European Psychiatry - Volume 33 - March 2016

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S740 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
EV1224
Radiotherapy and treatment of
cervical cancer – sexuality
implications
A. Fornelos∗, P. Macedo , S. Nunes , A. Figueiredo , M. Silva ,
M. Viseu
Centro Hospitalar Trás-os-Montes e Alto Douro, Psiquiatria e Saúde
Mental, Vila Real, Portugal
∗ Corresponding author.
Introduction Cancer of the uterine cervix represents 10%ofmalig-
nant tumors affecting women. Despite occupying fifth place in the
global mortality rate it is described with the highest healing poten-
tial. One of the most used treatments is radiotherapy, which has
a particularly significant impact on women’s quality of life, espe-
cially in their sexuality. Biological and psychic factors are suggested
as possible etiologies for sexual dysfunction situations. Changes in
body image may arouse feelings of shame and low self-esteem. In
what concerns biology, vaginal stenosis is referred as a cause of
vaginism and vaginal bleeding, with consequent decrease in libido
and pleasure.
Objective Describe the implications in the sexuality of women
with cancer of the uterine cervix after radiotherapy.
Methods A literature search using the PubMed and Scielo
databases of scientific articles published in the last 10 years.
Results In the literature, there are significant changes in sex-
ual behavior in women with cervical cancer in the period after
radiotherapy. A large percentage reveals sexual abstinence and
an equally significant part presents sexual dysfunction caused by
lack of lubrication, arousal and orgasm. Moreover, it is reported
decreased libido and sexual pleasure, vaginal bleeding and vagin-
ism. On the other hand, there is a small account of cases in which
it is mentioned increase libido and pleasure.
Conclusion Despite the high probability of healing this disease,
the patients’ quality of life after advanced stages of radiotherapy,
should be a source of concern, especially with regard to sexuality.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1225
Premature ejaculation – how to
treat?
A. Fornelos∗, P. Macedo , F. Veríssimo , M. Viseu
Centro Hospitalar Trás-os-Montes e Alto Douro, Psiquiatria e Saúde
Mental, Vila Real, Portugal
∗ Corresponding author.
Introduction Premature ejaculation (PE) corresponds to “a per-
sistent or recurring ejaculation pattern that occurs during sexual
activity with a partner approximately 1minute after vaginal pen-
etration and before the person wishes to”. It affects 5–20% of
men, having its origin in psychological factors and with impor-
tant biological contribution. It is considered generalised, when not
confined to certain patterns of stimulation, situations, or part-
ners, or may be situational. It may occur soon after the onset
of sexual activity (primary) or after a normal sexual functioning
(acquired). Primary EP is associated with the hyposensitivity 5-
HT2C receptors and/or hypersensitivity 5-HT1A receptors. High
performance anxiety levels are related to acquired EP. Increasing
this physiological knowledge has enabled significant advances in
treatment.
Objective Approach the therapeutic options of EP and its pecu-
liarities.
Methods Literature review of articles published in the last five
years, using the PubMed and Scielo databases.
Results At present, the approaches include psychosexual coun-
seling, behavioral and pharmacotherapy. Among the most
popular drugs, antidepressants stand out, particularly dapoxe-
tine, the first medication specifically approved. Local anesthetics,
phosphodiesterase-5 inhibitors and tramadol are also used.
Acupuncture is suggested as a useful therapeutic, but needs more
research.
Conclusion The behavioral therapies are referred to as first-line
treatment in the long-term, associated or not with medication.
Dapoxetine is the preferred symptomatic treatment. However, a
holistic approach, including psychotherapy and sex therapy, is the
most beneficial modality for sexual and marital relationship.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1226
Sexual function in schizophrenia
D. Lin
Napa, CA, USA
Objective This study surveys patients with schizophrenia or
schizoaffective disorder, to understand the relationship between
sexual function and treatment with antipsychotic medication. The
study compares patients on single versus multiple antipsychotics
as well differences between first and second-generation agents.
Design and methods Patients diagnosed with schizophrenia or
schizoaffective disorder are eligible. Once patients are evaluated to
ensure they meet enrollment criteria and are consented, they are
administered the Positive and Negative Syndrome Scale (PANSS),
Abnormal Involuntary Movement Scale (AIMS), and either the
International Index of Erectile Function for men, or the Female Sex-
ual Function Index for women. Inclusion criteria include age 18–65,
able to participate in a structured interview, fulfill DSM-IV criteria
for Schizophrenia or Schizoaffective disorder, and on stable doses of
one or more antipsychoticmedications for at least sixweeks. Exclu-
sion criteria include patients taking Selective Serotonin Reuptake
Inhibitors (SSRIs), and inability to provide informed consent.
Results Patients taking typical antipsychotic had marginally
worse score on sexual function scale. Patients taking multiple
antipsychotics scored better on the sexual function scales. Those on
prolactin-sparing agents tended to rate sexual function as higher.
Clozapine was associated with more sexual dysfunction compared
to other antipsychotics. No trend noticed between PANSS scores
and sexual dysfunction. No trend noticed related to AIMS scores.
Conclusions There is high prevalence of sexual dysfunction in
schizophrenic patients. Prolactin-sparing agents are associated
with less sexual dysfunction. There is an advantage to the use of
atypical antipsychotics.
Disclosure of interest The author has not supplied his declaration
of competing interest.
EV1227
Sex addiction: Myth or reality
D. Lin
Napa, CA, USA
Objective Since the concept of sexual addiction was first intro-
duced in the 1970’s, two schools of thought have emerged amongst
sexologists and mental health providers regarding whether hyper-
sexual behavior should be characterized as an addiction, or if it is
part of a co-existing psychiatric disorder. The objective of this study
is to help clarify this debate.
Method A literature review was conducted to explore these
opposing viewpoints. Articles published from the year 2000 to
present relating to the topic of sex addiction, hypersexuality, sexual
compulsivity/impulsivity were reviewed to determine whether or
not hypersexual behavior can be characterized as an addiction or if
it can only co-exist with a current psychiatric disorder.