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Analyses of risk factors for sexually transmitted diseases in patients with and without depressive disorder.
Source publication
Depressive disorder is a severe mental disorder associated with functional and cognitive impairment. Numerous papers in the literature investigated associations between sexually transmitted infections (STIs) and psychiatric illnesses. However, the results of these studies are controversial.
We explored the relationship between depressive disorder a...
Context in source publication
Citations
... Studies have shown that ACEs are associated with depressive symptoms (Chang et al., 2019;Schilling et al., 2007). Depressive symptoms could lead to having an STI as they may (1) reduce self-efficacy and thus the ability to negotiate safer sexual behavior, or (2) impair cognitive function resulting in a disregard for safer sexual behavior (Huang et al., 2018). Conversely, having an STI could lead to depressive symptoms. ...
... [25] According to a different study, women with depressive disorders had a considerably greater sequential risk of STIs. [26] However, in addition to physical issues, women who have STIs also face a variety of psychological problems. Patients with genital herpes and warts had higher overall rates of depression. ...
Background
Women with mental illness (WMI) are more likely to experience unreported sexual and reproductive health (SRH) problems. Mixed-method research studies with the strengths of quantitative and qualitative approaches provide deeper insight into SRH issues of WMI.
Methods
A sequential explanatory mixed-method design was used to understand better the SRH problems of WMI attending tertiary care psychiatry hospital. In phase 1, a survey was conducted to identify if they have SRH problems. Women who were identified to have SRH problems were part of Phase II. In this phase, in-depth interview was conducted to explore their lived-in experiences. Integration at the method level was adopted by connection through sampling. Using a narrative approach, integration was accomplished at the level of interpretation and reporting.
Results
Among the users, 261 (64.6%) female sterilization, 244 (93%) was the most common, and the other methods like coitus interruptus, male condoms, and intrauterine devices were reported less. Of the non-users, 137 (33.9%) WMI 100 (73%) were unaware of the best family planning approach. Most of them, 377 (93.3%), were ignorant about sexually transmitted infection (STI) symptoms. WMI reported 62 (15.3%) unusual foul-smelling vaginal discharge and 58 (14.4%) genital ulcers, with poor treatment-seeking behavior. Sexual dysfunction in desire, arousal, lubrication, orgasm, satisfaction, and pain were also reported. The findings were described in a single report based on the quantitative data followed by themes obtained from qualitative interviews using weaving techniques under the headings of contraceptive use and its awareness, prevalence of STI symptoms and its treatment, and sexual health experiences.
Conclusion
Data integration demonstrated that one-fourth of WMI had inadequate awareness of contraceptive use, were ignorant of STI symptoms, and experienced sexual dysfunction.
... Table 2). [7,36,37] and the scarcity of research on discrepant results of syphilis con rmatory tests, it is important to identify the factors that in uence TTs results. In this study, we used demographic information and comorbidities to determine the features associated with the discrepant results. ...
Background
Syphilis is becoming more prevalent and is diagnosed primarily through serologic tests. Confirmatory treponemal tests (TTs), such as Treponema pallidum particle agglutination (TPPA) and fluorescent treponema antibody absorption (FTA-Abs), are typically used. Although only one TT is needed for syphilis diagnosis, multiple TTs are still common in the disease course. Discrepant TT results can cause confusion and delay treatment. We aimed to explore the clinical characteristics of patients with discrepant TT results and develop a machine learning based tool to evaluate the risk of TT discrepancies.
Methods
In the retrospective cohort study, we linked electronic health records from a medical centerand national claims records in Taiwan between January 2001 and September 2018. Medical histories and demographic characteristics were considered as variables of interest to identify risk factors and develop machine learning models to assess the risk of TT discrepancy. We also analyzed the association between syphilis treatments and discrepant TT results.
Results
Among 5,780 eligible patients tested for syphilis, 133 (2.30%) had discrepant TT results. Risk factors associated with discrepant TT results were HIV and AIDS (adjusted odds ratio [aOR] = 2.6, 95% CI 1.4-4.7), osteoarthritis (aOR = 3.3, 95% CI 1.3-7.1), and pregnancy (aOR = 5.0, 95% CI 1.8-11.6). Patients with a top 5% risk probability from the LighGBM model were 10 times more likely to have discrepant TT results. For cases with discrepant TT results, TPPA was more likely than FTA-Abs to turn negative after treatment (OR 9.18, 95% CI 2.05-41.07).
Conclusions
Identifying risk factors and developing a machine learning based decision support tool could significantly aid in interpreting serologic tests for syphilis and guide accurate diagnosis.
... [9] The risk of newly diagnosed STIs such as syphilis, genital warts, and trichomoniasis may be higher during episodes of mania or psychosis. [10,11] Most women with schizophrenia are at a higher risk of contracting infections during sexual intercourse. [12] Engaging in unsafe sexual behavior and not complying with FP measures may cause chronic pelvic pain, increased risk of cervical cancer, and ectopic pregnancy among WMI. ...
Objectives
Sexual and reproductive health (SRH) is a vital concern among women with mental illness (WMI) due to the increased risk for unplanned pregnancy, sexually transmitted infections (STIs), and poor obstetric outcomes. Objective of the study was to explore the current use of family planning (FP) methods, symptoms of STIs and sexual dysfunction among WMI.
Materials and Methods
This descriptive study involved 404 WMI of reproductive age (18-49 years) attending tertiary care psychiatric outpatient clinics in India. During face-to-face interviews, centers for disease control and prevention (CDC)-reproductive health assessment toolkit-FP questionnaire, STI questionnaire and Female sexual function index (FSFI) were used to collect the data.
Results
Of 404 WMI, 261(64.6%) were users, and 137 (33.9%) were non-users of FP methods. About 6(1.5%) WMI did not respond FP methods question. Female sterilization was the highest among the users, 244(93%). Among non-users, 100 (73%) were unaware of choosing the effective method of FP. Most of the WMI, 377(93.3%), were unaware of STIs. The symptoms of STI reported include unusual genital discharge 62(15.3%) and genital ulcers/ sores 58(14.4 %). Most of them, 76(63.3%), were not on any treatment. The most common reason for not taking treatment was feeling ashamed 70(92.1%). Female sexual dysfunction was reported in 176(43.6%). Most of the WMI had difficulties in the arousal domain 288(71.3%), followed by low desire 233(57.7%) and dissatisfaction 186(46%).
Conclusion
Most WMI underwent sterilization. Non-users of FP methods were not aware of choosing the effective method. Awareness about STIs was poor, and feeling ashamed was the primary reason for not availing of medical help. Nearly half of the WMI reported sexual dysfunction, among which arousal difficulties, low desire and dissatisfaction were common. Health professionals need to increase awareness about FP methods and symptoms of STIs among WMIs. Women require appropriate counselling regarding SRH and treatment for sexual dysfunction.
... There is some evidence that people with mental illness are at a higher risk of becoming infected with blood-borne viruses (BBVs) such as HIV and hepatitis C. A systematic review and meta-analysis of BBVs in people with severe mental illness reported that HIV and hepatitis were more prevalent in people with severe mental illness compared with the general population. 3 Huang et al 4 reported that depressive disorder increased the risk of subsequent newly diagnosed sexually transmitted infections including HIV infection, syphilis, genital warts, gonorrhoea, chlamydial infection and trichomoniasis. A ...
Objective
To examine the prevalence of HIV in a cohort of people who have used secondary mental health services in the UK.
Design
Retrospective cohort study.
Setting
Routinely collected clinical data from secondary mental health services in South London, UK available for research through the Clinical Record Interactive Search tool at the National Institute for Health and Care Research Maudsley Biomedical Research Centre were matched with pseudonymised national HIV surveillance data held by the UK Health Security Agency using a deterministic matching algorithm.
Participants
All adults aged 16+ who presented for the first time to mental health services in the South London and Maudsley (SLaM) National Health Service Trust between 1 January 2007 and 31 December 2018 were included.
Primary outcome
Point prevalence of HIV.
Results
There were 181 177 people who had contact with mental health services for the first time between 2007 and 2018 in SLaM. Overall, 2.47% (n=4481) of those had a recorded HIV diagnosis in national HIV surveillance data at any time (before, during or after contact with mental health services), 24.73 people per 1000. HIV point prevalence was highest in people with a diagnosed substance use disorder at 3.77% (n=784). A substantial percentage of the sample did not have a formal mental health diagnosis (27%), but even with those excluded, the point prevalence remained high at 2.31%. Around two-thirds of people had their diagnosis of HIV before contact with mental health services (67%; n=1495).
Conclusions
The prevalence of HIV in people who have had contact with mental health services was approximately 2.5 times higher than the general population in the same geographical area. Future work should investigate risk factors and disparities in HIV outcomes between those with and without mental health service contact.
... Ramrakha et al. indicated that depression, substance dependence, mania, and schizophrenia are associated with risky sexual behaviors and subsequent sexually transmitted diseases (STIs) [4]. Previous studies showed that schizophrenia, bipolar disorder, and major depressive disorder are commonly comorbid with OCD, and that such comorbid conditions may be related to STI risk [5][6][7]. But whether OCD is an independent risk factor for subsequent STIs remains unclear. ...
... Several mechanisms may underlie the relationship between OCD and STI risk. First, OCD-related comorbidities, including schizophrenia, major depressive disorder, bipolar disorder, alcohol use disorder, and substance use disorder, may be linked to the elevated STI risk in patients with OCD [5][6][7]. Moreover, a cross-sectional study found that young adults with schizophrenia or depression were more likely to engage in risky sexual behaviors, develop STIs, and engage in sexual activity at a young age [4]. ...
Objectives: The association between obsessive–compulsive disorder (OCD) and sexually transmitted infections (STIs) and the effects of OCD medication on STI risk remain unknown. In the present study, we intended to study the risks of subsequent STIs after an OCD diagnosis and the effects of related OCD medications on STI risk. Methods: With the Taiwan National Health Insurance Research Database, we enrolled 15,908 adolescent and young adult patients with OCD and 159,080 age- and sex-matched individuals without OCD between 2001 and 2009, and followed them up until the end of 2011 for subsequent STI diagnoses. Results: The total patients with OCD were significantly more to acquire an STI, with a hazard ratio (95% confidence interval) being 3.25 (2.61–4.03), than their counterparts without OCD (p < 0.05). The associations between OCD medications, including antidepressants, mood stabilizers, and second-generation (atypical) antipsychotic drugs, and subsequent STI risk did not reach any significant differences. Conclusion: In this study, we found that OCD is an independent risk factor of acquiring any STI in the adolescent and young adult population. We recommend that clinicians should be more alert in identifying risky sexual behaviors and STI risks in such patients with OCD.
... Depression is a serious psychiatric disorder associated with cognitive disorder, including physical and psychological symptoms [1,2]. It is reported that approximately 350 million people worldwide are affected by depression [3], which is a major cause of incapacity to work and imposes a heavy financial and emotional burden on society. ...
Objective:
A large amount of evidence shows that the abnormal expression of miRNA plays an important role in the development of depression. Therefore, we investigated the effect of miR-124-3p on neuronal damage in the hippocampus of depression rats.
Methods:
The target genes of miR-124-3p were predicted by the database; the depression model was prepared by subcutaneous injection of corticosterone (CORT), and LV-miR-124-3p asponge lentiviral suspension was given to determine the weight of rats and open-field test, sugar preference experiment, Serum CORT, 5-HT, DA, and NE were measured, observe and record the behavior of rats, including behavior, diet, and hair. The expression of miR-124-3p, STAT3, Bcl-2, and Bax in rat hippocampus was measured. The rat hippocampal neuron cells were extracted and transfected with miR-124-3p inhibitor; the cells were cultured with CORT, and the cell survival rate was evaluated by MTT experiment, and the expressions of miR-124-3p, STAT3, Bcl-2, and Bax in the cells were detected. Luciferase reporter gene verifies the targeted regulation of miR-124-3p on STAT3.
Results:
Compared with depression rats, silencing miR-124-3p increased the weight of the rats, increased the number of open-field activities, and significantly improved the general state and pathological state of the rats. The sugar water preference rate was significantly increased, the CORT content in the serum of rats decreased significantly, and the levels of 5-HT, DA, and NE increased significantly. After the treatment of silencing miR-124-3p, the expression level of miR-124-3p was decreased, while the STAT3 mRNA and protein expression levels were increased. And the protein and mRNA expression levels of Bcl-2 were increased, and the Bax protein and mRNA expression were decreased. Cell experiments verified that silencing miR-124-3p increased cell survival, the expression level of miR-124-3p decreased remarkably, while the expression levels of STAT3 mRNA and protein increased significantly. Silencing miR-124-3p reversed the effects of CORT treatment on miR-124-3p and STAT3 in neuronal cells. The luciferase reporter gene experiment confirmed that miR-124-3p targets and regulates STAT3 expression.
Conclusion:
Silencing miR-124-3p may protect hippocampal neurons from damage in depression rats by upregulating STAT3 gene.
... Suicidal ideation may also indicate a person suffers from great distress and psychological burden. Sexually transmitted infection (STI) patients experience difficulties with stability and trust in long-term relationships [2] and have poor mental health [3][4][5][6][7], factors that may lead to suicidal ideation. ...
... Assuming 30.0% prevalence of lifetime suicidal ideation in STI patients, using alpha of 0.05 and a relative error for sampling of 0.15, we calculated a required sample size of 415 [7,33]. To allow for a 30% non-response rate, a total of 540 patients were recruited to participate, and 519 (96.1%) valid questionnaires were collected. ...
... Respondents rated how often they felt a certain way (e.g., "These days, the people in my life would be better off if I were gone"), scored from 1 (not at all true for me) to 7 (very true for me). Six items [7,8,10,13,49] were recoded before computing. Higher than the 75th percentile score of 49 was defined as interpersonal needs being unsatisfied (Cronbach's α: 0.855; range: 15-96). ...
Background:
Patients with sexually transmitted infections (STIs) experience difficulties with stability and trust in long-term relationships and have poor mental health, factors that may lead to suicidal ideation. We sought to verify whether psychosocial health problems among patients with STIs were associated with these patients' suicidal ideation and to examine the syndemic effect of multiple psychosocial problems on suicidal ideation.
Methods:
This was a cross-sectional study of 519 STI patients at the Shanghai Skin Disease Hospital. Demographic, psychosocial, and suicidal ideation information about the participants was collected by questionnaire. Logistic regressions were performed to detect the association between demographic variables and suicidal ideation, as well as each individual psychosocial variable and suicidal ideation, and to verify the syndemic effect of psychosocial factors.
Results:
Of the participants, 25.0% (130/519) reported having suicidal ideation. In univariable analysis, low self-esteem, loneliness, depression, entrapment, defeat, and unsatisfied interpersonal needs were associated with suicidal ideation. Multivariable analysis found depression (odds ratio [OR]: 4.1; 95% confidence interval [CI]: 2.3-7.2) and entrapment (OR: 2.1; 95%CI: 1.1-4.1) each had a more significant relation with suicidal ideation than the other psychosocial problems examined. STI patients who experienced two or more psychosocial health problems had approximately fourfold odds of suicide ideation (adjusted OR [AOR]: 4.2; 95%CI: 2.6-6.8) compared with those in the non-syndemic group, especially in the high-level (five or more psychosocial problems) group (AOR: 7.0; 95%CI: 3.9-12.5).
Conclusions:
The study found the participants had a high rate of suicidal ideation and suffered from severe psychosocial problems. These results show a syndemic effect of psychosocial problems on increasing the odds of suicidal ideation. Our findings suggest an urgent need for efforts to prevent suicidal ideation among STI patients toward improving the social and health conditions of this population.
... To be able to take maximum precautions, good data collection is also needed. This is needed to describe which areas are affected by STIs and are likely to have the risk of transmission [4]. ...
... Assuming 30.0% prevalence of lifetime suicidal ideation in STI patients, using alpha of 0.05 and a relative error for sampling of 0.15, we calculated a required sample size of 415 7,34 . To allow for a 30% non-response rate, a total of 540 patients were recruited to participate, and 519 (96.1%) valid questionnaires were collected. ...
Background We sought to verify whether psychosocial health problems among patients with sexually transmitted infections (STIs) were associated with these patients’ suicidal ideation, and to examine the magnifying effect of a syndemic of multiple psychosocial conditions on suicidal ideation. Methods This was a cross-sectional study of 519 STI patients at the Shanghai Skin Disease Hospital. Sociodemographic, psychosocial, and suicidal ideation information on the participants was collected. Logistic regressions were performed to detect the association between sociodemographic variables and suicidal ideation, as well as each individual psychosocial variable and suicidal ideation, and to verify the syndemic effect of psychosocial factors. Results Of the participants, 25.0% reported having suicidal thoughts. In univariate analysis, low self-esteem, loneliness, depression, entrapment, defeat, and unsatisfied interpersonal needs were associated with suicidal ideation. Multivariable analysis found depression (risk ratio [RR] 2.614; 95% confidence interval [CI]: 1.603–4.262) and entrapment (RR: 4.457; 95%CI: 2.649–7.496) remained significant. STI patients who experienced two or more psychosocial health problems had approximately five times the odds of suicide ideation (adjusted risk ratio [ARR]: 4.643; 95%CI: 2.882–7.481) compared with those in the non-syndemic group, especially in the high-level (five or more psychosocial problems) group (ARR: 6.072; 95%CI: 3.307–11.152). Conclusions The study confirmed that STI patients have a high rate of suicidal ideation and suffer from severe psychosocial problems. The results confirm a syndemic effect of psychosocial problems on increasing the odds of suicidal ideation. This suggests greater attention should be paid to STI patients’ psychosocial wellbeing in both nursing and interventions. Efforts to prevent suicidal ideation among STI patients are therefore urgently needed to ameliorate the social and health conditions of this population.
