Successful use of transcranial magnetic stimulation in difficult to treat hypersexual disorder

Neuroelectric Correlates of Human Sexuality: A Review and Meta-Analysis

Many reviews on sexual arousal in humans focus on different brain imaging methods and behavioral observations. Although neurotransmission in the brain is mainly performed through electrochemical signals, there are no systematic reviews of the electrophysiological correlates of sexual arousal. We performed a systematic search on this subject and reviewed 255 studies including various electrophysiological methods. Our results show how neuroelectric signals have been used to investigate genital somatotopy as well as basic genital physiology during sexual arousal and how cortical electric signals have been recorded during orgasm. Moreover, experiments on the interactions of cognition and sexual arousal in healthy subjects and in individuals with abnormal sexual preferences were analyzed as well as case studies on sexual disturbances associated with diseases of the nervous system. In addition, 25 studies focusing on brain potentials during the interaction of cognition and sexual arousal were eligible for meta-analysis. The results showed significant effect sizes for specific brain potentials during sexual stimulation (P3: Cohen's d = 1.82, N = 300, LPP: Cohen's d = 2.30, N = 510) with high heterogeneity between the combined studies. Taken together, our review shows how neuroelectric methods can consistently differentiate sexual arousal from other emotional states.

Emerging experience with selected new categories in the ICD-11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder

Among the important changes in the ICD-11 is the addition of 21 new mental disorders. New categories are typically proposed to: a) improve the usefulness of morbidity statistics; b) facilitate recognition of a clinically important but poorly classified mental disorder in order to provide appropriate management; and c) stimulate research into more effective treatments. Given the major implications for the field and for World Health Organization (WHO) member states, it is important to examine the impact of these new categories during the early phase of the ICD-11 implementation. This paper focuses on four disorders: complex post-traumatic stress disorder, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. These categories were selected because they have been the focus of considerable activity and/or controversy and because their inclusion in the ICD-11 represents a different decision than was made for the DSM-5. The lead authors invited experts on each of these disorders to provide insight into why it was considered important to add it to the ICD-11, implications for care of not having that diagnostic category, important controversies about adding the disorder, and a review of the evidence generated and other developments related to the category since the WHO signaled its intention to include it in the ICD-11. Each of the four diagnostic categories appears to describe a population with clinically important and distinctive features that had previously gone unrecognized as well as specific treatment needs that would otherwise likely go unmet. The introduction of these categories in the ICD-11 has been followed by a substantial expansion of research in each area, which has generally supported their validity and utility, and by a significant increase in the availability of appropriate services.

Hypersexuality in a Bangladeshi Female: A Case Report

Hypersexuality has been a debated disorder, which has not been able to secure its place into the classificatory systems. This article was aimed to report a female with hypersexuality in Bangladesh. Mrs X, a 20-year-old married lady, presented with the complaints of irritability, low mood, sleep disturbances for last one month. As per Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria and mental state examination findings, she was labeled as a case of major depressive disorder and borderline personality disorder. Her early childhood was uneventful, and she got married 2 years back after having a love relationship with the person. Immediately after her marriage, she was used to enjoy sex for 5 to 6 hours daily as she used to enjoy 5 to 6 orgasms per day. The couple enjoyed their sex daily, even the in the days of menstruation. For last one year her husband stopped daily intercourses as well as the duration of the intercourses was also decreased below 1 hour. Subsequently, the lady felt disturbances and used to demand sex more time as well as orgasms daily. She used to consume pornography, masturbate, and started extramarital relationship for sexual activity. She enjoys her persistent thoughts, fantasies regarding sex; however, she became frustrated when she was not getting expected duration and expected number of orgasms. She asked her husband to divorce her as he was not being able to have intercourses for 5 to 6 hours daily. This is the first reported case of hypersexuality in a sexually conservative country like Bangladesh which may open the whole hidden problem.