RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, …
SYNOPSIS
Rajiv Gandhi University of Health Sciences , Karnataka
Bengaluru
‘‘ SEXUAL DYSFUNCTION IN MALE PATIENTS WITH
ALCOHOL DEPENDENCE SYNDROME ’’
-A CLINICAL STUDY
Name of the candidate : Dr. PAVAN KUMAR KADIYALA
Guide : Dr. DENZIL A PINTO
Course and Subject : M.D. (PSYCHIATRY)
[pic]
Department of Psychiatry
Father Muller Medical College
Kankanady, Mangalore- 575002
AUGUST-2011
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE.
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
| | | |
|1 |Name of the Candidate |Dr. PAVAN KUMAR KADIYALA |
| |And address |DEPARTMENT OF PSYCHIATRY |
| |(In Block letters) |FATHER MULLER MEDICAL COLLEGE , KANKANADY, |
| | |MANGALORE -575 002 |
| | | |
|2. |Name of Institution |FR. MULLER MEDICAL COLLEGE |
| | |KANKANADY, |
| | |MANGALORE – 575 002 |
|3. |Course of study and Subject |M.D. PSYCHIATRY |
|4. |Date of admission to Course |31 MAY 2011 |
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|5. |TITLE OF THE TOPIC |
| |“ SEXUAL DYSFUNCTION IN MALE PATIENTS WITH ALCOHOL DEPENDENCE SYNDROME ” |
| |-A CLINICAL STUDY |
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|6 |BRIEF RESUME OF THE INTENDED WORK : |
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| |NEED FOR STUDY: |
| |Sexual function is the physiological capacity to experience desire, arousal, and orgasm. Alcohol may foster the |
| |initiation of sexual activity by removing inhibitions, but it impairs performance1. Sexual dysfunction in the |
| |alcoholic may be due to depressant effect of alcohol itself, alcohol related disease or due to a multitude of |
| |psychological forces related to the alcohol use2. Chronic and persistent alcohol use impairs erectile, orgasmic, and|
| |ejaculatory capacities, which leads to marked distress and interpersonal difficulty3. This, in turn, is known to |
| |worsen the alcohol abuse. A study by Benegal V and Arackal B S in |
| |NIMHANS found that 72% of alcohol dependent men had one or more sexual dysfunction, most common being premature |
| |ejaculation, low |
| |sexual desire and erectile dysfunction4. There are some studies that have looked into sexual dysfunction due to |
| |alcohol but there are only few studies reported from India. |
| | |
| |REVIEW OF LITERATURE : |
| |Alcohol is long regarded as a risk factor for sexual dysfunction5. |
| |Virtually all aspects of the human sexual response are affected by |
| |alcohol: Libido is reduced, performance is impeded, and dissatisfaction |
| |ensues. These effects can be seen by examination of the phases of |
| |excitement, plateau, orgasm, and resolution in the human sexual |
| |response6. The mechanism of association between alcohol and sexual |
| |dysfunction is thought to be due to hypogonadism characterized by loss |
| |of endocrine and reproductive function of gonads5 or central nervous |
| |system depressive action1 or due to reduction in penile blood flow 7. |
| |It was found that during heavy drinking, 84.4% of patients had |
| |experienced at least one kind of sexual dysfunction, |
| |59% patients experienced erectile dysfunction, 48% reported |
| |ejaculation incompetence8. |
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| |In a community epidemiological sample of over 3000 adults |
| |it was found that the most common sexual dysfunction associated |
| |with alcohol was anorgasmia5. A study in Nigeria found 10.3% of |
| |men with erectile dysfunction had alcohol abuse9. |
| |Sexual dysfunction in alcohol addicted males is related with |
| |age of subject ,education level, unemployment, age of onset of alcohol, |
| |quantity, frequency, onset of regular drinking and cigarette use 10. |
| |A study in Chinese men found that compared to never drinkers, |
| |those who consumed three or more standard drinks (one standard drink |
| |equals 12g of alcohol) a week were more likely to report |
| |erectile dysfunction11. Both moderate (4–6 drinks/day) or |
| |severe (>6 drinks/day) alcohol abuse was associated with low perceived |
| |partner's sexual desire and worse couple relationship7. |
| |Schiavi RC et al found that sexual dysfunction likely abate after |
| |prolonged periods of abstinence in the absence of substantial hepatic |
| |or gonadal failure12. |
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| |OBJECTIVES OF THE STUDY : |
| |To study the frequency of sexual dysfunction in male patients |
| |with alcohol dependence syndrome. |
| |To study the nature and severity of sexual dysfunctions in male |
| |patients with alcohol dependence syndrome. |
| |To study the relationship of sexual dysfunctions to |
| |socio- demographic and clinical variables. |
| | |
|7. |MATERIALS AND METHODS : |
| |Source of Data : |
| |The clinical study will be conducted in de-addiction centre of |
| |department of psychiatry in Father Muller Medical College, Kankanady, |
| |Mangalore. All patients admitted during the period between 2011 and 2014 |
| |with a clinical diagnosis of alcohol dependence syndrome will constitute the |
| |population for the study. Controls for the study would be non alcoholic |
| |volunteers who are relatives of the patients. |
| | |
| |7.2 Methods of Collection of data : |
| |CASES: |
| |Sample for study will consists of 100 consecutive in-patients |
| |admitted in the de-addiction centre with alcohol dependence syndrome |
| |who satisfy the inclusion and exclusion criteria. |
| | |
| |INCLUSION CRITERIA: |
| |In-patients with ICD-10 diagnosis of Alcohol Dependence Syndrome. |
| |Male patients |
| |Age: 25 - 60 years. |
| |Those who have given written informed consent. |
| | |
| |EXCLUSION CRITERIA: |
| |Female patients. |
| |Patients with prior sexual dysfunction. |
| |Patients with co-morbid physical disorder that can potentially cause |
| |sexual dysfunction. |
| |Patients with co-morbid psychiatric disorders that can potentially |
| |cause sexual dysfunction. |
| |Patients with other substance dependence other than nicotine. |
| |Patients on drugs affecting sexual functioning |
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| |CONTROLS: |
| |50 volunteers who are |
| |Male |
| |nonalcoholic relatives of patients with Alcohol Dependence Syndrome |
| |between age 25 to 60 years |
| |satisfying exclusion criteria as that of patients |
| |selected consecutively will constitute the control for the study. |
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| |TOOLS FOR ASSESSMENT: |
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| |ICD-10-AM Symptom Checklist for mental disorders. |
| |Sexual Dysfunction Checklist |
| |International Index of Erectile Function questionnaire (IIEF) |
| |Premature Ejaculation Diagnostic Tool (PEDT) |
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| |TYPE OF THE STUDY: |
| |Observational, analytical, case-control, cross sectional, clinical study |
| |Procedure: |
| |After explaining the purpose and design of the study, a written informed |
| |consent would be obtained for participation from all patients with Alcohol |
| |Dependence Syndrome and the controls recruited for the study. |
| |The socio-demographic and clinical variables will be recorded in a specific |
| |proforma prepared for the clinical study. |
| |All patients and the controls will be administered with |
| |ICD-10-AM Symptom Checklist for mental disorders screener. Those who |
| |require further examination will be administered the appropriate modules of |
| |same to establish Alcohol Dependence Syndrome in patients and to |
| |rule out other psychiatric disorders in patients and controls. |
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| |All the patients and controls will be asked for complete treatment history |
| |and will undergo a thorough clinical examination to rule medical disorders |
| |if any. Basic biochemical and clinical pathological laboratory investigations |
| |will be done. |
| |On the 3rd week of admission, all the patients of clinical sample and the |
| |subjects in control group will be screened using sexual dysfunction checklist to |
| |find out the presence and the type of sexual dysfunction. |
| |Those with sexual dysfunction will be further assessed with |
| |International Index of Erectile questionnaire (IIEF) and |
| |Premature Ejaculation Diagnostic Tool (PEDT) to establish and |
| |assess the severity of sexual dysfunctions . |
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| |STATISTICS: |
| |The results obtained will be analyzed using the following statistical methods. |
| |t- test |
| |Chi-square test |
| |Analysis of variance (ANOVA) |
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| |Does the study require any investigations or interventions to be conducted on patients or the humans or animals ? If |
| |so, please describe briefly. |
| |– NO – |
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| |Has ethical clearance been obtained from your institution in case of 7.3 |
| |- YES - |
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|8. |LIST OF REFERENCES: |
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| |Sadock VA. Normal human sexuality and sexual dysfunctions. In: Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th edn, |
| |(Ed) Sadock B J, Sadock VA, Ruiz P. Lippincott Williams & Wilkins: Philadelphia, PA; 2009, |
| |2027-2060. |
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| |Graham C A, Bancroft J. The sexual dysfunction. In: New Oxford Textbook of Psychiatry, 2nd edn, (Ed) Gelder M G, Andreasen C N, |
| |Lopez-Ibor J J, |
| |Geddes J R. Oxford University Press: Oxford, UK; 2009, 821-832. |
| | |
| |First M B, Tasman A. Substance-related disorders: Alcohol. In: Clinical Guide |
| |to the Diagnosis and Treatment of Mental Disorders,2nd ed. John Wiley & sons, Ltd: West Sussex, UK; 2010, 153-166. |
| | |
| |Benegal V, Arackal B S, Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian Journal of Psychiatry.|
| |2007; 49(2): 109–112. |
| | |
| |Tate S R, Drapkin M L, Brown S A. Substance Abuse Diagnosis, |
| |Comorbidity and Psychopathology. In: Oxford Textbook of Psychopathology, |
| |2nd edn, (Ed) Blaney P H, Millon T. Oxford University Press: |
| |Oxford, UK; 2009, 227-248. |
| | |
| |Miller, Norman S, Gold, Mark S. The human sexual response and alcohol |
| |and drugs. Journal of Substance Abuse Treatment. 1988; 5(3): 171-177. |
| | |
| |Boddi V, Corona G, Monami M, Fisher A D, Bandini E, Melani C, |
| |Balzi D, Sforza A, Patussi V, Forti G, Mannucci E and Maggi M. |
| |Priapus is Happier with Venus than with Bacchus. The Journal of |
| |Sexual Medicine. 2010, 7: 2831–2841. |
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| |Mandell W and Miller C M. Male Sexual Dysfunction as Related |
| |to Alcohol Consumption: A Pilot Study. Alcoholism: Clinical and |
| |Experimental Research. 1983, 7: 65–69. |
| | |
| |Okulate G, Olayinka O, Dogunro A S. Erectile dysfunction: prevalence and |
| |relationship to depression, alcohol abuse and panic disorder. General Hospital |
| |Psychiatry, 2003; 25: 209–213. |
| | |
| |Dissiz M and Oskay U Y. Evaluation of Sexual Functions in |
| |Turkish Alcohol-Dependent Males. The Journal of Sexual Medicine. |
| |2011, online version. |
| | |
| |Lee A C K, Ho L M, Yip A W C, Fan S and Lam T H. The effect of alcohol |
| |drinking on erectile dysfunction in Chinese men. International Journal of |
| |Impotence Research, 2010, 22: 272-278. |
| | |
| |Schiavi R C, Stimmel B B, Mandeli J, White D. Chronic alcoholism and |
| |male sexual function. American Journal of Psychiatry. 1995, 152: 1045-1051 |
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|9. |Signature of Candidate | |
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|10. |Remarks of Guide | |
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|11. |Name and Designation of |DR. DENZIL.A.PINTO |
| |(in Block letters) |PROFESSOR |
| | |DEPARTMENT OF PSYCHIATRY |
| |Guide |FATHER MULLER MEDICAL COLLEGE , MANGALORE - 575002 |
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| |Signature | |
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| |Co-Guide (if any ) | |
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| |Signature | |
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| |Head of Department |DR.P JOHN MATHAI |
| | |PROFESSOR & HOD |
| | |DEPARTMENT OF PSYCHIATRY |
| | |FATHER MULLER MEDICAL COLLEGE MANGALORE – 575002. |
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| |Signature | |
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|12 |12.1 REMARKS OF THE CHAIRMAN AND PRINCIPAL | |
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| |12.2 SIGNATURE | |
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