics of women.