Sexual dysfunction among young men : prevalence and associated factors

Les dysfonctions sexuelles représentent une préoccupation importante et parfois mésestimée dans la population masculine générale. L'éjaculation précoce et les dysfonctions érectiles faisant partie des dysfonctions sexuelles les plus fréquentes, nous avons choisi, dans le présent article, de nous concentrer sur ces deux aspects. Selon plusieurs études, la prévalence d'éjaculation précoce se situe entre 17 et 30%. Les associations décrites avec l'éjaculation précoce concernent le stress, la dépression et un jeune âge (<25 ans). La prévalence de dysfonction érectile, quant à elle, oscille entre 2 et plus de 80% dépendant principalement de l'âge. Beaucoup d'autres facteurs associés ont été décrits dans la littérature, tels que le diabète, les pathologies cardiovasculaires ou neurologiques, les médicaments, l'obésité ou l'inactivité physique. Tous ces facteurs étant plus fréquents au sein de populations vieillissantes, nous disposons de peu d'études concernant la dysfonction érectile chez de jeunes hommes. Notre étude propose donc d'évaluer la prévalence d'éjaculation précoce et de dysfonction érectile chez une population de jeunes hommes et d'étudier les associations possibles avec les consommations de substances, l'index de masse corporelle (IMC), l'activité physique ou la santé mentale. Chaque homme suisse entre 18 et 25 ans est appelé à participer à 2 journées de recrutement militaire. De septembre 2010 à mai 2011, les jeunes hommes recrutés à Lausanne et à Zürich (N= 9761) ont été invités à participer à l'étude C-SURF (Cohort Study on Substance Use Risk Factors). 5276 d'entre eux acceptèrent de répondre au questionnaire complet, et 73% (N=3886) le firent de manière effective. Le but de notre recherche étant d'étudier les dysfonctions sexuelles, nous nous sommes concentrés sur les participants sexuellement actifs (N=2507) et les avons divisés en 2 groupes, selon qu'ils présentaient ou non la dysfonction étudiée. Pour chaque dysfonction (éjaculation précoce et dysfonction érectile), nous avons utilisé une analyse bivariée afin de comparer les deux groupes (avec ou sans trouble) quant à d'éventuels facteurs associés. A cause de la nature transversale de l'étude, nous ne pouvions pas postuler de lien de cause à effet entre ces facteurs et les dysfonctions sexuelles, raison pour laquelle nous avons choisi d'utiliser des modèles log-linéaires pour mettre en exergue les associations significatives. Nos résultats montrent une prévalence d'éjaculation précoce de 11.4% avec comme associations principales la consommation de tabac et de drogues illégales (autres que le cannabis). La prévalence des dysfonctions érectiles est quant à elle proche du 30% et s'associe principalement avec l'usage de médicaments, ainsi qu'avec la santé physique et la santé mentale. Un jeune homme suisse sur trois souffre ainsi d'au moins une dysfonction sexuelle. Beaucoup de facteurs compromettants pour la santé y sont possiblement associés, raison pour laquelle les professionnels de la santé devraient saisir chaque occasion pour parler de sexualité avec leurs jeunes patients de sexe masculin.

Cognitive and Emotional Deficits Associated with Minor and Serious Delinquency in High-Risk Adolescents

This study aims at evaluating how minor and serious delinquency relates to cognitive and emotional functioning in high-risk adolescents, taking problematic substance use into account. In 80 high-risk adolescent males (13-19 years), the frequency of minor and serious offences committed over the last year was predicted, in multiple regression analyses, from problematic substance use, intellectual efficiency, trait impulsivity, alexithymia (inability to express feelings in words), and cognitive coping strategies. Both minor and serious delinquency were more frequent in adolescents with more problematic substance use and higher intellectual efficacy. Minor delinquency was further related to a tendency to act out when experiencing negative emotions, and difficulties in focusing energy on instrumental action when under stress; while serious delinquency was predominantly and strongly related to rigid and dichotomous thinking. The results underline the heterogeneous nature of delinquency, minor offences being primarily associated with emotional regulation deficits, while major offences are related with a lack of cognitive flexibility.

Analyse des données migrants du Monitorage suisse des addictions

L'office fédéral de la santé publique (OFSP) a lancé le Monitorage suisse des addictions en 2011 (en anglais : Addiction Monitoring in Switzerland- AMIS). A intervalles réguliers, des données représentatives de la population suisse sont recensées, notamment en ce qui concerne la consommation d'alcool, de tabac, de drogues illégales et de médicaments ainsi que les risques qui lui sont liés. A cet effet, 11'000 personnes âgées de 15 ans et plus sont contactées annuellement pour répondre à un questionnaire. A ce jour, les données de 2011 et 2012 sont disponibles. Dans le cadre du Programme national migration et santé (2008-2013), l'OFSP désire compléter les données disponibles sur la santé des migrants. Ce rapport présente une analyse secondaire des données portant sur les migrants dans le cadre de l'enquête téléphonique continue mentionnée ci-dessus qui a été effectuée auprès de plus de 22'000 personnes de 15 ans et plus, résidant en Suisse en 2011 et 2012.

Gambling among youths in Switzerland and its association with other addictive behaviours: a population-based study.

OBJECTIVE: To assess the prevalence of problem gambling in a population of youths in Switzerland and to determine its association with other potentially addictive behaviours. METHODS: Cross-sectional survey including 1,102 participants in the first and second year of post-compulsory education, reporting gambling, socio-demographics, internet use and substance use. For three categories of gambling (nongambler; nonproblem gambler and at-risk/problem gambler). socio-demographic and addiction data were compared using a bivariate analysis. All significant variables were included in a multinominal logistic regression using nongamblers as the reference category. RESULTS: The prevalence of gamblers was 37.48% (n = 413), with nonproblem gamblers being 31.94% (n = 352) and at-risk/problem gamblers 5.54% (n = 61). At the bivariate level, severity of gambling increased among adults (over 18 years) and among males, vocational students, participants not living with both parents and youths having a low socio-economic status. Gambling was also associated to the four addictive behaviours studied. At the multivariate level, risk of nonproblem gambling was increased in males, older youths, vocational students, participants of Swiss origin and alcohol misusers. Risk of at-risk/problem gambling was higher for males, older youths, alcohol misusers, participants not living with both parents and problem internet users. CONCLUSIONS: One-third of youths in our sample had gambled in the previous year and gambling is associated with other addictive behaviours. Clinicians should screen their adolescent patients for gambling habits, especially if other addictive behaviours are present. Additionally, gambling should be included in prevention campaigns together with other addictive behaviours.

Prevalence of and associated factors for adult attention deficit hyperactivity disorder in young Swiss men.

OBJECTIVE: The present study aimed to measure the prevalence of adult attention deficit hyperactivity disorder (ADHD) in a large, representative sample of young Swiss men and to assess factors associated with this disorder. METHODS: Our sample consisted of 5656 Swiss men (mean age 20 years) who participated in the Cohort Study on Substance Use Risk Factors (C-SURF). ADHD was assessed with the World Health Organization (WHO) adult ADHD Self Report Screener (ASRS). Logistic regression analyses were conducted to assess the association between ADHD and several socio-demographic, clinical and familial factors. RESULTS: The prevalence of ADHD was 4.0%, being higher in older and French-speaking conscripts. A higher prevalence also was identified among men whose mothers had completed primary or high school/university and those with a family history of alcohol or psychiatric problems. Additionally, adults with ADHD demonstrated impairment in their professional life, as well as considerable mental health impairment. CONCLUSION: Our results demonstrate that ADHD is common among young Swiss men. The impairments in function and mental health we observed highlight the need for further support and interventions to reduce burden in affected individuals. Interventions that incorporate the whole family also seem crucial.

Dépendances: nouveautés en médecine 2008 [Addiction]

L'actualité 2008 des dépendances est centrée sur l'avancée des neurosciences psychiatriques dans le domaine des addictions mais aussi sur les clarifications nécessaires face à la complexité des comorbidités psychiatriques des addictions, notamment en cas de schizophrénie. Enfin, le praticien trouvera des considérations utiles pour la prescription de traitements de substitution chez des patients VIH en trithérapie. The highlights 2008 in the addiction field are correlated to the progress of psychiatric neurosciences. Clarifications are also necessary towards the psychiatric comorbidities (schizophrenia) with the addictions. Then, useful considerations are given for the prescription of substitution treatment among HIV patients under tritherapy.

Prevalence of and potential influencing factors for alcohol dependence in europe.

Alcohol use disorders (AUDs), and alcohol dependence (AD) in particular, are prevalent and associated with a large burden of disability and mortality. The aim of this study was to estimate prevalence of AD in the European Union (EU), Iceland, Norway, and Switzerland for the year 2010, and to investigate potential influencing factors. The 1-year prevalence of AD in the EU was estimated at 3.4% among people 18-64 years of age in Europe (women 1.7%, men 5.2%), resulting in close to 11 million affected people. Taking into account all people of all ages, AD, abuse and harmful use resulted in an estimate of 23 million affected people. Prevalence of AD varied widely between European countries, and was significantly impacted by drinking cultures and social norms. Correlations with level of drinking and other drinking variables and with major known outcomes of heavy drinking, such as liver cirrhosis or injury, were moderate. These results suggest a need to rethink the definition of AUDs.

Acute pain in adults admitted to the emergency room: development and implementation of abbreviated guidelines.

AIM: Although acute pain is frequently reported by patients admitted to the emergency room, it is often insufficiently evaluated by physicians and is thus undertreated. With the aim of improving the care of adult patients with acute pain, we developed and implemented abbreviated clinical practice guidelines (CG) for the staff of nurses and physicians in our hospital's emergency room. METHODS: Our algorithm is based upon the practices described in the international literature and uses a simultaneous approach of treating acute pain in a rapid and efficacious manner along with diagnostic and therapeutic procedures. RESULTS: Pain was assessed using either a visual analogue scale (VAS) or a numerical rating scale (NRS) at ER admission and again during the hospital stay. Patients were treated with paracetamol and/or NSAID (VAS/NRS <4) or intravenous morphine (VAS/NRS > or =04). The algorithm also outlines a specific approach for patients with headaches to minimise the risks inherent to a non-specific treatment. In addition, our algorithm addresses the treatment of paroxysmal pain in patients with chronic pain as well as acute pain in drug addicts. It also outlines measures for pain prevention prior to minor diagnostic or therapeutic procedures. CONCLUSIONS: Based on published guidelines, an abbreviated clinical algorithm (AA) was developed and its simple format permitted a widespread implementation. In contrast to international guidelines, our algorithm favours giving nursing staff responsibility for decision making aspects of pain assessment and treatment in emergency room patients.

Consommation d'alcool à risque dans un collectif de patients de la Policlinique médicale universitaire de Lausanne [High risk alcohol consumption in a sample of patients of the Lausanne University Medical Polyclinic].

OBJECTIVES AND METHODS: This study indicates the prevalence, the characteristics, and the screening methods of patients with at risk alcohol drinking at the University Medical Clinic of Lausanne. RESULTS: The results reported demonstrate that one patient out of six is a drinker at risk without criteria for alcohol-dependance. The questionnaire AUDIT (Alcohol Use Disorders Identification Test) with a cut-off of five points seems to be the best screening test for at risk alcohol consumption. CONCLUSIONS: The high prevalence of at risk drinking in this study, combined with scientific evidence of the efficiency of brief interventions in changing drinking habits, emphasises the importance of alcohol screening for all patients attending outpatient medical settings.

A forensic perspective of the AFL investigation into peptides: an antidoping investigation case study.

BACKGROUND: The World Anti-Doping Agency (WADA) is introducing enhancements to doping investigations in its 2015 Code, which include improved sharing of information between antidoping organisations (including sporting bodies) and enhanced accountability of athlete support staff. These additions will improve the control of links between sports doping and organised crime. In February 2013 the Australian Crime Commission released a report that linked several professional sporting codes, professional athletes with links to organised crime, performance enhancing drugs and illicit substances. Following this report the Australian Football League (AFL) partnered the Australian national antidoping organisation to investigate peptide use in Australian football. METHODS: This review compared the model proposed by Marclay, a hypothetical model for anti-doping investigations that proposed a forensic intelligence and analysis approach, to use the forensic capabilities of the AFL investigation to test the model's relevance to an actual case. RESULTS: The investigation uncovered the use of peptides used to enhance athlete performance. The AFL investigation found a high risk of doping where athlete support staff existed in teams with weak corporate governance controls. A further finding included the need for the investigation to provide a timely response in professional team sports that were sensitive to the competition timing. In the case of the AFL the team was sanctioned prior to the finals as an interim outcome for allowing the risk of use of performance-enhancing substances. Doping violation charges are still being considered. DISCUSSION: Antidoping strategies should include the investigation of corporate officers in team doping circumstances, the mandatory recording of all athlete substance use during competition and training phases, the wider sharing of forensic intelligence with non-sporting bodies particularly law enforcement and collaboration between antidoping and sporting organisations in doping investigations. CONCLUSIONS: The AFL investigation illustrated the importance of the 2015 WADA Code changes and highlighted the need for a systematic use of broad forensic intelligence activities in the investigation of doping violations.

Health impact of sport and exercise in emerging adult men: a prospective study.

PURPOSE: Health benefits of sport and exercise are well documented in children, adolescents and adults, but little is known about emerging adulthood-a period of life characterized by significant demographic and developmental changes. The present study aimed to assess the health impact of changes in sport and exercise levels during that specific period of life. METHODS: The analysis used baseline and 15-month follow-up data (N = 4,846) from the cohort study on substance use risk factors. Associations between baseline exercise levels or changes in exercise levels and health indicators (i.e., health-related quality of life, depression, body mass index, alcohol dependence, nicotine dependence and cannabis use disorder) were measured using chi-squared tests and ANOVA. Direction of effects was tested using cross-lagged analysis. RESULTS: At baseline, all health indicator scores were observed to be better for regular exercisers than for other exercise levels. At follow-up, participants who had maintained regular exercise over time had better scores than those who had remained irregular exercisers or had discontinued, but their scores for health-related quality of life and depression were close to those of participants who had adopted regular exercise after the baseline questionnaire. Cross-lagged analysis indicated that regular exercise at baseline was a significant predictor of health-related quality of life and substance use dependence at follow-up, but was itself predicted only by health-related quality of life. CONCLUSIONS: From a health promotion perspective, this study emphasizes how important it is for emerging adult men to maintain, or adopt, regular sport and exercise.

Prendre des risques, ça rapporte ? Conduites à risques et perception des risques chez des adolescents tout-venant

Risk taking and its association with substance use by adolescents are often studied among clinical populations. The behavior of non-clinical adolescent samples is less well-known. According to some scholars, the adoption of risk behaviors can be predicted by a function of perceptions of both benefits and risks of such behaviors. However, the literature is still controversial about their respective significance. In this study, a non-clinical sample of 221 adolescents, aged 14 to 20, completed two questionnaires: the RIPS-R to estimate risk taking behaviors as well as perception of the risks and benefits of such behaviors, and the DEP-ADO to measure substance use. Our results show a high annual prevalence of socially accepted risk behaviors (drinking alcohol, not studying for exams, smoking tobacco). However, socially repressed behaviors (brawling, vandalism) are very occasional and are associated with problematic substance use. Globally, engagement in risk behaviors is more closely linked with the perceptions of its benefits than the perception of its risks. Finally, limitations and implications of these results for research and prevention are provided. Les prises de risques et leur association avec la consommation de substances chez les adolescents ont souvent été étudiées auprès de populations cliniques. Le comportement des jeunes tout-venant est en revanche moins bien connu. Selon certains théoriciens, la participation à des conduites à risques peut être déterminée en fonction des perceptions de leurs bénéfices et dangers potentiels. Toutefois, la littérature ne s'accorde pas sur l'importance respective que ces perceptions revêtent. Dans cette étude, 221 adolescents tout-venant, âgés de 14 à 20 ans, ont complété deux questionnaires : le RIPS-R pour évaluer la prise de risques et leur perception en termes de risques et de bénéfices, et la DEP-ADO pour mesurer la consommation de substances. Les résultats mettent en évidence une prévalence annuelle élevée des comportements à risques socialement acceptables (boire de l'alcool, fumer du tabac). En revanche, les comportements réprimés socialement (bagarres, actes de vandalisme) s'avèrent très occasionnels et sont associés à la consommation problématique de substances. Globalement, c'est la perception des bénéfices qui est le plus fortement liée au fait d'adopter un comportement à risque. Finalement, les limites et les implications pratiques de ces résultats sont discutées. © 2010 Elsevier Masson SAS. Tous droits réservés.

Health-risk behaviors and quality of life among young men.

PURPOSE: To examine the associations between substance use and other health-risk behaviors and quality of life (QOL) among young men. METHODS: The analytical sample consisted of 5,306 young Swiss men who participated in the Cohort Study on Substance Use Risk Factors. Associations between seven distinct self-reported health-risk behaviors (risky single-occasion drinking; volume drinking; cigarette smoking; cannabis use; use of any other illicit drugs; sexual intercourse without a condom; low physical activity) were assessed via chi-square analysis. Logistic regression analyses were conducted to study the associations between each particular health-risk behavior and either physical or mental QOL (assessed with the SF-12v2) while adjusting for socio-demographic variables and the presence of all other health-risk behaviors. RESULTS: Most health-risk behaviors co-occurred. However, low physical activity was not or negatively related to other health-risk behaviors. Almost all health-risk behaviors were associated with a greater likelihood of compromised QOL. However, sexual intercourse without a condom (not associated with both physical and mental QOL) and frequent risky single-occasion drinking (not related to mental QOL after adjusting for the presence of other health-risk behaviors; positively associated with physical QOL) differed from this pattern. CONCLUSIONS: Health-risk behaviors are mostly associated with compromised QOL. However, sexual intercourse without a condom and frequent risky single-occasion drinking differ from this pattern and are therefore possibly particularly difficult to change relative to other health-risk behaviors.

Analyse des données du Dispositif Cantonal d'Indication et de Suivi pour les personnes Toxicodépendantes (DCIST) : 2010-2012

Le Dispositif Cantonal d'Indication et de Suivi pour les personnes Toxicodépendantes (DCIST) est un outil central de la politique de prévention et de lutte contre la toxicodépendance dans le canton de Vaud a. Ses principaux objectifs sont : Améliorer l'adéquation entre l'offre de prestations et les besoins des usagers; Améliorer la coordination des prestations sociales et médicales en développant le travail en réseau, aussi bien dans la prise en charge de l'usager que dans son suivi et son maintien dans le réseau social et médical. Le DCIST a donc pour but de renforcer le rôle du canton de Vaud dans le pilotage et la planification des prestations dans le domaine de l'aide aux personnes dépendantes et s'adresse à toute personne toxicodépendante, avec ou sans problématique d'alcool associée, ayant un projet de prise en charge dans un établissement socio-éducatif (ESE). Le passage par ce dispositif est également un préalable nécessaire à l'octroi d'une garantie financière par le SPAS dans le cadre des séjours résidentiels.