The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.

To describe the sexual health interventions (including sexual counselling and sexual therapy) for patients with chemsex practices in the NGO Apoyo Positivo in Madrid. We describe the main sexual problems.

Descriptive analysis.

The main sexual problems were dissatisfaction in sexual intercourse without substance and difficulties with sexual desire activation (70%); compulsive sexual behaviour (70%), difficulties with sexual orientation and non normative gender expression, difficulties in erection (34%), premature ejaculation (7%) and delayed ejaculation (10%).

Chemsex is a phenomenon that needs a multidisciplinary approach and mental and sexual health must be taken into account. “Sexo, Drogas y Tu” is a model of collaborative approach which is a pioneering intervention developed by an NGO in Spain.

The intentional use of drugs before or during sexual intercourse (chemsex), due to its impact on mental health, is a phenomenon of high importance in men who have sex with men.

We report the case of a patient with polysubstance acute intoxication, including 2C-B, in order to review the evidence about the mechanisms of action of 2C-B, its efects on sexual pleasure, toxicity, patterns of abuse and somatic and mental health related consequences it may present.

Case report and narrative review.

We present the case of a patient using 2C-B as a substance in chemsex practice. As the patient presented in our emergency with psychotic symptoms, he was diagnosed with “stimulant acute intoxication” and “acute psychotic symptoms induced by stimulants”. 2C-B increases dopamine (DA) serotonin (5-HT) and norepinephrine (NE) and cause stimulating and hallucinogenic effects.

MSM is a group vulnerable to the problematic use of drugs in a sexual context. Several mental health problems have been associated with chemsex users such as psychotic sypmptoms, suicidal ideation, encephalopaty, delirium. Polysubstance use is common in chemsex practice and it can be difficult to identify the drugs used in states of acute intoxication but psychiatrists must explore the use of differents drugs from the “classic chemsex drugs” (mephedrone, GHB and metanphetamine) including 2C-B and other substances such as cocaine, MDMA, ketamine, and other cathinones different from mephedrone.

L’évolution du phénomène est observée en croisant plusieurs approches : dispositifs de surveillance sur les phénomènes émergents (TREND) ou les produits nouveaux ou dangereux (SINTES) ; outils de veille sur Internet développés dans le cadre du projet I-Trend (analyse de l’offre et des discours sur les forums, enquête en ligne) ; plus récemment, premières données valides en population générale (baromètre santé).

L’identification de nouvelles molécules se stabilise en France autour de 3 par mois mais s’accélère au plan européen (101 en 2014). Les cannabinoïdes restent majoritaires mais les familles chimiques se diversifient. Les sites de vente se rendent de plus en plus accessibles et sécurisants pour les acheteurs tout en développant des accès vers des espaces plus discrets (deep-web). Les substances observées sur le marché « physique » demeurent peu nombreuses même si leur accessibilité progresse en espace festif. La consommation se développe selon une cinétique plus lente que l’offre, presque uniquement parmi les personnes déjà usagers de drogues. En 2014, 4 % des 18–34 ans auraient consommé un cannabinoïde synthétique. L’offre demeure d’une complexité extrême pour la majeure partie des usagers et la méconnaissance des produits et des risques s’accroît lorsqu’on s’éloigne du noyau des usagers « psychonautes ». Hors milieu festif, l’usage a émergé parmi certains « anciens » héroïnomanes insérés.

Le phénomène « NPS » accélère la mutation du champ vers des usages de plus atomisés, laissant les usagers plus isolés face à la pression d’une offre de plus en plus complexe.

The present paper provides an updated review of both the large number of new/novel/emerging psychoactive substances (NPS) and their associated psychopathological consequences. Focus was here given on identification of those NPS being commented in specialised online sources and the related short-/long-term psychopathological and medical ill-health effects.

NPS have been identified through an innovative crawling/navigating software, called the ‘NPS.Finder®’, created in order to facilitate the process of early recognition of NPS online. A range of information regarding NPS, including chemical and street names; chemical formula; three-dimensional image and anecdotally reported clinical/psychoactive effects, were here made available.

Using the ‘NPS.Finder®’ approach, a few thousand NPS were here preliminarily identified, a number which is about 4-fold higher than those figures suggested by European and international drug agencies. NPS most commonly associated with the onset of psychopathological consequences included here synthetic cannabinoids/cannabimimetics; new synthetic opioids; ketamine-like dissociatives; novel stimulants; novel psychedelics and several prescription and over-the-counter medicines.

The ever-increasing changes in terms of recreational psychotropics' availability represent a relatively new challenge for psychiatry, as the pharmacodynamics and pharmacokinetics of many NPS have not been thoroughly understood. Health/mental health professionals should be informed about the range of NPS; their intake modalities; their psychoactive sought-after effects; the idiosyncratic psychotropics' combinations and finally, their medical and psychopathological risks.

Both neuropsychiatric symptoms (NPS) and psychotropic drug use (PDU) are common in institutionalized People with Young Onset Dementia (PwYOD) and can produce negative outcomes such as reduced quality of life and high workload. In community-dwelling PwYOD, NPS are found to be associated with unmet care needs. This emphasizes the importance of a care program for the management of NPS in institutionalized PwYOD that also addresses unmet care needs and PDU. The objectives of the Behavior and Evolution of Young ONset Dementia part 2 (BEYOND-II) study are to develop a care program for the management of NPS in institutionalized PwYOD and to evaluate its effectiveness.

The care program consists of an educational program combined with an intervention to manage NPS with the following five steps: the evaluation of psychotropic drug prescription, detection, analysis (including the detection of unmet needs), treatment and the evaluation of NPS. A stepped wedge design will be used to evaluate its effectiveness. The primary outcomes are agitation and aggression and other NPS. The secondary outcomes are PDU, quality of life, the workload of nursing staff and job satisfaction. Additionally, a process analysis and a cost-consequence analysis will be conducted.

The study protocol of the Beyond-II study describes the development, implementation and evaluation of a care program for the management of NPS in institutionalized PwYOD. This care program provides a structured method for the management of NPS, in which unmet needs and PDU are also addressed.

Neuropsychiatric symptoms (NPS) have a high prevalence among patients with dementia, up to 80%. NPS can be grouped by type and stage of dementia. However, NPS have not previously been grouped by gender. Our objective was to investigate whether NPS cluster differently in men or women in the nursing home patients.

Factor analysis to assess the clustering of items in the Cohen-Mansfield Agitation Inventory (CMAI) and Neuropsychiatric Inventory-Nursing home version (NPI-NH) into components, for both scales and for gender. Differences in symptom clustering between male and female patients were assessed using a three-step procedure: (1) identifying a gender specific distinctive item, (2) describe the correlation between the distinctive item with any other item in this cluster, (3) testing whether the correlation between a distinctive item and any other item in the cluster (which is present in both sexes) is different for males and females using a general linear model.

Our database consisted of 1,609 patients. There were five male and three female clusters for NPI-NH and eight male and seven female clusters for CMAI. There were three distinctive items in the NPI-NH and ten in the CMAI.

There are other clusters of NPS in males and females. Our analysis revealed more significant relations in female than male patients. This might have an implication on the clinical course.