Mental disorders associated with abnormal sexual function

Introduction to mental disorders associated with sexual dysfunction A mental disorder caused by abnormal gonad function refers to a disorder of gonad hormone imbalance due to physiological and pathological causes, and a mental disorder caused by abnormal gonad function. Generally refers to the female gonads in different periods, such as menstrual period, pregnancy, childbirth, postpartum and menopause, due to various mental disorders caused by endocrine changes (but also reports of male menopausal mental disorders). The difference between this disease and other endocrine diseases is that the clinical manifestations are mainly emotional changes, intentional disorders, instinct abnormalities (appetite, libido), etc., the general symptoms are mild, the prognosis is good, and there is no brain organic syndrome. basic knowledge The proportion of illness: the incidence rate is about 0.011% - 0.02% Susceptible people: women Mode of infection: non-infectious Complications: snoring, disturbance of consciousness

Causes of mental disorders associated with sexual dysfunction

(1) Causes of the disease

1. Premenstrual syndrome (PMS): may be related to premenstrual sex hormone disorder, mainly due to imbalance of estrogen and progesterone leading to central nervous system dysfunction and mental disorders.

2. Menstrual period mental disorder: The reason may be the increase in estrogen secretion during the first half of menstruation, the physical symptoms of physical symptoms, sexual impulses and emotional instability caused by decreased progesterone secretion.

3. Mental disorder during pregnancy: It is related to the endocrine pathophysiological changes of the pituitary gland and the adrenal hyperfunction, the increase of estrogen level, hypothyroidism and other factors during pregnancy. It is also related to the mental personality.

4. Postpartum mental disorder: It is generally believed that endocrine factors play a role. During pregnancy, thyroxine, corticosteroids, estrogen and progesterone are increased to varying degrees, and after delivery, due to the delivery of the placenta, chorionic hormone is rapidly reduced to cause progesterone secretion. Disorders and imbalances may be the main factors in the occurrence of this disease. It is also reported that the reduction of catecholamines during childbirth is related to postpartum depression. Pre-existing personality defects and childbirth itself can impair maternal resistance to negative life events and induce puerperal spirit. Barriers, postpartum hemorrhage and puerperal infection may also be contributing factors.

5. Menopausal Syndrome: Emotional disorders are often the result of interactions between biological and psychosocial factors.

6. Periodic Psychosis: As far as is unknown, most scholars believe that it is related to endocrine disorders.

(two) pathogenesis

1. Menstrual mental disorder: It is the simultaneous emotional disorder and behavioral change. The reason may be the increase of estrogen secretion in the first half of menstruation, the physical symptoms of progesterone secretion, sexual impulses and emotional instability. Performance, symptoms are most obvious in the menstrual period, disappear after menstruation, recurrence in the menstrual period in the next month, but there are also reports of impulsiveness in the menstrual period, increased after menstruation, until the mid-term.

2. Mental disorders during pregnancy:

(1) Endocrine changes: The thalamus-pituitary-gonadal endocrine system is in turbulent changes in the first 3 to 4 months of pregnancy. At this time, pregnant women are prone to emotional instability, irritability, anxiety, etc., and the endocrine system in the later pregnancy. At the same time, the mental activity is relatively stable. In the third trimester of pregnancy, the secretion system changes again, such as adrenal hyperfunction, increased estrogen secretion, hypoparathyroidism, and the aging of the placenta. Prone to mental disorders.

(2) Psychological and personality factors: life events, such as family, work and other unpleasant can induce the disease, pre-existing personality introversion, stubbornness, sensitivity, suspicious, fear, etc. are also related to the occurrence of this disease.

(3) People with a history of mental illness in the past or in the family, or those with gestational mental disorders in the family are prone to develop the disease. (Domestic Yuan reported that a group of four generations of grandparents and three women had mental disorders during pregnancy).

3. Menopausal Syndrome:

(1) Biological factors: hypogonadism, especially ovarian dysfunction, estrogen and (or) progesterone, follicle stimulating hormone and luteinizing hormone are elevated, causing imbalance of hypothalamic-pituitary-ovarian axis, causing endocrine Functional and metabolic disorders, autonomic dysfunction, etc. Many scholars prefer estrogen deficiency as the main cause of this disease. The reason is that 1 studies have shown that depression, anxiety and physical symptoms of menopause occur and severity Sex hormone levels are related; 2Keer et al believe that depression is a deficiency of estrogen, leading to a decrease in free tryptophan concentration in the blood and inhibiting the synthesis of 5-HT. 3 There are clinical reports that estrogen can improve the mood of menopausal women and Cognitive function, our multi-factor study on this disease also suggests that changes in sex hormones play a role in menopausal mood disorders, but biological factors alone cannot provide a satisfactory explanation for this disease, because not all women will appear in menopause. Symptoms, and hormone replacement therapy does not completely and satisfactorily eliminate symptoms, with or without menopause Two groups of controlled studies with mental disorders showed no significant differences in serum follicle estrogen (FSH), luteinizing hormone (LH), and estradiol (E2) levels between the two groups.

(2) Psychosocial factors: In recent years, there have been many studies on this aspect at home and abroad, and there are dozens of psychosocial factors involved, which can be summarized as personality characteristics (introversion, emotional instability, neuroticism, etc.), behavioral methods. , economic status, living environment, cultural background, stressful life events, cognitive assessment of menopause, social support and past physical and mental health status.

4. Periodic psychosis: Most scholars believe that it is related to endocrine disorders. Clinical and endocrine studies have shown that this disease is related to the dysfunction of the diencephalon-pituitary and hypothalamic system. The patient has unstable ovarian function, hypothalamic-pituitary-thyroid Axillary function is low, adrenal cortex hyperfunction, pituitary-gonadal function is insufficient; psychological factors also play a role in the induction of this disease, according to the survey, 35% to 75% of patients have mental stimulation on the onset, the patient's personality characteristics are mostly Sensitive, suspicious, timid, fragile (50%), enthusiasm, active, irritating (35%), and clinical performance and personality are also related.

Prevention of mental disorders associated with sexual dysfunction

In order to ensure the safety of mothers, fetuses, newborns, health and eugenics, perinatal women should be actively monitored and researched from the diagnosis of pregnancy, and the maternal management system should be implemented carefully. Menopausal women should know some physiological health knowledge of menopause. Understand that this is a period of physiological transition. After 1-2 years, it can be naturally relieved, which is beneficial to relieve unnecessary mental burden. At the same time, family members, neighbors, partners and colleagues should also understand the main performance of menopause, at work and in life. Give them care and understanding. In addition, avoid excessive, overworked, over-stressed work; avoid excessive mental stress, avoid bad mental stimulation as much as possible, create a relaxed and pleasant environment for them, and strengthen physical exercise, but not Excessive, not too intense and nervous, to do what you can, to participate in group activities, including recreational activities, adjust sleep habits, ensure adequate rest time, more obvious symptoms of menopausal syndrome, you can take appropriate medication, but most Okay, please consult a doctor for some cardiovascular and endocrine systems. Symptoms and menstrual changes, abnormal vaginal bleeding, etc., do not easily explain with menopausal syndrome, but should first go to the hospital for necessary examinations, exclude organic diseases, and then psychological and symptomatic treatment, so as not to delay treatment, while A comprehensive physical examination, gynaecological examination and anti-cancer examination are necessary for menopausal women every year.

Mental disorders associated with sexual dysfunction Complications

Can lead to schizophrenic psychosis symptoms: more acute morbidity, mostly uncoordinated excitement, agitation, impulsivity, resistance, stereotype, injury, destruction; some patients with mild disturbance of consciousness, after the recurrence Can not recall and other characteristics, identification is not very difficult. Symptoms of snoring: the patient's emotional irritability, emotional instability, eruption, and crying and laughing. Disorder of consciousness: often a lethargy, confusion, a small number of states can occur paralyzed state.

Symptoms of mental disorders associated with sexual dysfunction Common symptoms Mental disorders Suspicious moody face flushing Red madness irritating conscious disorder Unreasonable laughter Insomnia speech increase

Premenstrual tension syndrome

(1) Mental symptoms:

1 emotional instability: performance as anxious, irritability, irritability, easy to quarrel.

2 Depressed state: Negative, whispering, depression, boredom, crying or anger without reason, unwilling to move, lonely and ignorant, ignoring relatives and friends, lazy, lethargy, inattention, forgetfulness, difficulty in judgment, etc.

3 occasional absence of seizures.

4 A small number of cases have been illegal before going through the law.

(2) physical symptoms: headache, fatigue, nipple and abdominal pain or nausea, constipation, vomiting, bloating, body aches, edema, hypersexuality, increased appetite, weight gain within 2 to 3 days before menstruation, etc. After menstruation, it disappears quickly, and some continue until the end of menstruation.

2. Menstrual period mental disorder

(1) Mental disorders:

1 emotional disorder: depression, tension, anxiety, depression is more common.

2 Excited state: visible impulses, attacks and wounds, destruction, and quarrels.

3 disturbance of consciousness is not obvious.

(2) Somatic symptoms: autonomic symptoms such as chills, internal heat, dizziness, and breast tenderness.

3. Mental disorders during pregnancy

There are many differences between early and late pregnancy.

(1) Mental disorders:

1 In the early stage, emotional instability, anxiety, agitation, allergies, and suspiciousness may occur.

2 cerebral weakness syndrome such as headache, insomnia, fatigue, weakness and so on often appear.

3 severe cases can appear manic state with consciousness disorder, patients say more words, busy, go out, etc., but emotional joy, Lenovo runaway is not strong, similar to arrogant mania.

4 types of schizophrenia symptoms, such as apathy, relaxation of thinking, strange behavior, no reason to laugh, hallucinations, delusions, etc., in addition to cerebral weakness syndrome in late pregnancy, depression is also more common, patients have depression, sadness, negative, self-blame , anxiety, etc., in addition to concurrent toxionemia or complicated eclampsia, can occur sputum or disorder state and other disturbances of consciousness, and occasionally Kosakov syndrome.

Most of the above mental disorders are transient, often disappearing 1 to 3 weeks after delivery, and recurrence can be recurred (about 1/2 of those reported recurrence).

(2) Physical and neurological symptoms: initial blood pressure drop, thirst, oliguria, heterosexual, etc., nervous system symptoms occur in the third trimester of pregnancy, pregnancy chorea, eclampsia, high blood pressure and so on.

4. Postpartum mental disorders

There are mainly acute brain syndromes, functional psychosis, neurosis and other symptoms.

(1) or disorder state: Most of the illness is severe insomnia, excitement, early awakening, mood changes, sudden crying or inexplicably laughing, more often occurs after childbirth.

(2) disturbance of consciousness: it occurs in a few days after delivery, and begins to suffer from insomnia. After excitement, it gradually develops to a state of paralysis or disorder, often occurring in the case of co-infection.

(3) Illusion or delusion state: mostly more systematic delusions or verbal auditory hallucinations, loose thinking, association relaxation, and bizarre behavior, as well as tension syndrome or stupor state, similar to schizophrenic psychosis.

(4) Manic or depressed state: In addition to the obvious emotions, the manic state is often accompanied by euphoria, impulsivity, attack and other behaviors, mild disturbance of consciousness, depression in depression, depression, sadness, anxiety, more common I am overly concerned about the health of the baby, have an impulsive suicidal intention, fear of hurting the baby and killing the baby, commit suicide, blame, and feel guilty. I am worried that I cannot be a good mother. Will the child grow up to be a fool, afraid? The child is not his own, etc., when severe, can enter the stupor, similar to depressive stiff.

(5) snoring-like episodes: Some patients may present with seizures or numbness of the limbs, emotional outbursts, paralysis or multiple discomforts in the body.

5. Menopausal syndrome and menopausal mental disorders

According to the key performance of clinical symptoms, it can be roughly classified into the following three common clinical types:

(1) Menopausal syndrome: Menopause can cause a series of physiological and psychological changes.

1 Physiological aspects: abnormal feeling, hypersensitivity, feeling fading, ant walking, numbness; pain throughout the body including low back pain, myalgia, spinal pain, joint pain, shoulder acid and sciatica; autonomic symptoms, such as tide Heat, coldness, palpitations, tachycardia or tachycardia, frequent urination, dysuria, diarrhea or constipation, dry mouth, excessive sweating, good hunger or lack of appetite.

2 psychiatric symptoms: headache, head weight, dizziness, dizziness, tinnitus, vertigo, fatigue, weakness, emotional mood, anxiety, nervousness, irritability, depression, suspicious, inattention, memory loss and insomnia.

(2) Menopausal mood disorder: At this time, the emotional changes are more serious and prominent, and the physical and autonomic symptoms are relatively insignificant. Clinically, there are menopausal depression and menopausal anxiety. The clinical manifestations are similar to depression and anxiety, but the patients have no previous experience. History, accompanied by the characteristics of the symptoms of menopausal syndrome, the disease unit has been eliminated in the classification of mental illness at home and abroad, and in the emotional psychosis, but in clinical observation, menopausal depression still has its certain characteristics For example, depression is often accompanied by obvious anxiety, body complaints are more, speech, exercise is not slow, and acute anxiety is rare.

(3) Menopausal paranoid state: The patient has no mental abnormality in the past. In the menopause, there are mental disorders that are mainly caused by murder, sputum, and suspicion. The content of delusions involves relatives and friends, neighbors, which are more specific and not generalized. Accompanied by auditory hallucinations, the patient's personality remains intact, and people outside the delusional object are in good contact. Although the course of the disease does not decline, the taxonomy has been classified into paranoid psychosis, but the gonadal function is occurring in this disease. It has a certain effect.

6. Periodic psychosis

(1) Mental disorders: Most patients have prodromal symptoms, appearing several days before menstruation, insomnia, lethargy, headache, dizziness, loss of appetite, etc. The prodromal symptoms of each episode are the same, and the mental symptoms are diverse and colorful. Almost all the symptoms of mental illness, but each patient's symptoms are relatively solid, similar to the previous episode, the common clinical types are:

1 Manic state: euphoric, optimistic, but not contagious; increased language and no associations; emotional excitement, but not lasting, and feeling tired.

2 Depression status: Although the patient is depressed and anxious, panic, restless, but the grief is not obvious; although the speech movement is restrained, the speech is negligible, but no association is slow, daily life is active, and there are often unexpected suicidal behaviors, which can be related to internal factors. Sexual mania depression is differentiated.

3 Illusion delusion state: mainly speech and critical auditory hallucinations, illusion is less, illusion is more short-lived, murder of fragments, relationship delusions, emotional reactions are more intense.

4 schizophrenic psychosis symptoms: the incidence is more urgent, mostly uncoordinated excitement, incitement, impulsivity, resistance, stereotypes, wounding, destruction or stupor, association more relaxation, similar to schizophrenia youthful or nervous, but The periodic episodes of the disease and the normal mental state of the seizures; some patients with mild disturbance of consciousness, recurrence after the onset of the scene can not recall characteristics, identification is not difficult.

5 symptoms of symptoms: patients with emotional irritability, emotional instability, outbreaks, crying and laughing.

6 disturbance of consciousness: often sleepiness, confusion, embarrassing state, a few can appear paralyzed state.

(2) physical symptoms: dysmenorrhea at the onset, amenorrhea or prolonged or shortened menstruation, often accompanied by headache, palpitations, insomnia, facial flushing or pale, sweating, thirst, polydipsia, tachycardia, frequent urination and other autonomic nerves Symptoms of dysfunction, there are also hypothalamic symptoms such as hyperthyroidism or loss of libido, endocrine examination and vaginal cytology.

According to the relationship between onset and menstrual period can be divided into 5 types: 1 month before menstruation, menstruation begins to recover; 2 months before menstruation, menstrual symptoms continue, until menstruation stops to recover; 3 menstrual disease, to the second half of menstruation recovery 4 is equivalent to a short episode of ovulation, generally in the clinical manifestations of premenstrual morbidity with excitement, high mood, and even confusion, erotic hyperactivity is dominant, at this time the urinary estrogen is higher, the late menstrual disease tends to inhibit The state, there are slow movements, low language, low sexual desire, at this time the estrogen in the urine is lower.

Examination of mental disorders associated with sexual dysfunction

Meet laboratory changes with the original disease or physiological condition.

Diagnosis and diagnosis of mental disorders associated with sexual dysfunction

Diagnostic criteria

Mental disorder during pregnancy

(1) It can be diagnosed according to the typical mental disorder that occurs during pregnancy.

(2) The original mental illness, such as schizophrenia and depression, should be ruled out due to pregnancy.

2. Postpartum mental disorders

(1) Mental disorders occur within 6 weeks after birth.

(2) The occurrence of mental disorders has a significant relationship with childbirth.

(3) Mental disorders should be ruled out as a cause of childbirth, which leads to the recurrence of the original mental illness and is differentiated from mental disorders caused by other physical diseases.

3. Periodic psychotic diagnosis

(1) Most of them are young women, especially before and after menarche.

(2) Periodic multiple episodes are related to the menstrual cycle. The onset is more urgent, the recovery is faster, and the course of disease is shorter, usually 5 to 10 days. Usually, it occurs once a month, but there are also monthly or several months of episodes. Cases can occur once every 1-2 years; no mental defects are left behind after the disease, these are also important basis for the diagnosis of this disease.

(3) The onset is sharp, the course of disease is short, and it will heal quickly without treatment, leaving no mental defects after the illness.

(4) mental disorders are often accompanied by mild disturbance of consciousness. Patients often have amnesia after recovery. If necessary, they can be used for endocrine examination. For example, before menstruation, and multiple times, the estrogen discharge curve can be detected in urine. Healthy ovulation and premenstrual estrogen are consistent, and vaginal cytology can also be performed.

(5) Clinical features are more acute, recovery is faster, the course of disease is shorter, usually 5 to 10 days; usually one episode per month, but there are also episodes every month or several months, very few cases can occur 1 to 2 years 1 Times; no mental defects remain after the illness, these are also important basis for the diagnosis of this disease.

Mental disorders associated with sexual dysfunction must have symptoms of abnormal dysfunction or physiological changes, signs and laboratory, auxiliary examination, and other endocrine dysfunction accompanied by mental disorders and other functional psychosis such as schizophrenia, Identification of snoring and depression.

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