In the last few years, there has been a wave of articles related to behavioral addictions; some of them have a focus on online pornography addiction. However, despite all efforts, we are still unable to profile when engaging in this behavior becomes pathological. Common problems include: sample bias, the search for diagnostic instrumentals, opposing approximations to the matter, and the fact that this entity may be encompassed inside a greater pathology (i.e., sex addiction) that may present itself with very diverse symptomatology. Behavioral addictions form a largely unexplored field of study, and usually exhibit a problematic consumption model: loss of control, impairment, and risky use. Hypersexual disorder fits this model and may be composed of several sexual behaviors, like problematic use of online pornography (POPU). Online pornography use is on the rise, with a potential for addiction considering the “triple A” influence (accessibility, affordability, anonymity). This problematic use might have adverse effects in sexual development and sexual functioning, especially among the young population. We aim to gather existing knowledge on problematic online pornography use as a pathological entity. Here we try to summarize what we know about this entity and outline some areas worthy of further research.

Major depressive disorder is a serious mental disorder in which treatment with antidepressant medication is often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) has a low rate of spontaneous reports by patients, and this side effect therefore remains underestimated in clinical practice and in technical data sheets for antidepressants. Moreover, the issue of TESD is rarely routinely approached by clinicians in daily praxis. TESD is a determinant for tolerability, since this dysfunction often leads to a state of patient distress (or the distress of their partner) in the sexually active population, which is one of the most frequent reasons for lack of adherence and treatment drop-outs in antidepressant use. There is a delicate balance between prescribing an effective drug that improves depressive symptomatology and also has a minimum impact on sexuality. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antidepressant with a low rate of TESD) to possible pharmacological interventions aimed at improving patients’ tolerability when TESD is present. The suggested recommendations include the following: for low sexual desire, switching to a non-serotoninergic drug, lowering the dose, or associating bupropion or aripiprazole; for unwanted orgasm delayal or anorgasmia, dose reduction, “weekend holiday”, or switching to a non-serotoninergic drug or fluvoxamine; for erectile dysfunction, switching to a non-serotoninergic drug or the addition of an antidote such as phosphodiesterase 5 inhibitors (PD5-I); and for lubrication difficulties, switching to a non-serotoninergic drug, dose reduction, or using vaginal lubricants. A psychoeducational and psychotherapeutic approach should always be considered in cases with poorly tolerated sexual dysfunction.

In recent decades, hormonal contraceptives (HC) has made a difference in the control of female fertility, taking an unequivocal role in improving contraceptive efficacy. Some side effects of hormonal treatments have been carefully studied. However, the influence of these drugs on female sexual functioning is not so clear, although variations in the plasma levels of sexual hormones could be associated with sexual dysfunction. Permanent hormonal modifications, during menopause or caused by some endocrine pathologies, could be directly related to sexual dysfunction in some cases but not in all of them. HC use seems to be responsible for a decrease of circulating androgen, estradiol, and progesterone levels, as well as for the inhibition of oxytocin functioning. Hormonal contraceptive use could alter women’s pair-bonding behavior, reduce neural response to the expectation of erotic stimuli, and increase sexual jealousy. There are contradictory results from different studies regarding the association between sexual dysfunction and hormonal contraceptives, so it could be firmly said that additional research is needed. When contraceptive-related female sexual dysfunction is suspected, the recommended therapy is the discontinuation of contraceptives with consideration of an alternative method, such as levonorgestrel-releasing intrauterine systems, copper intrauterine contraceptives, etonogestrel implants, the permanent sterilization of either partner (when future fertility is not desired), or a contraceptive ring.

BACKGROUND There are previous experiences on the perception of patients with the use of telemedicine (TM). After break down caused by pandemic Covid19 crisis, mental health professionals in Spain should develop their work in a telematics way. OBJECTIVE Explore about the perceptions and interests of mental health professionals who have performed TM in the pandemic situation. METHODS An Ad-hoc questionary on the perception of the TM, the Work Satisfaction Questionnaire of Font Roja, and questions on patients satisfaction ere used. The data collected included 112 professionals of the Psychiatric Service who began to perform TM massively on March 16, following the alarm status declaration for ten weeks. More than 12.000 medical consultations were carried out on the phone. RESULTS High levels of satisfaction was detected among professional TM would function as a complement to the traditional system of face-to-face visits (n-112, f-109, 96.5%), only 9.7% (f-11) believed that the telematic system would completely replace face-toface visits. 60,8% did not consider this a monotonous work. The older the health workers were, the more satisfied they felt on their telephone follow-up consultation. The higher the previous experience the more satisfaction was showed. There are gender differences and women seems to be more adapted. CONCLUSIONS TM can be implemented without much effort, although the time, methods and resources used must be managed. Satisfaction among professionals is high, especially among those with more clinical experience. Patient satisfaction must be contrasted. CLINICALTRIAL This study is not a trial

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: There are previous experiences on the perception of patients with the use of telemedicine (TM). After break down caused by pandemic Covid19 crisis, mental health professionals in Spain should develop their work in a telematics way. Objective: Explore about the perceptions and interests of mental health professionals who have performed TM in the pandemic situation. Methods: An Ad-hoc questionary on the perception of the TM, the Work Satisfaction Questionnaire of Font Roja, and questions on patients satisfaction ere used. The data collected included 112 professionals of the Psychiatric Service who began to perform TM massively on March 16, following the alarm status declaration for ten weeks. More than 12.000 medical consultations were carried out on the phone. Results: High levels of satisfaction was detected among professional TM would function as a complement to the traditional system of face-to-face visits (n-112, f-109, 96.5%), only 9.7% (f-11) believed that the telematic system would completely replace face-toface visits. 60,8% did not consider this a monotonous work. The older the health workers were, the more satisfied they felt on their telephone follow-up consultation. The higher the previous experience the more satisfaction was showed. There are gender differences and women seems to be more adapted. Conclusions: TM can be implemented without much effort, although the time, methods and resources used must be managed. Satisfaction among professionals is high, especially among those with more clinical experience. Patient satisfaction must be contrasted. Clinical Trial: This study is not a trial