Purpose: Individuals with gender dysphoria (GD) may request hormone therapy and various surgical operations to change their physical characteristics. The present study aimed to investigate the effects of two treatments, mastectomy and gender-affirming hormone therapy (GAHT), on adults with GD who were assigned female at birth (GD AFAB). Methods: In this cross-sectional study, we gathered data from a total of 269 individuals in three groups: (a) untreated group (n = 121), (b) GAHT group (n = 84) who had been receiving treatment for at least 6 months, and (c) GAHT-MAST group (n = 64) who had been using GAHT for at least 6 months and had undergone mastectomy at least 3 months prior. All participants were asked to complete the Symptom Checklist-90-Revised (SCL-90-R), the Body Uneasiness Test (BUT), and the World Health Organization’s Quality of Life Questionnaire- Brief Form, Turkish Version (WHOQOL-BREF-Tr). Results: We found that individuals in the untreated group had higher psychopathological symptoms and body uneasiness scores, and lower quality of life scores compared to both GAHT and GAHT-MAST groups. There was no difference in psychopathology between the GAHT-MAST group and the GAHT group, but body uneasiness scores were lower, and quality of life scores were higher in the GAHT-MAST group. Conclusion: Our study suggests that individuals receiving GAHT improved mental health, body satisfaction, and overall quality of life. Combining mastectomy with GAHT may further enhance these benefits.

Problematic pornography use has gained increasing scholarly and clinical attention over the past decade. Despite this, definitions remain contested, classification models are inconsistent, and measurement approaches vary, creating barriers for cumulative knowledge and evidence-based practice. This review provides an overview of the conceptual, methodological, and clinical landscape of problematic pornography use. The goal is to guide researchers and practitioners by summarizing current knowledge, identifying research gaps, and highlighting future directions. A narrative review of the literature was conducted, synthesizing theoretical models, epidemiological findings, measurement tools, identified risk and protective factors, and available intervention approaches. Special attention was given to cultural variation, usage characteristics, and the role of moral incongruence. Findings indicate that problematic pornography use is situated at the intersection of behavioral addictions, impulse-control difficulties, and compulsive tendencies, with no consensus on a unifying framework. Prevalence estimates vary widely due to sampling bias and definitional inconsistencies. Risk factors include impulsivity, insecure attachment, and early exposure, while protective factors such as family support and ethical disapproval may buffer risk. Excessive pornography use has been linked to psychological distress, relationship difficulties, and aggressive sexual attitudes, though associations are moderated by contextual variables. Measurement remains inconsistent, with few tools aligned with diagnostic criteria. Interventions such as cognitive behavioral therapy, acceptance and commitment therapy, mindfulness, and pharmacological options show promise, but evidence is limited by small samples and short follow-ups. Future research should prioritize standardized definitions, culturally adapted measurement, inclusion of content-type variables, and methodologically rigorous longitudinal designs. Clinical efforts must expand to diverse populations and relational contexts, moving the field toward an empirically grounded and ethically responsible science of problematic pornography use

Background: The relationship between impulse control and premature ejaculation (PE), the most common sexual dysfunction in men, is not yet well understood. Aim: To assess the association between impulse control issues and the severity of PE in men with a lifelong diagnosis of this condition. Methods: A cross-sectional observational study was designed to evaluate patients who presented to the clinic with complaints of PE between March 2023 and March 2024. The final study sample comprised 40 men with lifelong PE and 40 healthy control subjects. Outcomes: Impulse control was evaluated with the UPPS Impulsive Behavior Scale and the Barratt Impulsivity Scale-11 (BIS-11), while depression and anxiety levels were measured using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The severity of PE was assessed using the Arabic Index of PE (AIPE). Results: The mean AIPE score was 15.13 ± 3.33 in the PE group and 32.05 ± 2.06 in the control group (P ˂ 0.001). Compared to the control group, the PE group had significantly higher UPSS Impulsive Behavior Scale scores in all subscales (P ˂ 0.001 for planning, urgency, and lack of perseverance; P = 0. 001 for sensation seeking) and total scores (P ˂ 0.001). The BIS-11 scores were also significantly higher in the PE group compared to the control group for all subscales (P ˂ 0.001 for all). The patients in the PE group also had higher levels of anxiety and depression (P ˂ 0.001 for all). Clinical Implications: A clinician’s quantitative assessment of ejaculation time and the severity of PE among men presenting to the clinic with complaints of PE may reveal accompanying comorbid conditions more effectively. Strength and Limitations: The current study is a novel investigation that quantitatively evaluates PE in terms of intravaginal ejaculatory latency time and severity, aiming to identify comorbid conditions. As a limitation, the necessity for patients and their partners to measure the time to ejaculation limited the sample size, making it challenging to generalize the findings. Conclusion: Our findings suggest that impulse control plays a significant role in lifelong PE. It is important for clinicians to assess impulse control and consider therapeutic interventions for men presenting with PE complaints, particularly in those classified as severe.

We aimed to investigate the effects of COVID-19 outbreak and public health measures on the psychological well-being of patients with psychiatric disorders. This cross-sectional study assessed 436 outpatients recruited from a tertiary psychiatry clinic in Istanbul, Turkey, nearly one month after the government introduced strict measures of lockdown against the ongoing outbreak. Respondents completed a web-based survey on sociodemographic data, subjective sleep quality, and a range of psychiatric symptoms using the Impact of Events Scale-Revised (IES-R), and Hospital Anxiety and Depression Scale (HADS). Respondents reported high frequencies of clinically significant posttraumatic stress disorder (PTSD) (32.6%, IES-R score ≥ 33), anxiety (36.4%, HADS anxiety score > 10), and depression (51%, HADS depression score > 10). 20.5% of respondents described that their psychological status worsened during the COVID-19 outbreak, and 12.1% of respondents described poor or very poor sleep in the prior month. Positive predictors of increased PTSD symptoms included the chronic medical diseases, knowing someone in the social vicinity diagnosed with the COVID-19 infection, job loss or being on temporary leave after the outbreak, and increased exposure time to TV or social media. In contrast, male gender, older age, higher educational attainment, and the psychiatric diagnoses of schizophrenia and (to a lesser degree) bipolar disorder were the negative predictors. Our results suggest that patients with psychiatric disorders are prone to substantial psychological distress during the COVID-19 outbreak, and various individual, behavioral, and social factors mediate this effect.