Related Distress Research Articles

Delirium related distress experienced by nurses

Background: Delirium is described as a distressful experience by patients and their families. Also, among healthcare staff, nurses caring for patients with delirium are the most at risk of high distress related to this syndrome. Aims: To assess nurses’ distress related to delirium and its specific symptoms and severity. To identify factors nurses’ sociodemographic and psychological characteristics and professional experience, that may be associated to this distress. Methods: A prospective study was carried out with nurses caring older adults with delirium in Intensive Care Medicine Service. Distress related to delirium, global psychological distress and burnout in nurses were measured with Delirium Experience Questionnaire, Kessler Psychological Distress Scale and Copenhagen Burnout Inventory, respectively. Results: Eighteen nurses were included (mean age=32 years; 89% women). About 46% of the nurses classified the experience of caring for patients in delirium as moderately distressing. Disorientation and psychomotor agitation were the most distressing symptoms. High distress related to delirium was associated with greater personal (p=0.040) and work-related burnout (p=0.020), and more global psychological distress (p=0.007). Conclusion: Caring for patients with delirium is distressing for nurses, particularly if the disorientation and psychomotor agitation are present and if nurses presented high burnout or psychological distress. This study highlights the need for development of education and support strategies for all professionals dealing with these patients.

Suicidal ideation during the transitioning from prison to the community: financial hardship, relational distress, health issues, and gender

Individuals who had contact with the criminal justice system are at high risk for suicidal ideation and attempts. The links between suicide risk and adverse experiences during the transition from prison to community are not well understood. This study sought to fill that gap by examining adverse reentry experiences as determinants of suicidal ideation among post-incarcerated men and women. Longitudinal data documenting reentry experiences during the first four to eight months after release were analyzed in binary cross tabulations and multivariate regression models. Results indicated that multiple reentry barriers in financial, relational and health domains exerted positive effects on suicidal ideation. Further, gender intersected with reentry barriers to predict suicidal ideation. Post-incarcerated women were more sensitive to relational reentry barriers, whereas health-related barriers exerted an amplified effect on suicidal ideation for their male counterparts. Policy implications and directions for future research are provided.

Associations between COVID-19 mental impact and distress, resilience, burnout and well-being in Hong Kong community adults: A structural equation model

ABSTRACT The COVID-19 pandemic poses substantial risks to individuals’ physical and mental health and prolonged psychological responses to the pandemic could lead to emotional exhaustion. The present study aimed to examine the mediating role of COVID-19 related mental impact and distress in the relationship among resilience, burnout, and well-being. The present study recruited 500 community adults (mean age = 38.8 years, SD = 13.9; 76% females) in Hong Kong via an online survey in autumn 2021. The participants completed the Mental Impact and Distress Scale: COVID-19 (MIDc) and validated measures on resilience, burnout, and well-being. Confirmatory factor analysis was conducted to evaluate the psychometric properties of the MIDc. Direct and indirect effects of resilience on burnout and well-being via MIDc were examined via structural equation modeling. Confirmatory factor analysis supported factorial validity for the three factors of MIDc (situational impact, anticipation, and modulation). Resilience showed negative effects on the MIDc (β = −0.69, SE = 0.04, p < 0.01) and burnout (β = 0.23, SE = 0.06, p < 0.01). Burnout was positively associated with MIDc (β = 0.63, SE = 0.06, p < 0.01) and negatively associated with well-being (β = −0.47, SE = 0.07, p < 0.01). Resilience showed a significant and positive indirect effect (αβγ = 0.203, 95% CI = 0.131 to 0.285) on well-being via MIDc and burnout. The results support a potential mediating role for MIDc as psychological responses in the relationship among resilience and burnout and well-being.

High diabetes-specific distress among adults with type 1 diabetes and impaired awareness of hypoglycaemia despite widespread use of sensor technology.

Impaired awareness of hypoglycaemia (IAH) has been associated with increased diabetes distress and use of sensor technology can reduce diabetes distress. The aim of this study was to examine diabetes-specific distress (emotions, cognitions, behaviours) in relation to IAH status and use of glucose sensors in people with type 1 diabetes. Individuals with type 1 diabetes from an academic diabetes outpatient clinic completed the Clarke questionnaire (to assess hypoglycaemic awareness), Problem Areas in Diabetes (PAID-5), Hypoglycaemia Fear Survey-II (HFS-II), Attitudes to Awareness of Hypoglycaemia Survey (A2A), Nijmegen Clinical Screening Instrument Survey (NCSI) and Hyperglycaemia Avoidance Scale (HAS). Of the 422 participants (51.9% male, diabetes duration 30 [16-40] years, HbA1c 60 ± 11 mmol/mol [7.6 ± 1.0%], 351 [88.2%] used a glucose sensor; 82 [19.4%]) had IAH. Compared to individuals with normal awareness, those with IAH more often had PAID-5 scores ≥8 (35.4% vs. 21.5%, p = 0.008) and higher scores on all HFS-II subscores (total [40.2 ± 21.5 vs. 27.9 ± 17.2, p < 0.001]), HFS-II behaviour (18.5 ± 10.0 vs. 15.1 ± 8.0, p = 0.005), HFS-II worry (21.8 ± 13.5 vs. 12.7 ± 10.9, p < 0.001), HAS worries (17.5 ± 7.3 vs. 14.3 ± 7.0, p < 0.001) and NCSI hypoglycaemia items. HAS behaviour, A2A and NCSI hyperglycaemia scores did not differ between individuals with or without IAH. Restricting the analyses to individuals using a glucose sensor did not materially change the results. Diabetes-specific distress remains a major problem among individuals with type 1 diabetes, particularly those with IAH, despite the widespread use of (intermittently scanned) sensor technology. Further studies are needed to examine strategies to lower diabetes-specific distress in individuals with IAH.

The way you make me feel: an ecological momentary assessment study on couple similarity in sexual arousal and its sexual, relational, and affective correlates.

Although sexual arousal is commonly experienced in the daily context of relationships, most of what we know about sexual arousal comes from studies on individuals, often conducted in a laboratory context. To explore to what extent similarity in levels of sexual arousal during nongenital physical intimacy (ie, cuddling and kissing) was associated with each partner's affect as well as sexual and relationship satisfaction. Ninety-four cohabitating couples (mean ± SD age,26.30 ± 7.60; 88 mixed gender, 6 same gender) completed 6 ecological momentary assessments a day for 10 consecutive days. We used response surface analysis to examine the associations among the degree and direction of similarity in partners' sexual arousal and affective, sexual, and relational outcome variables. Sexual satisfaction, relationship satisfaction, and positive and negative affect. Sexual arousal levels covaried only when partners engaged in physically intimate behaviors, unlike affective responses, which covaried within couples more globally over time. Within-couple similarity at high levels of sexual arousal was positively associated with women's sexual satisfaction but unrelated to men and women's relationship satisfaction and affect. Individual- and couple-level sexual arousal was positively associated with men's sexual satisfaction and women's sexual and relationship satisfaction. Couple-level sexual arousal was relevant to men's affect such that positive affect was higher when sexual arousal levels within the couple were high. Our analyses also revealed a discrepancy effect in that women's positive affect was higher when their own sexual arousal levels were higher than those of their partners. These findings suggest that as long as sexual arousal levels within a couple are sufficiently high, sexual arousal similarity and discrepancy can be beneficial to one's well-being, supporting the relevance of therapeutical techniques aimed at increasing arousal levels to promote a better affective and relational climate for couples. This study is the first to test the daily associations among sexual arousal similarity and its correlates in a sample of cohabitating couples, providing a more comprehensive view of the interpersonal dynamics through which sexual arousal may influence individual, relational, and sexual well-being. Given our sample's relatively young age, as well as high sexual and relationship satisfaction, the results may not generalize to couples experiencing sexual or relational distress. Within the context of daily relationships, individual- and couple-level dynamics of sexual arousal were associated with sexual and relationship satisfaction, as well as with affective responses of relationship partners.

COVID-19 Psikolojik Zorlanma Ölçeği’nin Geliştirilmesi ve Psikometrik Özelliklerinin Değerlendirilmesi

Recent findings indicate that the COVID-19 outbreak is associated with high distress levels. The present study reports the development and psychometric evaluation of the COVID-19 Distress Scale, a fourteen-item self-report measure assessing anxiety, threat perception, and hopelessness related to COVID-19. In Study 1, 626 individuals completed the COVID-19 Distress Scale and established measures of mental health. Exploratory factor analysis suggested a three-factor structure, consisting of anxiety, threat perception, and hopelessness regarding COVID-19. The COVID-19 Distress Scale was internally consistent, had test-retest reliability, concurrent, divergent, and predictive validity. In Study 2, 548 participants completed the COVID-19 Distress Scale. Confirmatory factor analysis supported the three-factor structure of the scale. These results suggest that the COVID-19 Distress Scale is a robust and multidimensional measure for assessing COVID-19 related distress.

Relationship of Temporomandibular Joint Disorders and Psychological Distress in Young Adults

Background: Temporomandibular disorders (TMD) relate to dysfunctions that impact the temporomandibular joint (TMJ), masticatory muscles, and connected structures. Psychological well-being can be among the various factors that TMD affects. Prior studies conducted in different countries have demonstrated a correlation between TMD symptoms and psychological distress in young adults. However, research on this topic is limited in Indonesia. Objective: To assess the association of symptoms of temporomandibular joint disorder and psychological stress in young adults. Materials and Methods: This research employed an analytical cross-sectional design and involved 354 participants (141 males and 213 females) aged 19-21 from Kampus A of Universitas Trisakti. The subjects' general characteristics, including gender, age, and ethnicity, were described. The data were gathered through two types of questionnaires: DC/TMD axis I (Symptom Questionnaire) and axis II (Patient Health Questionaire-PHQ-4), and were analyzed using the Spearman correlation test administered through Google Form. Result: The study's findings revealed that 141 participants (39.8%) were male, while 213 (60.2%) were female. Among the research subjects, 91 individuals - 32 males and 59 females - experienced the most discomfort in the pain category, with the mean PHQ-4 score for pain being the highest at 4.68. The bivariate analysis demonstrated a moderate correlation coefficient value (r = 0.401) and a significant relationship (p 0.05) between temporomandibular disorders (TMD) in the pain category and psychological distress. The prevalence of TMD was 39.8% in males and 60.2% in females. Conclusions: TMD is a common problem among young adults aged 19-21 years, and pain associated with TMD can lead to psychological distress in this age group.

The Role of Resilience as an Emotional Protective Factor to Mental Fatigue During the COVID-19 Lockdown: The Experience of Undergraduate Medical Students in Oman

The impact of COVID-19 on mental health across the globe has been colossal. Student mental health and well- being during the pandemic has caused increasing concern due to the drastic transition to online classes, lowered opportunities for socialization and stress related to COVID-19. The aim of the present study was to explore the prevalence of mental fatigue among undergraduate medical students at the College of Medicine and Health Sciences (COMHS), National University of Science and Technology, Sultanate of Oman and study the impact of resilience as a protective factor during the COVID-19 pandemic. Results indicated that participants experienced mild levels of mental fatigue. Normal levels of resilience capacity were seen among medical students. Significant negative correlation was seen between Mental Fatigue and Resilience. Linear regression analysis indicated that gender was a moderate predictive factor in the experience of mental fatigue. Post-lockdown survey results indicated that medical students continued to experience signs of mental fatigue, though restrictions have eased. They also continued to exhibit normal levels of resilience capacity. Students at the COMHS experienced mild levels of mental fatigue during the pandemic lockdown period. Normal level of resilience capacity effectively contributed as an emotional protective factor. Medical students continue to experience mild levels of mental fatigue, though lockdown restrictions have eased. Enhancing campus-based counselling support services to target COVID-19 related psychological distress and improve resiliency capacity is vital.

Composition and implications of foreign‐language anxiety among American study‐abroad students in Morocco

AbstractIn this study, the foreign‐language anxiety (FLA) of American students of Arabic on three study‐abroad programs in Morocco was examined. Exploratory factor analyses (EFAs) of the students’ data based on items from the Foreign Language Classroom Anxiety Scale yielded four distinct factors, or domains, of FLA: Somatic Distress, Self‐Doubt, Nonengagement, and Apprehension. Although the students had a moderate level of self‐doubt concerning their studies as well as a moderate level of apprehension about being with Arabic L1 users, they tended to report engagement and absence of somatic distress in relation to Arabic. Scores among all four factors differed significantly from each other, apart from the comparison between Self‐Doubt and Apprehension. In addition to having implications for pedagogical practice and study‐abroad programs, this research is an attempt to demonstrate best practice in EFA.

Mediating Roles of Fear of Missing Out and Boredom Proneness on Psychological Distress and Social Media Addiction Among Indian Adolescents.

The closure of schools and other educational institutes around the world has been one of the consequences of the COVID-19 and has resulted in online teaching. To facilitate online teaching, there has been an increase in the use of smartphones and tablets among adolescents. However, such enhancement in technology use may put many adolescents at the risk of problematic use of social media. Consequently, the present study explored the direct relationship of psychological distress with social media addiction. The relationship between the two was also assessed indirectly via the fear of missing out (FoMO) and boredom proneness. A cross-sectional online survey was conducted with 505 Indian adolescents aged 12 to 17years, studying in grades 7 to 12. Standardized tools (with some modifications to suit the context of the present study) were used to collect data. The results showed significant positive associations between psychological distress, social media addiction, FoMO, and boredom proneness. Psychological distress was found to be a significant predictor of social media addiction. Moreover, FoMO and boredom proneness partially mediated the relationships between psychological distress and social media addiction. The present study is the first to provide evidence for the specific pathways of FoMO and boredom proneness in the relationships between psychological distress and social media addiction.

The perceived long-term impact of COVID-19 on OCD symptomology

A pandemic outbreak can lead to excessive, maladaptive levels of anxiety, particularly among individuals who already suffer from obsessive-compulsive disorder (OCD). The Coronavirus Disease 2019 (COVID-19) provided a novel opportunity to examine the possibility that individuals with OCD, compared to those without OCD, might experience greater distress from this common stressor. The present study examined the lasting effects of COVID-19 in the year after the outbreak. Additionally, there is limited research regarding the stability of OCD dimensions; therefore, this study examined whether the COVID-19 pandemic impacted the stability of OCD dimensions. One hundred and forty-three adults who reported they had been diagnosed with OCD and ninety-eight adults without OCD, completed an online survey assessing the impact the COVID-19 pandemic had on symptoms of OCD in the year after the initial outbreak. The OCD group showed greater concern about the pandemic and greater concern about future pandemics compared to the comparison group. In addition, COVID-19 related distress differentially related to OCD symptoms dimensions, showing the strongest association with the contamination dimension. Lastly, results showed that many individuals reported that their OCD dimension shifted to obsessions about COVID-19 from their pre-existing OCD dimension.

HYPERTENSION AND RISK FACTOR TO MORTALITY IN CORONAVIRUS DISEASE (COVID-19)

Objective: the aim of this study is to assess whether hypertension was considered a risk factor for mortality in in adult patients with COVID-19 hospitalized for acute respiratory distress syndrome (ARDS). Design and method: Retrospective study with analysis of electronic medical records of adult patients admitted for mild and moderate COVID-19 and related acute respiratory distress syndrome in a single quaternary private hospital in Rio de Janeiro, Brazil. Consecutive patients aged 18 years and older with COVID-19 confirmed by a positive reverse transcription polymerase chain reaction (RT-PCR) testing. ll data were collected in spreadsheets in Microsoft Excel version 365 (Microsoft Corp., Redmon – WA – USA) and the statistical analysis was performed using SAS Guide 4.3 (SAS Institute Inc., Cary – NV – USA). Results: Two hundred and two patients were were consecutively admitted for mild or moderate COVID-19 related ARDS and were included in this study. The mean age of the studied population was 69.1 ± 14.8 years. Of these, 130 patients (64.4%) were male. The mean BMI was 29.9 ± 6 kg/m2. Hypertension was present in 134 patients, corresponding to 67% of the studied population. 35.8% of patients had diabetes and 10.45% dyslipidemia. Among hypertensive patients, 58 (74%) died, with a relative risk of 1.45 (CI 0.96-2.2) Conclusions: The studies presented systemic arterial hypertension as the most common chronic disease in subjects diagnosed with covid-19. Hypertension is one of the main risk factors for adverse outcomes in subjects with covid-19. The results found in this study suggest that hypertension is associated with an increased risk of developing the severe form of covid-19, and increased mortality. Future studies should include the analysis of individual variables that may influence the outcome of systemic arterial hypertension subjects infected by SARS-CoV-2, such as genetic factors, race/ethnicity, occupation, lifestyle habits, in addition to the evaluation of educational level and diagnosis of the socioeconomic and environmental situation.

Failing categorization of severe COVID-19 ARDS into ventilatory subphenotypes studied via the clinical-histopathologic relationship

BackgroundCategorization of severe COVID-19 related acute respiratory distress syndrome (CARDS) into subphenotypes does not consider the trajectories of respiratory mechanoelastic features and histopathologic patterns. This study aimed to assess the correlation between mechanoelastic ventilatory features and lung histopathologic findings in critically ill patients who died because of CARDS. MethodsMechanically ventilated patients with severe CARDS who had daily ventilatory data were considered. The histopathologic assessment was performed through full autopsy of deceased patients. Patients were categorized into two groups according to the median worst respiratory system compliance during ICU stay (CrsICU). ResultsEighty-seven patients admitted to ICU had daily ventilatory data. Fifty-one (58.6%) died in ICU, 41 (80.4%) underwent full autopsy and were considered for the clinical-histopathological correlation analysis. Respiratory system compliance at ICU admission and its trajectory were not different in survivors and non-survivors. Median CrsICU in the deceased patients was 22.9 ml/cmH2O. An inverse correlation was found between the CrsICU and late-proliferative diffuse alveolar damage (DAD) (r = −0.381, p = 0.026). Late proliferative DAD was more extensive (p = 0.042), and the probability of stay in ICU was higher (p = 0.004) in the “low” compared to the “high” CrsICU group. Cluster analysis further endorsed these findings. ConclusionsIn critically ill mechanically ventilated patients, worsening of the respiratory system compliance correlated pathologically with the transition from early damage to late fibroproliferative patterns in non-survivors of CARDS. Categorization of CARDS into ventilatory subphenotypes by mechanoelastic properties at ICU admission does not account for the complexity of the histopathologic features.

Focus Group Study of Medical Stakeholders to Inform the Development of Resilient Together for Dementia: Protocol for a Postdiagnosis Live Video Dyadic Resiliency Intervention.

Alzheimer disease and related dementias (ADRD) are increasingly common conditions that disrupt the lives of persons living with dementia and their spousal care partners. At the time of ADRD diagnoses, many couples experience challenges that produce emotional distress and relationship strain. At present, there are no interventions to address these challenges early after diagnoses to promote positive adjustment. The study protocol described here is part of the first phase of a larger program of research that aims to develop, adapt, and establish the feasibility of Resilient Together for Dementia (RT-ADRD), a novel dyadic skills-based intervention to be delivered over live video early after diagnosis, with the goal of preventing chronic emotional distress. This study will elicit and systematically summarize perspectives of ADRD medical stakeholders to inform the procedures (eg, recruitment and screening methods, eligibility, timing of intervention, and intervention delivery) of the first iteration of RT-ADRD prior to pilot-testing. We will recruit interdisciplinary medical stakeholders (eg, neurologists, social workers, neuropsychologists, care coordinators, and speech language pathologists) from academic medical center clinics in the departments treating persons living with dementia such as neurology, psychiatry, and geriatric medicine via flyers and word-of-mouth referrals from clinic directors and members of relevant organizations (eg, dementia care collaboratives and Alzheimer disease research centers). The participants will complete electronic screening and consent procedures. Consenting individuals will then participate in a 30- to 60-minute qualitative virtual focus group, held either via telephone or Zoom, using an interview guide designed to assess provider experiences with postdiagnosis clinical care and to gather feedback on the proposed RT-ADRD protocol. The participants will also have the opportunity to participate in an optional exit interview and web-based survey to gather additional feedback. Qualitative data will be analyzed using a hybrid inductive-deductive approach and the framework method for thematic synthesis. We will conduct approximately 6 focus groups with 4-6 individuals in each group (maximum N=30 individuals; until saturation is reached). Data collection began in November 2022 and will continue through June 2023. We anticipate that the study will be completed by late 2023. The results from this study will inform the procedures of the first live video RT-ADRD dyadic resiliency intervention focused on the prevention of chronic emotional and relational distress in couples shortly after ADRD diagnoses. Our study will allow us to gather comprehensive information from stakeholders on ways to best deliver our early prevention-focused intervention and gain detailed feedback on study procedures prior to further testing. DERR1-10.2196/45533.

(215) Design of the ALETTA Clinical Study: A Randomized Double-Blind Placebo-Controlled Study investigating the Efficacy and Safety of LybridoTM in Premenopausal Women with Acquired FSIAD

Abstract Introduction Low sexual desire is the most common sexual complaint in women. As a result, many women suffer from sexual dissatisfaction and related distress which often negatively interferes with their quality of life. Currently, limited drug treatments are available globally to treat women with Hypoactive Sexual Desire Disorder/Female Sexual Interest &amp; Arousal Disorder (FSIAD). Consequently, there is an unmet need, and relevance to developing a drug treatment for women with sexual dysfunction. LybridoTM is a novel on-demand dual-route/dual release fixed-dose combination tablet of sublingual testosterone and oral sildenafil, with the aim to synergistically enhance both central and peripheral processes. It has shown a promising efficacy and safety profile in Phase 2 and is ready for Phase 3 testing. Objective Description of a study design to evaluate two-dose strength and compared to placebo for the treatment of FSIAD Methods A double-blind, randomized, placebo-controlled, 3-arm, 6-month study to evaluate the efficacy and safety of LybridoTM in premenopausal women with acquired FSIAD. An interim analysis will be performed and overseen by an independent Data Monitoring Committee, to re-estimate the sample size according to predefined criteria. Study Population: European premenopausal women, at least 18 years of age, with a clinical diagnosis of acquired FSIAD. Study Duration: Up to 4-week screening period, followed by a 4-week wash-out baseline period, 24-week treatment period, and 4-week safety follow-up period. Interventions: The study drug is a fixed-dose combination tablet consisting of an inner core containing sildenafil with an outer delayed immediate release coating and an additional outer film coating containing testosterone. Two dose strengths will be evaluated and compared with a placebo. Results Primary endpoint: change from baseline to Week 24 in sexual desire assessed by Female Sexual Function Index Desire Domain (FSFI-D) (Items 1 and 2). Secondary efficacy endpoints: sexual distress assessed by Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) score for Item 13; Elements of Desire Questionnaire (EDQ) ‘event-based’ (ie, within 24 hours of a sexual or dosing event); sexual arousal assessed by FSFI Arousal Domain (FSFI-A); sexual function assessed by FSFI total score; sexual distress assessed by FSDS-DOA total score; the number of satisfying sexual events (SSEs) using the Sexual Satisfaction of an Event Questionnaire (SSEQ), reported within 24 hours and assessed relative to the total number of sexual events; patient-reported impression of improvement assessed by the Patient Global Impression of Improvement (PGI-I) Scale; patient-reported impression of severity assessed by the Patient Global Impression of Severity (PGI-S) Scale; and the total number of sexual events. Safety outcomes: frequency of (serious) adverse events. Conclusions First Patient In: Q1 2023; Interim Analysis: Q4 2023; Last Patient Out: Q2 2024. Disclosure Yes, this is sponsored by industry/sponsor: Freya Clarification Industry initiated, executed and funded study Any of the authors act as a consultant, employee or shareholder of an industry for: Freya

(053) The Prevalence of Low Sexual Desire Among Premenopausal Women and Their Wish for Drug Treatment

Abstract Introduction Low female sexual desire (HSDD) is one of the most common sexual complaints in women. As a result, many women suffer from sexual dissatisfaction and related distress, which often negatively interferes with their quality of life. Little is known about the underlying biological mechanism of low desire, but it is conceivable that sexual functions are the result of an interaction between biological, psychological, and relational factors, for which neurological and hormonal central and peripheral processes are involved. Women's sexual desires naturally fluctuate over the years and commonly coincide with the beginning or end of a relationship, health status, medication use, and/or major life events. The treatment approach for females with low sexual desire is aimed at the many causes behind this condition. Recommendations may include sex education, counseling, and sometimes medication and hormone therapy mainly for women who go through menopause or post-menopause. So far no medical therapy for HSDD is available in Europe. While some women movements, such as “right to desire” wish to support the development of drugs for HSDD and reduce the distress associated with HSDD, others are against what they call “the pathologizing of variation in the population” and drug developments. Objective The aim of this survey was to find the prevalence of HSDD among young, premenopausal, social media active women and their willingness to receive medical therapy. Methods A social media survey has been conducted among women between 18 and 50 years old who are regularly using social media apps, in Israel. A country with a mix of cultures, religions, and personal social backgrounds. Women were asked about their sexual desire, current experience with a reduction of their desire for more than 6 months, and the presence of distress. Women who suffer from low desire have been asked about their willingness to receive medical treatment for this condition. Results 4079 women observed the survey but only 1493 (36.6%) answered the questions. 42% (624) stated that they suffer from a decline in desire for a period longer than 6 months, while 49% (727) said they did not suffer from a decline in sexual desire. 9% (142) of the women answered that they didn’t know. On the question: “would you be interested in drug treatment ‘that ’ was asked only to the women who reported a decline in sexual desire, 22% (138) were interested in drug treatment, 40% (249) were not interested in drug treatment, 12% (75)said they don’t know and 26% (162) stated that their wiliness to use a drug for HSDD depended on the risk and benefits. Conclusions HSDD is prevalent even among premenopausal women in a multicultural country. Despite the multifactorial factors involved in the etiology of HSDD, almost half of the women have an interest in using a safe medication for HSDD. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Freya, Besins, Ohhmed.

(433) Exploratory Analysis of Women’s Perception of Flibanserin’s Impact on Their Relationship with Their Partner

Abstract Introduction Most women suffering from HSDD are married or living with a partner. A market research survey of women with self-described low sexual desire and related distress assessed women's attitudes to their low sexual desire and how they perceived their condition impacted their relationship with their partner. Most women responded that they believed their condition negatively impacted some aspect of their relationship with their partner. Flibanserin is approved to treat premenopausal women suffering from HSDD. However, there is limited data on the impact of treatment on partner relationships. This exploratory retrospective analysis was conducted to bridge this knowledge gap. Objective The primary aim of this analysis was to explore if women with HSDD treated with flibanserin perceived changes in their relationship with their partners. Methods Eligible patient and clinician free-text encounter notes (notes) served as the primary data source for this analysis. Eligibility criteria include female, ≥18 years, seen at the clinic between September 1, 2015, and August 31, 2020, a confirmed diagnosis of HSDD or low libido (R68.82 or F52.0), prescribed ≥1 flibanserin prescription through the clinic's electronic health record (EHR) and ≥1 note documenting flibanserin usage. Data were deidentified and extracted from the clinic’s EHR and downloaded into an Excel spreadsheet. The key search terms “partner”, “spouse”, “husband”, “marriage” and “relationship” were used to identify relevant notes. Flibanserin usage dates were compared to relevant note dates to ensure they coincided. Results Over the 5-years study period, 146 women were eligible for inclusion in the analysis. Key search terms were identified in notes of fifteen (10%) women, all with documented positive HSDD treatment responses. Fourteen women had ≥ 1 relevant note that included ≥ 1 perceived positive relationship change, and one woman stated that “flibanserin helped her realize she was not the problem in her relationship". Seven (50%) women with positive changes were premenopausal, 7 (50%) were postmenopausal, and eleven (76%) were on concomitant sexual health-related medications, most notably intravaginal prasterone and testosterone. Positive relationship changes documented during treatment included: partner noticed an improvement in libido (n=5), a happier partner (n=4), more intimate with partner (n=2), better communication in the relationship (n=2), better mood with partner (n=1), partner noticed improvements in premenstrual syndrome (n=1), “now in couples therapy and much better” (n=1). Six (43%) women with positive notes reported ≥1 AE. Five women reported AEs related to CNS depression, and one woman experienced anxiety and depression. These AEs are consistent with those observed among all women treated with flibanserin at the clinic. Conclusions Relationships are complex and subject to multiple personal and interpersonal variables. Therefore, the changes reported here may not be related to flibanserin alone. However, our findings suggest that in some women who experience HSDD treatment benefits, flibanserin may also positively impact their relationship with their partner. Although informative, more extensive studies that consider couple's counseling, concomitant medications, and validated relationship satisfaction surveys are needed to verify these finding. Disclosure No

(497) Is Drug Development for Female Sexual Dysfunction Dead?

Abstract Introduction Various agents have been tested to treat female sexual dysfunction (FSD), particularly Hypoactive Sexual Desire Disorder and Female Sexual Arousal Disorder, but only two, flibanserin and bremelanotide, have met any regulatory standards (US only), and none is popular with patients or prescribers. Several more agents, e.g., sildenafil, testosterone, alprostadil, buspirone, bupropion and trazodone, have shown early promise but have not been developed further. Objective Evaluate whether drug development for FSD at a standstill and identify related factors. Methods Selective literature review using the largest, most high-quality surveys available on factors relating to the proportion of women likely to be treated for FSD and of the factors relating to convenience of the posology and the safety of agents for FSD. Results Surveys show that about 40% of women have sexual dysfunction, but lack of related distress and complicating factors decrease the proportion of women likely to be treated medically for primary FSD to about 0.1%. Such complicating factors include antidepressant use and chronic medical illness that prevent diagnosing primary FSD, lack of awareness, and prescriber reluctance. The posology of the available agents and their side effects may limit benefits and thus acceptance, also. Fear of regulatory rejection amid shifting standards for evaluation of efficacy and diagnostic criteria is an intangible but likely factor stalling drug development for FSD, too. Conclusions Major investment in developing medications for FSD may well have ended. The proportion of women with primary (stand-alone) FSD likely to be treated medically is limited to no more than 0.1% of the population because of low awareness of the diagnosis, lack of willingness to be treated, and lack of prescriber knowledge and willingness to diagnose and prescribe. Benign medications for primary FSD are not available with sufficiently robust efficacy and convenience to break down the barriers of patient and practitioner reluctance toward medical treatment. The lack of marketing success with current agents and the fear of surmounting regulatory hurdles probably have had additional chilling influences on drug development in this field. Developing agents for secondary FSD (FSD comorbid with common chronic medical conditions), e.g., HSDD and/or FSAD in women with the genitourinary syndrome of menopause, diabetes, cancer, depression, and antidepressant users, could help far more women, perhaps 10% of the female population. However, such patients should be expected to be more difficult to treat, might well require multimodal approaches using the biopsychosocial model of FSD. A combination of medication with targeted psychotherapy, couples’ therapy, and/or a mindfulness-based intervention might be necessary. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: S1 Biopharma, Sprout Pharma, Gedeon Richter.

Covid related distress and its impact on mental health a study based on early and late adolescents in Bangalore

The closure of educational institutions and social distancing norms have impacted the life of adolescents. Forced to stay at home, limited interaction with friends and online schooling are some of the factors that have affected their lives. While some researchers believe that the true extent of the impact on the mental health of the adolescent is still not clear, others propose that the impact will only be observable in later stages of their life. In an attempt to understand the impact of the COVID related distress factors on the mental well being of adolescents, the current study collected data from 100 early adolescents and 100 late adolescents. The COVID related distress factors were measured through an instrument designed for the same, while mental well being was measured through depression symptoms and general anxiety levels. The finings of the study identify the particular distress factors that have a significant impact on the mental well-being of adolescents. The findings also identify the factors that are significant in predicting the mental well-being of each category, separately.

Serum levels of vitamin D in preterm neonates and its association with respiratory distress syndrome

Objectives: Prematurity and related respiratory distress syndrome (RDS) is the major cause of mortality among neonates in India. Although some studies were showing an association between vitamin D and lung maturation, conclusive evidence was not found yet. The objective of this study was to assess the serum vitamin D in preterm neonates and to determine its possible association with RDS. Material and Methods: A case–control study in which the preterm neonates &lt;37 weeks of age and &lt;2 kg birth weight admitted to neonatal intensive care unit and in postnatal wards in a tertiary care center were included and divided as cases-those with RDS and controls-those without RDS. Two milliliters of whole blood samples were collected from the study population for 25 (OH) D levels. Results: (1) RDS was predominantly seen in &lt;32 weeks (&lt;30 and 30–31 weeks) when compared with the other two gestational age groups. (2) The mean serum vitamin D levels in cases (RDS) were lower compared to controls (non-RDS) (6.97 ± 3.24 in cases vs. 17.08 ± 4.15 in controls). (3) A significant difference in vitamin D levels was obtained among those on a mechanical ventilator and received surfactant administration compared to those who were not on a mechanical ventilator or administered surfactant (P = 0.001 and 0.003). (4) A significant association between vitamin D and adequacy of maternal vitamin D-rich food intake and sunlight exposure was found to be present (P &lt; 0.001 and 0.018). (5). Serum levels of vitamin D were found to be lower (3.3 ± 1.6 ng/mL) in cases who died during the hospital stay compared to those who survived (8.4 ± 2.6 ng/mL), (P &lt; 0.001). Conclusion: A significant difference in vitamin D concentration between preterms with respiratory distress syndrome and those without RDS was reflected in our study. And we also noted low serum vitamin D levels associated with poor outcome.