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Despite the high prevalence of sexual dysfunction in patients with schizophrenia, its origins are still unclear.to determine the prevalence and causal factors of sexual dysfunction in a group of outpatients with schizophrenia.The study was designed to be cross-sectional and naturalistic, including outpatients with schizophrenia undergoing second generation antipsychotic monotherapy. Patients receiving antidepressants and/or mood stabilisers were excluded. The following data were recorded: sexual functionality, sociodemographic information, sexual history, psychotic and depressive psychopathology, metabolic syndrome and BMI. Psychotropic-Related Sexual Dysfunction Questionnaire (PR SexDQ-Salsex); Positive and Negative Syndrome Scale; Hamilton Depression Rating Scale; Plasma concentrations of prolactin, testosterone, estradiol, progesterone and the International Diabetes Federation diagnostic criteria for metabolic syndrome, were used to complete the study.Of the 57 patients included in the study, 80% exhibited sexual dysfunction, one-third of which suffered severe levels of dysfunction. However, only 30% of patients spontaneously reported this problem. Although there were significant differences in the prevalence of hyperprolactinemia and metabolic syndrome according to the antipsychotic received, multivariant regression analysis did not show a correlation between sexual dysfunction and prolactin, sexual hormones, type of antipsychotic received, psychotic psychopathology or metabolic syndrome. Sexual dysfunction was only associated with age, civil status and depressive psychopathology.There is a high prevalence of sexual dysfunction in the patients with schizophrenia who participated in the study, but it was only associated with higher age, being single or divorced or having depressive psychopathology; this suggests a multifactorial etiology for sexual dysfunction in schizophrenia.

Introduccion: Las premisas teoricas de larecuperacion cuestionan el concepto kraepeliniano dela psicosis. Asumir la reversibilidad de esta condicionfavorece la incorporacion de tratamientos integradoscon el fin de abordar de forma eficiente las distintasdimensiones que la conforman. Objetivos del estudio:Describir la puesta en marcha de intervenciones grupalesdesde el punto de vista de la recuperacion en personascon psicosis en un dispositivo comunitario de la redpublica. Confirmar la eficacia de dichas intervencionesidentificando los factores clinicos mejorados. Analizarel efecto de las intervenciones terapeuticas prolongadasen la evolucion clinica. Pacientes: 28 personas condiagnosticos incluidos en los codigos CIE-10 (F20-25,F31, F60.0 y F60.1), tradicionalmente relacionadoscon la psicosis. Metodo: Se describe la estructura y elcontenido del grupo, que han sido adaptados al contextode trabajo: Grupo abierto en cuanto a pacientesy profesionales, sesiones quincenales, incorporacionde tecnicas corporales, evolucion hacia la ayuda mutuaetc… Se evalua la situacion clinica mediante lasescalas PANSS y GAF. Resultados: Se objetiva unamejoria significativa a nivel de los sintomas negativosy sociales que se mantiene e incrementa entre lospacientes que continuan en seguimiento a lo largo deltiempo. Discusion: Dichos hallazgos resultan especialmentevaliosos dada la resistencia de las dimensionesemocionales y sociales a los abordajes exclusivamentefarmacologicos. Se plantean lineas de trabajo futuras,las dificultades en la generalizacion de los logros obtenidosen el contexto terapeutico a las actividades dela vida cotidiana y los ensayos que se han puesto enmarcha para vencer dichas trabas. Asimismo se considerala posibilidad de incluir otros instrumentos deevaluacion de naturaleza cualitativa que incluyan lavision subjetiva de los pacientes en su propio proceso.PALABRAS CLAVE: Psicosis, consultas externas, recuperacion,grupo terapeutico. ABSTRACT: Introduction: Theoretical backgroundin recovery confronts the kraepelian concept of psychosis.Considering this condition as reversible involveslooking for more efficient therapies for someof the dimensions.Objectives: Description of the process to start agroup with people with psychosis under the recoveryparadigm in a public health team. Confirmationof the efficacy of group intervention and treatedsymptoms. Analysis of effect of long-term groupintervention.Patients: This work is based on a recovery grouptherapy experience in a community mental healthteam from a public health service in Spain. 28 subjectswere diagnosed of disorders included in ICD-10: F20-25, F31, F60.0 and F60.1 related to psychosis.Method: The study describes structure andcontents of the group and clinical assessment troughPANSS and GAF scales.Results: Negative and social symptoms remarkablyimproved in a progressive way trough the two yearscourse.Discussion: These facts are considered especiallyworthy given their traditionally resistant conditionto an isolated pharmacological assessment. Futurelines of study are drawn. Difficulties in generalizationof results in real framework are discussed. Weare considering new measurement tools includingsubjective and qualitative instruments.KEY WORDS: Psychosis, outpatients, recovery,group therapy

El modelo de la recuperacion se basa en la incorporacion de las propias personas con trastornos mentales de naturaleza psicotica a su proceso de mejoria. Trabajando en este paradigma surge una experiencia denominada plataforma terapeutica que se desarrolla en un dispositivo de salud mental comunitaria publica y que incluye intervenciones multiples, multidisciplinares e integradas con la intencion de fomentar el uso de los recursos sanos de todas las dimensiones identificadas. Los factores referidos cristalizan en una propuesta desde los propios integrantes para iniciar una actividad grupal de baile liderada por uno de ellos en un contexto extra-sanitario con la intencion de fomentar los aspectos sanos sociales y normalizar las actividades al margen de la vivencia de la experiencia psicotica. Se senalan las dificultades desde la institucion y la propia clinica psicotica para llevar a cabo actividades en el paradigma de la recuperacion en encuadres comunitarios y desde la sanidad publica. Recovery model is based on the implication of the people who suffer psychosis in their own improvement process. We propose a therapeutical experience in a Community Mental Health. Team in the Andalusian Health Service. It includes integrated interventions from different professional roles (Social worker, nursery and psychiatrist) to increase healthy areas. This article exposes a 3-year evolution including a self-promoted movement from the users. It includes bodily aspects and mutual self-help. This experience is set in a non-medical environment to promote healthy social aspects and increase experience out from the psychosis. We also remark institutional and clinical difficulties to develop recovery activities in comunnity environment from public health settings.

After previous demonstration of paradoxical GH responses to TRH and oral glucose loading tests in some constitutionally tall adolescents, we studied the effects of a small dose of bromocriptine (5 mg/day) on GH secretion and adult height prediction. In 10 patients, each of whom had a substantial plasma GH increase after TRH injection, bromocriptine reduced or suppressed this abnormal response. In 4 of these patients who also had paradoxical GH increases after glucose loading, bromocriptine suppressed this abnormality in 2. Predicted adult height was reduced in 10 of the 12 patients after 6-12 months of treatment. This reduction resulted either from a decrease in growth velocity, an increase in skeletal maturation rate, or both. Since no side effects were noticed we suggest that bromocriptine may be a valuable alternative to sex steroid treatment to limit final height in excessively tall adolescents.