A critical reevaluation of nocturnal penile tumescence monitoring in the diagnosis of erectile dysfunction

Article Abstract:

Erectile dysfunction is usually diagnosed by nighttime penile erection measurements known as nocturnal penile tumescence (NPT) monitoring. Spontaneous erections are known to occur during sleep and this nocturnal erectile activity is evaluated by measuring the change in circumference of the penis. NPT monitoring is a popular method of assessment used in many sexual dysfunction clinics. This testing procedure is used to distinguish organic and psychological causes of penile dysfunction. However, many investigators have recently questioned the accuracy and validity of this technique. Monitoring penile erections must be done with an understanding of the difference between nocturnal and daytime erections. Patients usually spend three nights in a sleep laboratory located in a medical center. Alternate and less expensive methods of measuring penile tumescence have been developed, such as home monitoring. A complete review of NPT monitoring is described, including its development, methodology, and limitations. Even with the developments of NPT technology, a definitive diagnosis of erectile dysfunction requires thorough review of psychosexual history, medical history, physical examination, and hormonal, vascular, and neurological evaluations. A multifactor approach for assessing erectile dysfunction is recommended, and exclusive reliance upon NPT for evaluation should be avoided. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Impotence, Penis

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Personality and sexual functioning of transvestitic fetishists and other paraphilics

Article Abstract:

While transvestite behavior has been well-studied, the personality characteristics and sexual functioning of heterosexual men who dress as women have not received widespread attention. In the present study, 24 men with transvestitic fetishism were interviewed, and data from a personality inventory and a sexual functioning inventory were compared with data obtained from 26 men diagnosed with other sexual disorders, paraphilias. All subjects, regardless of their type of paraphilia, reported high levels of neuroticism (disorders characterized by anxiety and hostility) and low levels of agreeableness. Transvestites and other paraphilics were both observed to be hostile, and sometimes self-centered individuals, who can be interpersonally abrasive. TVs and OPs were also characterized by low need or low capacity for emotional intimacy. One of the few significant differences found between the groups was that TVs scored significantly higher than OPs on measures of role identity, indicating that TVs identify more with femininity. It was generally concluded that TVs and OPs are more similar than they are different. Due to their personality characteristics, their interpersonal problems may transcend their paraphilic behaviors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Personality, Personality (Psychology), Transvestism

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Psychiatric symptoms in mentally ill chemical abusers

Article Abstract:

A significant proportion of people with major psychiatric disorders are also substance abusers, but little is known about the psychiatric symptoms specific to these mentally ill chemical abusers (MICAs). To learn more concerning these patients, who suffer from multiple problems, a study was carried out of 32 outpatient MICAs and 31 outpatients with major psychiatric disorders but no history of substance abuse (a comparison group). All subjects underwent testing with the SCL-90-R, a 90-item self-report form designed to measure patterns of psychiatric symptoms. Results showed that MICA patients had higher scores, reflecting greater levels of distress, than controls on all test scales, including those measuring somatization (expressing psychiatric problems as physical problems), obsessive-compulsive tendencies, depression, anxiety, paranoid thinking, and psychosis. Substance abusers had both a greater number of symptoms, and more severe symptoms. Clinicians should be aware of the complex nature of the problems experienced by MICA patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Mentally ill persons, Mentally ill, Substance abuse, Drug addicts, Drug abusers, Drug use, Alcoholics, Substance abuse treatment

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