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Maguire E, Mulryan N, Sheerin F, McCallion P, McCarron M. Autism spectrum disorder in older adults with intellectual disability: a scoping review. Ir J Psychol Med 2021;:1-14. [PMID: 34612183 DOI: 10.1017/ipm.2021.65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Ireland has an ageing population of persons with intellectual disability (ID), autism spectrum disorder (ASD) and both (ID/ASD). Despite this, little is known about the prevalence of ASD and its effect on functional outcomes, psychiatric comorbidity or diagnostic issues in an older population with ID. This article reviews the literature on older adults with ID/ASD and identifies opportunities for future research in this population. METHOD The authors searched the Medline, Pubmed, Embase, CINAHL and PsychInfo databases using the search terms using key words: (older adults) AND (ID OR mental retardation OR learning disability) AND (autism OR ASD). After excluding articles for relevance, a scoping review was carried out on the results retrieved. RESULTS Of the 1227 articles retrieved from the literature on ID and autism/ASD in older adults, 85 articles were relevant to an adult population with ID/ASD. The data were collated and are presented covering domains of diagnosis, prevalence, psychiatric comorbidities and functional outcomes. CONCLUSIONS Despite increased prevalence in childhood ASD in the last 20 years, there is a lack of research regarding adults, especially older adults, with ASD, up to half of whom will have some level of ID. The existing literature suggests that older adults with ID/ASD may have reduced functional independence, increased psychiatric comorbidity and psychotropic prescribing and more behavioural presentations than the older population generally or those with ID only. There is a need for longitudinal data to be collected on this ageing population so that care and management needs can be met in the future.
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Hussain R, Wark S, Janicki MP, Parmenter T, Knox M, Tabatabaei-Jafari H. Mental health of older people with mild and moderate intellectual disability in Australia. J Intellect Disabil Res 2021; 65:535-547. [PMID: 33786909 DOI: 10.1111/jir.12825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/30/2020] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The progressive increase in life expectancy of people with intellectual disability (ID) has resulted in enhanced survival into old age and has also seen a growth in research on both lifelong and emerging ageing-related health issues. Health issues amongst provider-supported adults have been previously studied, but these studies have not always included older community-dwelling adults with ID. METHODS A study examining the extent of mental health of 391 community-dwelling adults with ID age 60 and older in both metropolitan and rural areas of two East Coast Australian states was undertaken using a cross-sectional survey. Examined were a range of demographic (age, sex, living arrangements, employment and socio-economic status) and life (co-morbidities, adverse life events and social support) factors. Data were parsed by two age groupings (60-65: n = 234 and >65: n = 157). RESULTS Findings revealed that older community-dwelling adults with ID have many of the same mental health disorders as do other ageing people, with the exception of significant psychiatric disorders often associated with older age. Over a third (35%: n = 137) reported some one or more mental health disorders. Age, sex, location (rural or urban), financial hardship, social support or type of living arrangement were not statistically significant as risk factors for poor mental health. However, employment status was a clear predictor. Stepwise regression models showed a strong association between mental ill-health and adverse life events and between mental ill-health and multiple physical co-morbidities. CONCLUSIONS The cross-sectional nature of the study limits causal inference. The cumulative effect of chronic health conditions and adverse life events cannot be prevented retrospectively. However, greater awareness amongst both health professionals and care staff that older adults with ID have a high likelihood of significant and/or repeated traumas and need better health care to limit physical co-morbidity may assist in providing support that is better tailored to individual needs in older age to reduce the burden of mental ill-health.
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Affiliation(s)
- R Hussain
- ANU Medical School, Australian National University, Australia
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - S Wark
- School of Rural Medicine, University of New England, Armidale, NSW, Australia
| | - M P Janicki
- Disability and Human Development, University of Illinois, Chicago, IL, USA
| | - T Parmenter
- Center for Disability Studies, Sydney Medical School, University of Sydney, NSW, Australia
| | - M Knox
- Center for Disability Studies, Sydney Medical School, University of Sydney, NSW, Australia
| | - H Tabatabaei-Jafari
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, ACT, Australia
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Robertson J, Raghavan R, Emerson E, Baines S, Hatton C. What do we know about the health and health care of people with intellectual disabilities from minority ethnic groups in the United Kingdom? A systematic review. J Appl Res Intellect Disabil 2019; 32:1310-1334. [DOI: 10.1111/jar.12630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 04/23/2019] [Accepted: 05/15/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Janet Robertson
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine Lancaster University Lancaster UK
| | - Raghu Raghavan
- Faculty of Health and Life Sciences, Mary Seacole Research Centre De Montfort University Leicester UK
| | - Eric Emerson
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine Lancaster University Lancaster UK
- Centre for Disability Research and Policy University of Sydney Sydney New South Wales Australia
| | - Susannah Baines
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine Lancaster University Lancaster UK
| | - Chris Hatton
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine Lancaster University Lancaster UK
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Lim E, Gandhi K, Siriwardhana C, Davis J, Chen JJ. Racial and ethnic differences in mental health service utilization among the Hawaii medicaid population. J Ment Health 2018; 28:536-545. [PMID: 30417731 DOI: 10.1080/09638237.2018.1521917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Racial/ethnic differences have not been adequately addressed in the utilization of mental health services among Medicaid populations. Aim: This study aimed to examine racial/ethnic differences in the utilization of health services for mental disorders in a Medicaid adult population aged between 21 and 64 years. Methods: Racial/ethnic differences in inpatient, outpatient and emergency department services utilization were assessed using 2010 Hawaii Medicaid data. Zero-inflated negative binomial regressions were employed adjusting for age, sex and residential area. Results: Among 73,200 beneficiaries, 29.7% were Whites, 28.5% Asians, 34.7% Native Hawaiians and Pacific Islanders (NHPIs); 60.2% were younger (21-44 years) and 58.6% were females. The patterns of utilization of health services differed across race/ethnicity. Compared to Whites, Asians and NHPIs were less likely to use outpatient services and had lower rates of inpatient visits. NHPIs were also estimated to have lower rates of outpatient and emergency department visits. Conclusion: Variation in the utilization of health services emphasizes the importance of race/ethnicity in mental health management. Various factors, such as language barriers and cultural differences, should be considered in developing clinical interventions or integrative health programs that aim to reduce racial/ethnic disparities among people with mental disorders.
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Affiliation(s)
- Eunjung Lim
- Department of Complementary and Integrative Medicine, John A. Burns School of Medicine, University of Hawaii , Honolulu , HI , USA
| | - Krupa Gandhi
- Department of Complementary and Integrative Medicine, John A. Burns School of Medicine, University of Hawaii , Honolulu , HI , USA
| | - Chathura Siriwardhana
- Department of Complementary and Integrative Medicine, John A. Burns School of Medicine, University of Hawaii , Honolulu , HI , USA
| | - James Davis
- Department of Complementary and Integrative Medicine, John A. Burns School of Medicine, University of Hawaii , Honolulu , HI , USA
| | - John J Chen
- Department of Complementary and Integrative Medicine, John A. Burns School of Medicine, University of Hawaii , Honolulu , HI , USA
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Friedman DJ, Parrish RG, Fox MH. A Review of Global Literature on Using Administrative Data to Estimate Prevalence of Intellectual and Developmental Disabilities. J Policy Pract Intellect Disabil 2018; 15:43-62. [PMID: 29681966 DOI: 10.1111/jppi.12220] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
As understanding of health deficits among people with intellectual and developmental disabilities (IDD) increases, concerns grow about how to develop comprehensive, sustainable surveillance systems to reliably monitor the health of this population over time. This study reviews literature from 12 countries in which retrospective administrative data have been used to estimate population-based prevalence of IDD, identifies promising practices in that literature, and discusses the feasibility of applying those promising practices to other countries. Administrative data sources can be used to identify the number of people with IDD (numerators) in the presence of population estimates from which people with IDD are drawn (denominators) for discrete geographic locations. Case ascertainment methods, age groupings, data years captured, and other methods vary, contributing to a wide variation in prevalence rates. Six methods are identified from five countries that appear to offer the greatest likelihood of expanded applications. Approaches in which administrative data collections are linked with other population-based data sources appear promising as a means of estimating the size and characteristics of populations living with IDD in defined geographic locations. They offer the potential for sustainability, timeliness, accuracy, and efficiency.
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Affiliation(s)
| | - R Gibson Parrish
- Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michael H Fox
- Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Antezana L, Scarpa A, Valdespino A, Albright J, Richey JA. Rural Trends in Diagnosis and Services for Autism Spectrum Disorder. Front Psychol 2017; 8:590. [PMID: 28473784 PMCID: PMC5397491 DOI: 10.3389/fpsyg.2017.00590] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 03/30/2017] [Indexed: 12/24/2022] Open
Abstract
Rural communities face significant challenges regarding the adequate availability of diagnostic-, treatment-, and support-services for individuals with autism spectrum disorder (ASD). Specifically, a variety of factors, including geographic distance between families and service providers, low reliance on health care professionals, and cultural characteristics, contribute to the diminished availability and utilization of services. Together, these factors lead to risks for delayed ASD screening and diagnosis, yielding lower educational and functional outcomes. The purpose of this review is to outline the specific diagnosis and treatment barriers that affect individuals with ASD and their families in rural settings. Telehealth feasibility and efficacy research is also reviewed, suggesting that telecommunication services may offer an inroad for addressing the specific service barriers faced by rural communities. Together, the current review identifies specific needs for both research and support services that address the specific access barriers characteristic of rural settings.
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Affiliation(s)
- Ligia Antezana
- Department of Psychology, Virginia Tech, BlacksburgVA, USA.,Virginia Tech Center for Autism Research, BlacksburgVA, USA
| | - Angela Scarpa
- Department of Psychology, Virginia Tech, BlacksburgVA, USA.,Virginia Tech Center for Autism Research, BlacksburgVA, USA
| | | | - Jordan Albright
- Department of Psychology, Virginia Tech, BlacksburgVA, USA.,Virginia Tech Center for Autism Research, BlacksburgVA, USA
| | - John A Richey
- Department of Psychology, Virginia Tech, BlacksburgVA, USA.,Virginia Tech Center for Autism Research, BlacksburgVA, USA
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Laundy Frisenstam K, van den Bosch M, Chen Y, Friberg P, Osika W. Self-Reported Psychosomatic Complaints In Swedish Children, Adolescents, and Young Adults Living in Rural and Urban Areas: An Internet-Based Survey. JMIR Public Health Surveill 2017; 3:e9. [PMID: 28270381 PMCID: PMC5360894 DOI: 10.2196/publichealth.5902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 12/09/2016] [Accepted: 01/03/2017] [Indexed: 12/02/2022] Open
Abstract
Background Frequencies in reported psychosomatic illnesses have increased in Sweden among children, adolescents, and young adults. Little is known about demographic differences in self-reported psychosomatic complaints, such as between urban and rural areas, and whether surveys launched on the Internet could be a useful method in sampling such data. Objectives This study examines the connection between psychosomatic illnesses and demographics in Swedish children and youth. The feasibility of using the Internet to gather large amounts of data regarding psychosomatic complaints in this group is another major objective of this study. Methods A cross-sectional study using 7 validated questions about psychosomatic health, were launched in a controlled way onto a recognized Swedish Internet community site, which targeted users 10 to 24 years of age. The subjects were able to answer the items while they were logged in to their personal domain. The results were analyzed cross-geographically within Sweden. Results In total, we received 100,000 to 130,000 individual answers per question. Subjects of both sexes generally reported significantly higher levels of self-reported psychosomatic complaints in major city areas as compared with minor city/rural areas, even though the differences between the areas were small. For example, 12.00% (4472/37,265) of females in minor regions reported always feeling tense, compared with 13.80% (3156/22,873) of females in major regions (P<.001). In males, the answer pattern was similar, 16.40% (4887/29,801) in major regions versus 15.60% (2712/17,386) in minor regions, (P=.006). Females reported significantly higher frequencies of psychosomatic complaints than males (P<.001). Conclusions In subjects aged 10 to 24 years, higher levels of psychosomatic complaints appear to correlate with living in major city areas in comparison with minor city/rural areas. Surveys launched on the Internet could be a useful method in sampling data regarding psychosomatic health for this age group.
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Affiliation(s)
- Katarina Laundy Frisenstam
- The Sahlgrenska Academy and University Hospital, Department of Molecular and Clinical Medicine/Clinical Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Matilda van den Bosch
- School of Population and Public health, The University of British Columbia, Vancouver, BC, Canada.,Department of Forest and Conservation Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Yun Chen
- The Sahlgrenska Academy and University Hospital, Department of Molecular and Clinical Medicine/Clinical Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Peter Friberg
- The Sahlgrenska Academy and University Hospital, Department of Molecular and Clinical Medicine/Clinical Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Walter Osika
- Center för Social Sustainability, Department for Neurobiology, Care Sciences and Society, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Ramsay H, Mulryan N, McCallion P, McCarron M. Geographical Barriers to Mental Health Service Care Among Individuals With an Intellectual Disability in the Republic of Ireland. Journal of Policy and Practice in Intellectual Disabilities 2016. [DOI: 10.1111/jppi.12182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Niamh Mulryan
- Daughters of Charity Service, Dublin, Ireland
- Trinity College Dublin, The University of Dublin; Dublin Ireland
| | - Philip McCallion
- Center for Excellence in Aging & Community Wellness, University at Albany; Albany New York
| | - Mary McCarron
- Trinity College Dublin, The University of Dublin; Dublin Ireland
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Flores-Pajot MC, Ofner M, Do MT, Lavigne E, Villeneuve PJ. Childhood autism spectrum disorders and exposure to nitrogen dioxide, and particulate matter air pollution: A review and meta-analysis. Environ Res 2016; 151:763-776. [PMID: 27609410 DOI: 10.1016/j.envres.2016.07.030] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 07/18/2016] [Accepted: 07/19/2016] [Indexed: 05/23/2023]
Abstract
BACKGROUND AND OBJECTIVE Genetic and environmental factors have been recognized to play an important role in autism. The possibility that exposure to outdoor air pollution increases the risk of autism spectrum disorder (ASD) has been an emerging area of research. Herein, we present a systematic review, and meta-analysis of published epidemiological studies that have investigated these associations. METHODS We undertook a comprehensive search strategy to identify studies that investigated outdoor air pollution and autism in children. Overall, seven cohorts and five case-control studies met our inclusion criteria for the meta-analysis. We summarized the associations between exposure to air pollution and ASD based on the following critical exposure windows: (i) first, second and third trimester of pregnancy, (ii) entire pregnancy, and (iii) postnatal period. Random effects meta-analysis modeling was undertaken to derive pooled risk estimates for these exposures across the studies. RESULTS The meta-estimates for the change in ASD associated with a 10μg/m3 increase in exposure in PM2.5 and 10 ppb increase in NO2 during pregnancy were 1.34 (95% CI:0.83, 2.17) and 1.05 (95% CI:0.99, 1.11), respectively. Stronger associations were observed for exposures received after birth, but these estimates were unstable as they were based on only two studies. O3 exposure was weakly associated with ASD during the third trimester of pregnancy and during the entire pregnancy, however, these estimates were also based on only two studies. CONCLUSION Our meta-analysis support the hypothesis that exposure to ambient air pollution is associated with an increased risk of autism. Our findings should be interpreted cautiously due to relatively small number of studies, and several studies were unable to control for other key risk factors.
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Affiliation(s)
- Marie-Claire Flores-Pajot
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada; Epistream Consulting Inc, Ottawa, Ontario, Canada
| | - Marianna Ofner
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Minh T Do
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Epistream Consulting Inc, Ottawa, Ontario, Canada.
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Limoncin E, Galli D, Ciocca G, Gravina GL, Carosa E, Mollaioli D, Lenzi A, Jannini EA. The psychosexual profile of sexual assistants: an internet-based explorative study. PLoS One 2014; 9:e98413. [PMID: 24919176 PMCID: PMC4053354 DOI: 10.1371/journal.pone.0098413] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 05/02/2014] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Sexual assistance may have some aspects that resemble prostitution and others that might lead one to think of sexual assistants as similar to a group of subjects whose sexual object is disability (devotees). In this study, we investigate whether a rigorous selection and training process on the part of specialised organisations may reduce the risk of training subjects with an atypical sexual interest and behaviours resembling prostitution. MATERIALS AND METHODS The study population consisted of 152 subjects defining themselves as sexual assistants. Subjects were initially contacted on websites specifically dedicated to sexual assistants and prostitutes. One hundred and twenty subjects were selected, by propensity score analysis, and studied by means of a modified version of a semi-structured questionnaire previously developed to investigate a population of subjects attracted by disability. RESULTS The study group was composed of 80 trained and 40 untrained sexual assistants, with mean ages of 41.5 (SD +/-12.58) and 44.5 (SD +/-11.62), respectively. A significant number of untrained subjects affirmed that their motivation in carrying out sexual assistance was of a remunerative nature, while this number was lower among the trained assistants (p = 0.001). Nearly all untrained subjects claimed to do one or more of the following activities during sexual assistance: sexual intercourse, oral sex, and masturbation. Among the trained subjects, however, only 47.5% claimed to do one or more of these activities, which means that there is a significant gap between trained and untrained assistants (p<0.0001). The existence of an atypical sexual interest was more evident between untrained rather than between trained subjects (p<0.0001). CONCLUSIONS Sexual assistance represents a way through which people affected by disabilities may attain the right to explore their sexuality in a safe setting. This can be guaranteed only if sexual assistants are trained and carefully selected by specialised organisations.
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Affiliation(s)
- Erika Limoncin
- Department of Clinical and Applied Sciences and Biotechnologies, School of Sexology, University of L’Aquila, L’Aquila, Italy
| | - Debora Galli
- Department of Clinical and Applied Sciences and Biotechnologies, School of Sexology, University of L’Aquila, L’Aquila, Italy
| | - Giacomo Ciocca
- Department of Clinical and Applied Sciences and Biotechnologies, School of Sexology, University of L’Aquila, L’Aquila, Italy
| | - Giovanni Luca Gravina
- Department of Clinical and Applied Sciences and Biotechnologies, School of Sexology, University of L’Aquila, L’Aquila, Italy
| | - Eleonora Carosa
- Department of Clinical and Applied Sciences and Biotechnologies, School of Sexology, University of L’Aquila, L’Aquila, Italy
| | - Daniele Mollaioli
- Department of Clinical and Applied Sciences and Biotechnologies, School of Sexology, University of L’Aquila, L’Aquila, Italy
| | - Andrea Lenzi
- Department of Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Emmanuele A. Jannini
- Department of Clinical and Applied Sciences and Biotechnologies, School of Sexology, University of L’Aquila, L’Aquila, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- * E-mail:
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