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Opioid maintenance treatment (OMT) is the most widespread therapy for both females and males opioid addicts. While many studies have evaluated the OMT impact on men’s sexuality, the data collected about the change in women’s sexual functioning is still limited despite the fact that it is now well-known that opioids - both endogenous and exogenous - affect the endocrine system and play an important role in sexual functioning. The present study aims to determine how OMT with buprenorphine (BUP) or methadone (MTD) affects sexual health in women; examining also any possible emerging correlation between sexual dysfunction (SD), type of opioid and patients’ mental health. This multi-center study case recruited 258 female volunteers attending Italian public Addiction Outpatients Centers that were stabilized with OMT for at least 3 months. SD was assessed with the Arizona Sexual Experience Scale. The twelve-item General Health Questionnaire was used to assess participants’ mental health conditions. The results show that 56.6% of women receiving OMT for at least 3 months presented SD without significant differences between MTD e BUP groups. The majority of the subjects with SD have a poorer quality of intimate relationships and worse mental health than the average. To the best of our knowledge, the present study is the largest report on the presence of SDs in women as a side effects of MTD and BUP used in OMT. Since SDs cause difficulties in intimate relationships, lower patients’ quality of life and interfere with OMT beneficial outcomes, we recommend that women undertaking an opioid therapy have routine screening for SD and we highlight the importance to better examine opioid-endocrine interactions in future studies in order to provide alternative potential treatments such as the choice of opioid, opioid dose reduction and hormone supplementation.

Massimiliano Beghi,1,2 Paola Beffa Negrini,1 Cecilia Perin,1,3 Federica Peroni,1,3 Adriana Magaudda,4 Cesare Cerri,1,3 Cesare Maria Cornaggia1,3 1Department of Surgery and Translational Medicine, University of Milano-Bicocca, 2Department of Mental Health, “Guido Salvini” Hospital, Garbagnate Milanese, Milan, Italy; 3Rehabilitation Medicine, Istituti Clinici Zucchi, Carate Brianza, Monza and Brianza, Italy; 4Epilepsy Center, Department of Neuroscience, University of Messina, Messina, Italy Abstract: In Diagnostic and Statistical Manual of Mental Disorders, fifth edition, psychogenic non-epileptic seizures (PNES) do not have a unique classification as they can be found within different categories: conversion, dissociative, and somatization disorders. The ICD-10, instead, considers PNES within dissociative disorders, merging the dissociative disorders and conversion disorders, although the underlying defense mechanisms are different. The literature data show that PNES are associated with cluster B (mainly borderline) personality disorders and/or to people with depressive or anxiety disorders. Defense mechanisms in patients with PNES with a prevalence of anxious/depressive symptoms are of “neurotic” type; their goal is to lead to a “split”, either vertical (dissociation) or horizontal (repression). The majority of patients with this type of PNES have alexithymia traits, meaning that they had difficulties in feeling or perceiving emotions. In subjects where PNES are associated with a borderline personality, in which the symbolic function is lost, the defense mechanisms are of a more archaic nature (denial). PNES with different underlying defense mechanisms have different prognoses (despite similar severity of PNES) and need usually a different treatment (pharmacological or psychological). Thus, it appears superfluous to talk about psychiatric comorbidity, since PNES are a different symptomatic expression of specific psychiatric disorders. Keywords: epilepsy, PNES, defense mechanisms, comorbidity

Starches from six different species (cassava, arrowroot, sweet potato, yam, canna and ginger) were isolated and some structural and physicochemical characteristics analysed and correlated. Phosphorous and amylose contents were determined using a colorimetric method and measuring iodine affinity, respectively. Molecular weight distributions of starches were analysed by Sepharose CL 2B. Granular shape and size distribution were performed using an image analyser system attached to a light microscope. Swelling power was determined at 60, 70, 80 and 90°C. Pasting and thermal properties were measured using a rapid viscoanalyser, and a differential scanning calorimeter, respectively. Phosphorous content varied from 0.007 to 0.031% for cassava and canna starches, respectively. Yam, canna and ginger starches displayed higher amylose contents (32.6, 31.7 and 26.5%, respectively) than cassava, arrowroot and sweet potato starches (19.8, 20.8 and 22.6%, respectively). These last three starches displayed amylose molecules of higher molecular weight than those shown for yam, canna and ginger starches. Canna starch showed higher proportions of longer branch chains of amylopectin than others starches. The size and shape of granules were quite variable among all starches and the average size of granules varied from 13.9 to 42.3 µm for sweet potato and canna, respectively. Swelling power, pasting, and thermal properties were affected by structural characteristics of the starches. [ABSTRACT FROM AUTHOR]