While researchers and physicians can see the presence of abnormalities associated with schizophrenia in the brain by using Magnetic Resonance Imagery (MRI) and Magnetic Resonance Spectroscopy (MRS), there’s no real test for diagnosing the mental illness. In other words, if you are at risk for diabetes, doctors have definitive tests they can use to predict your risk and to monitor progression of the disease, if already present. Nothing like this exists for predicting and monitoring schizophrenia. (See: Early Warning Signs of Schizophrenia.)

Even so, the schizophrenia brain scans produced by sophisticated machines, like the MRIs and MRSs mentioned above, indicate structural differences in certain areas of the brain of affected people.

Abnormalities in the Schizophrenic Brain

Brain scans and microscopic tissue studies indicate a number of abnormalities common to the schizophrenic brain. The most common structural abnormality involves the lateral brain ventricles. These fluid-filled sacs surround the brain and appear enlarged in images of the brains of those with schizophrenia.

Neuroscientists from the National Institutes of Mental Health (NIMH) and other schizophrenia researchers report seeing up to 25 percent loss of gray matter in certain areas of the schizophrenic brain. Gray matter refers to certain areas of the brain involved in hearing, speech, memory, emotions, and sensory perception. The studies found that patients who had the most severe schizophrenia symptoms also had the highest loss of brain tissue.

Although significant brain tissue loss is a reason for concern, researchers have reason to believe that the loss of gray matter could be reversible. Researchers are working on drug studies, investigating new drugs that doctors can prescribe to reverse cognitive function loss associated with schizophrenia.

Hope from Scans of Schizophrenia in the Brain

Imaging scans of schizophrenia in the brain have helped researchers locate a small area of the brain that may help them predict whether people will develop schizophrenia with 71 percent accuracy for high-risk patients. The study results, which appear in the September 2009 issue of Archives of General Psychiatry, pinpoint the exact area of a part of the brain that shows hyperactivity in schizophrenics.

The researchers used high-resolution MRI equipment to show what areas of the brain are affected by schizophrenia. The scientists discovered three areas of the schizophrenic brain that differed from normal brains – two areas in the frontal lobes and one very small area of the hippocampus, known as CA1. We’ve always known that schizophrenics have a more active hippocampus, the area used for memory and learning, but this study pinpoints the exact spot of hyperactivity in patients with the illness.

This discovery brings new hope and promise to those at risk for developing a schizophrenic brain and for those already suffering from it. Doctors hope that once researchers further develop the findings, that they can use this as a diagnostic marker to predict whether certain high-risk patients will go on to develop full-blown psychosis after prodrome. They also hope to use the CA1 subfield marker in the hippocampus to indicate the efficacy of treatments. For example, a decreased amount of activity in the area could indicate the success of treatment strategies.

To view some interesting brain images of schizophrenia, along with associated explanations, click here. On the page, you’ll find links to MRI images showing the disease progression, a three-dimensional map of schizophrenic gene activity, and more.

article references

While sex is an arousing and stimulating activity, it seems to cause a drop in body temperature, which makes it easier to fall asleep. Sex also appears to induce a deep sleep. Experts usually discourage exercise within a few hours of bedtime because exercise can be stimulating and actually make it harder to fall asleep, but the physical activity of sex seems to be a positive exception to that rule.

Bind my ankles with your white cotton rope so I cannot walk. Bind my wrists so I cannot push you away. Place me on the bed and wrap your rope tighter around my skin so it grips my flesh. Now I know that struggle is useless, that I must lie here and submit to your mouth and tongue and teeth, your hands and words and whims. I exist only as your object. Exposed.

Of every 10 people who reads these words, one or more has experimented with sadomasochism (S & M), which is most popular among educated, middle- and upper-middle-class men and women, according to psychologists and ethnographers who have studied the phenomenon. Charles Moser, Ph.D., M.D., of the Institute for Advanced Study of Human Sexuality in San Francisco, has researched S & M to learn the motivation behind it--to understand why in the world people would ask to be bound, whipped and flogged. The reasons are as surprising as they are varied.

For James, the desire became apparent when he was a child playing war games--he always hoped to be captured. "I was frightened that I was sick," he says. But now, he adds, as a well-seasoned player on the scene, "I thank the leather gods I found this community."

At first, the scene found him. When he was at a party in college, a professor chose him. She brought him home and tied him up, told him how bad he was for having these desires, even as she fulfilled them. For the first time, he felt what he had only imagined, what he had read about in every S & M book he could find.

James, a father and manager, has a Type A personality--in-control, hard-working, intelligent, demanding. His intensity is evident on his face, in his posture, in his voice. But when he plays, his eyes drift and a peaceful energy flows through him as though he had injected heroin. With each addition of pain or restraint, he stiffens slightly, then falls into a deeper calm, a deeper peace, waiting to obey his mistress. "Some people have to be tied up to be free," he says.

As James' experience illustrates, sadomasochism involves a highly unbalanced power relationship established through role-playing, bondage, and/or the infliction of pain. The essential component is not the pain or bondage itself, but rather the knowledge that one person has complete control over the other, deciding what that person will hear, do, taste, touch, smell and feel. We hear about men pretending to be little girls, women being bound in a leather corset, people screaming in pain with each strike of a flogger or drip of hot wax. We hear about it because it is happening in bedrooms and dungeons across the country.

For over a century, people who engaged in bondage, beatings, and humiliation for sexual pleasure were considered mentally ill. But in the 1980s, the American Psychiatric Association removed S & M as a category in its Diagnostic and Statistical Manual of Mental Disorders. This decision--like the decision to remove homosexuality as a category in 1973--was a big step toward the societal acceptance of people whose sexual desires aren't traditional, or vanilla, as it's called in S & M circles.

What's new is that such desires are increasingly being considered normal, even healthy, as experts begin to recognize their potential psychological value. S & M, they are beginning to understand, offers a release of sexual and emotional energy that some people cannot get from traditional sex. "The satisfaction gained from S & M is something far more than sex," explains Roy Baumeister, Ph.D., a social psychologist at Case Western Reserve University. "It can be a total emotional release."

Although people report that they have better-than-usual sex immediately after a scene, the goal of S & M itself is not intercourse: "A good scene doesn't end in orgasm, it ends in catharsis."

S & M: No Longer A Pathology

"If children at [an] early age witness sexual intercourse between adults ... they inevitably regard the sexual act as a sort of ill-treatment or act of subjugation: they view it, that in a sadistic sense."--Sigmund Freud, 1905

Freud was one of the first to discuss S & M on a psychological level. During the 20 years he explored the topic, his theories crossed each other to create a maze of contradictions. But he maintained one constant: S & M was pathological.

People become masochistic, Freud said, as a way of regulating their desire to sexually dominate others. The desire to submit, on the other hand, he said, arises from guilt feelings over the desire to dominate. He also argued that the desire for S & M can arise on its own when a man wants to assume the passive female role, with bondage and beating signifying being "castrated or copulated with, or giving birth."

The view that S & M is pathological has been dismissed by the psychological community. Sexual sadism is a real problem, but it is a different phenomenon from S & M. Luc Granger, Ph.D., head of the department of psychology at the University of Montreal, created an intensive treatment program for sexual aggressors in La Macaza Prison in Quebec; he has also conducted research on the S & M community. "They are very separate populations," he says. While S & M is the regulated exchange of power among consensual participants, sexual sadism is the derivation of pleasure from either inflicting pain or completely controlling an unwilling person.

Lily Fine, a professional dominatrix who teaches S & M workshops across North America, explains: "I may hurt you, but I will not harm you: I will not hit you too hard, take you further than you want to go or give you an infection."

Despite the research indicating that S & M does no real harm and is not associated with pathology, Freud's successors in psychoanalysis continue to use mental illness overtones when discussing S & M. Sheldon Bach, Ph.D., clinical professor of psychology at New York University and supervising analyst at the New York Freudian Society, maintains that people are addicted to S & M. They feel compelled to be "anally abused or crawl on their knees and lick a boot or a penis or who knows what else. The problem," he continues, "is that they can't love. They are searching for love, and S & M is the only way they can try to find it because they are locked into sadomasochistic interactions they had with a parent."

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Linking Childhood Memories And Adult Sex

"I can explore aspects of myself that I don't get a chance to explore otherwise. So even though I'm playing a role, I feel more connected with myself."--Leanne Custer, M.S.W., AIDS counselor

Meredith Reynolds, Ph.D., the Sexuality Research Fellow of the Social Science Research Council, confirms that childhood experiences may shape a person's sexual outlook.

"Sexuality doesn't just arise at puberty," she says. "Like other pans of someone's personality, sexuality develops at birth and takes a developmental course through a person's life span."

In her work on sexual exploration among children, Reynolds has shown that while childhood experiences can indeed influence adult sexuality, the effects usually "wash out" as a person gains more sexual experience. But they can linger in some people, causing a connection between childhood memories and adult sexual play. In that case, Reynolds says, "the childhood experiences have affected something in the personality, and that in turn affects adult experiences."

Reynolds' theory helps us develop a greater understanding of the desire to be a whip-bearing mistress or a bootlicking slave. For example, if a child has been taught to feel shame about her body and desires, she may learn to disconnect herself from them. Even as she gets older and gains more experience with sex, her personality may retain some part of that need for separation. S & M play may act as a bridge: Lying naked on a bed bound to the bedposts with leather restraints, she is forced to be completely sexual. The restraint, the futility of struggle, the pain, the master's words telling her she is such a lovely slave--these cues enable her body to fully connect with her sexual self in a way that has been difficult during traditional sex.

Marina is a prime example. She knew from the time she was 6 years old that she was expected to succeed in school and sports. She learned to focus on achievement as a way to dismiss emotions and desires. "I learned very young that desires are dangerous," she says. She heard that message in the behavior of her parents: a depressive mother who let her emotions overtake her, and an obsessively health-conscious father who compulsively controlled his diet. When Marina began to have sexual desires, her instinct, cultivated by her upbringing, was to consider them too frightening, too dangerous. "So I became anorexic," she says. "And when you're anorexic, you don't feel desire; all you feel in your body is panic."

Marina didn't feel the desire for S & M until she was an adult and had outgrown her eating disorder. "One night I asked my partner to put his hands around my neck and choke me. I was so surprised when those words came out of my mouth," she says. If she gave her partner total control over her body, she felt, she could allow herself to feel like a completely sexual being, with none of the hesitation and disconnection she sometimes felt during sex. "He wasn't into it, but now I'm with someone who is," Marina says. "S & M makes our vanilla sex better, too, because we trust each other more sexually, and we can communicate what we want."

Escaping the Modern Western Ego

"Like alcohol abuse binge eating and meditation, sadomasochism is a way people can forget themselves." Roy Baumeister, Ph.D., professor of psychology, Case Western Reserve University

It is human nature to try to maximize esteem and control: Those are two general principles governing the study of the self. Masochism runs contrary to both, and was therefore an intriguing psychological puzzle for Baumeister, whose career has focused on the study of self and identity.

Through an analysis of S & M-related letters to the sex magazine Variations. Baumeister came to believe that "masochism is a set of techniques for helping people temporarily lose their normal identity." He reasoned that the modern Western ego is an incredibly structure, with our culture placing more demands on the self than any other culture in history. Such high demands increase the stress associated with living up to expectations and existing as the person you want to be. "That stress makes forgetting who you are an appealing escape," Baumeister says. That is the essence of "escape" theory, one of the main reasons people turn to S & M.

"Nothing matters except you, me and the sound of my voice," Lily Fine tells the tied-up and exposed businessman who begged to be spanked before breakfast. She says it slowly, making her slave wait for every sound, forcing him to focus only on her, to float in anticipation of the sensations she will create inside him. Anxieties about mortgages and taxes, stresses about business partners and job deadlines are vanquished each time the flogger hits the flesh. The businessman is reduced to a physical creature existing only in the here and now, feeling the pain and pleasure.

"I'm interested in manipulating what's in the mind," Lily says. "The brain is the greatest erogenous zone."

In another S & M scene, Lily tells a woman to take off her clothes, then dresses her only with a blindfold. She commands the woman not to move. Lily then takes a tissue and begins moving it over the woman's body in different patterns and at varying speeds and angles. Sometimes she lets the edge of the tissue just barely brush the woman's stomach and breasts; sometimes she bunches the tissue and creates swirls on her back and all the way down. "The woman was quivering. She didn't know what I was doing to her, but she was liking it," Lily remembers with a smile.

Escape theory is further supported by an idea called "frame analysis," developed by the late Irving Goffman, Ph.D. According to Goffman, despite its popular conception as darkly wild and orgiastic, S & M play has complex rules, rituals, roles and dynamics that create a "frame" around the experience.

"Frames suspend reality. They create expectations, norms and values that set this situation apart from other parts of life," confirms Thomas Weinberg, Ph.D., a sociologist at Buffalo State College in New York and the editor of S & M: Studies in Dominance & Submission (Prometheus Books, 1995). Once inside the frame, people are free to act and feel in ways they couldn't at other times.

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S & M: Part of the Sexual Continuum

S & M has inspired the creation of many psychological theories in addition to the ones discussed here. Do we need so many? Perhaps not. According to Stephanie Saunders, Ph.D., associate director of the Kinsey Institute for Research in Sex, Gender and Reproduction at Indiana University, "a lot of behaviors that are scrutinized because they are seen to be marginal are really a part of the continuum of sexuality and sexual behavior."

After all, the ingredients in good S & M play--communication, respect and trust--are the same ingredients in good traditional sex. The outcome is the same, too--a feeling of connection to the body and the self.

Laura Antoniou, a writer whose work on S & M has been published by Masquerade Books in New York City, puts it another way: "When I was a child, I had nothing but S & M fantasies. I punished Barbie for being dirty. I did Bondage Barbie, dominance with GI Joe. S & M is simply what turns me on."

READ MORE ABOUT IT

Screw the Roses, Send Me the Thorns: The Romance and Sexual Sorcery of Sadomasochism, Philip Miller and Molly Devon (Mystic Rose Books, 1995)

S & M: Studies In Dominance and Submission, Thomas S, Weinberg, editor (Prometheus Books, 1995)

Dark Eros: The Imagination of Sadism, Thomas Moore (Spring Publications, 1996)

RELATED ARTICLE: Whip Smart: Beyond the Boundaries of Safe Play

While S & M can be a psychologically healthy activity--its motto is "safe, sane and consensual"--sometimes things do get out of hand:

Abuse It is rare, but some "Tops" get too involved in power and forget to monitor their treatment of the "Bottom." "I call them 'Natural Born Tops,'" says dominatrix Lily Fine, "and I don't have time for them." Also, some bottoms want to be beaten because they have low self-esteem and think they deserve it. They are forlorn, absent and unresponsive during and after a scene, in this case, S & M ceases to be play and becomes pathological.

Boundaries A small percentage of people inappropriately bring S & M power play into other facets of their life. "Most people in S & M circles are dominant or submissive in very specific situations, while in their everyday life they can play a whole range of roles," says psychology Professor Luc Granger. But, he continues, if the only way a person can relate to someone else is through a kind of sadomasochistic game, then there is probably a deeper psychological problem.

The Use of S & M as Therapy People often confuse the fact that they feel good after S & M with the idea that S & M is therapy, says psychology Professor Roy Baumeister. "But to prove that something is therapeutic, you have to prove that it has lasting beneficial effects on mental health ... and it's hard to prove even that therapy is therapeutic." In mental health terms, S & M doesn't make you better and it doesn't make you worse.

RELATED ARTICLE: Excerpts from an S & M Glossary

Sadomasochism (S & M): An activity involving the temporary creation of highly unbalanced power dynamics between two or more people for erotic or semi-erotic purposes.

Bondage and Discipline (B & D): A subset of S & M not involving physical pain.

Top: The dominant person in a scene; synonyms: dominant, dom, master/mistress.

Bottom: The submissive person in a scene; synonyms: submissive, sub, slave.

Switch: A person who enjoys being a Top in some scenes and a Bottom in others.

Sadist: A person who derives sexual pleasure from inflicting pain on others.

Masochist: A person who derives sexual pleasure from being abused by others. Sadist and masochist are sometimes used playfully in the S & M community but are generally avoided because of psychiatric denotation.

Scene: An episode of S & M activity; the S & M community.

Negotiating a Scene: The process of loosely outlining what the players want to experience before they begin a scene.

Play: participation in a scene.

Toy: Any implement used to enhance S & M play.

Safe Word: A prearranged word or phrase that may be used to end or renegotiate a scene. This is a clear signal meaning "Stop, this is too much for me."

Dungeon: A place designated for S & M play.

Dominatrix (pl. Dominatrices): A female Top, usually a professional.

Lifestyle Dominant/Submissive: A person involved in a relationship in which S & M is a defining dynamic.

Fetish: An object that is granted special powers, one of which is the ability to sexually gratify. It is often wrongly confused with S & M.

Vanilla Sex: Conventional heterosexual sex.

About the author: Marianne Apostolides is author of Inner Hunger: A Young Women's Struggle through Anorexia and Bulimia (W..W. Norton, 1996).

What makes oral sex so appealing and what are the most common fears about it? What are the names for oral sex and how to talk about it. Learn what not to do and what to do if you feel embarrassed about oral sex

Oral sex

Oral sex features in many of our fantasies, but for lots of people it's still taboo. Relationships counselor Suzie Hayman looks at the deep-seated reasons we shy away from even suggesting this intimate act, and puts forward sensitive ways to approach the subject.

Common fears

Some people are reluctant to try oral sex, or even to suggest it, because they fear rejection. Disgust also plays a part, as lots of men and women are brought up to consider their genitals to be unsavory.

Women might be convinced their partners will find their labia too big, too wrinkled or too hairy; men, that they'll be laughed at for not being sufficiently big, upright or straight.

Both may be scared the other will object to the smell or the taste, and that they'll feel vulnerable if they surrender themselves to being given pleasure by their partner.

But the truth is that many people would really like to offer to perform oral sex for their partner. (If you find it hard to raise the subject, try the exercises on, 'I'd like you to...')

What makes oral sex so appealing?

The fact that this form of pleasure is still seen by some as forbidden, and even a bit dirty, adds excitement. When your partner chooses to be in such intimate contact, it's like being told that, far from being unattractive, you're good enough and special enough to eat. It can feel like the ultimate expression of acceptance.

There's something irresistible about being treated in this way. Even though you can do it to each other at the same time, it's usually a case of one person lying back and having all their desires and needs attended to.

The mouth, lips, and tongue have a dynamite combination of flexibility and softness that can't help but please. You can kiss, lick, suck or nibble. Some people prefer gentle movements; others prefer firmer attention. It's up to you to discover your particular preferences together.

Talk about it

Discussing your concerns with your partner can really help. For example, if one person is happy to perform oral sex but refuses to receive it, the other might end up feeling guilty, because he's unable to return the pleasure he experiences to his partner, as well as rejected and untrusted.

Of course, it could be that the first partner is afraid to let him see, taste, smell and touch her, and perhaps simply needs to hear in no uncertain terms, "I love your body. I'd give anything to taste you."

Don't cover up

If you'd like to try oral sex with your partner, it's only courteous to make sure you're clean first. But don't forget that the natural taste and smell of your body may well be what attracts them the most, so don't cover up with perfumes or deodorant.

Many people are turned on by the sight, taste and smell of their partner's most intimate parts. If it's a new partner, it's advisable to use a condom or dental dam (thin latex that lines the mouth) to screen secretions and prevent infection.

If you feel embarrassed

Try it after a bath or shower. When you're clean and fresh, you'll feel more comfortable. Worried about the way you look? Dimming the lights and lighting candles can boost your confidence.

Names for oral sex

• Oral sex is often known as a sioxante-neuf or sixty-nine, because of the shape two bodies make when lying mouth-to-genitals.
• When one person performs oral sex on another, this is sometimes called a 'sixty-eight' ("You do me and I'll owe you one").
• Stimulation of the vagina with the mouth is called cunnilingus; stimulation of the penis with the mouth is called fellatio.

What not to do

Although oral sex is known as a 'blow job', the one thing you should never do is blow into your partner's body. You could cause an embolism (obstruction of an artery by an air bubble) or infection. But many people like their partner to blow gently on skin made damp by licking.

Related Information:

• Fantasies
• G-spot
• Orgasms
• Aphrodisiacs: Facts and Fantasies

• What is ecstasy
• Street names of ecstasy
• How is ecstasy taken?
• Effects of ecstasy
• Dangers of ecstasy
• Is ecstasy addictive?

What is ecstasy?

• Ecstasy is the chemical methyldioxymethamphetamine, or MDMA.
• MDMA is a synthetic substance that has both stimulant and hallucinogenic effects.

Street Names

• "X," "E," XTC, MDMA, "love drug," "hug drug," or Adam

How is it taken?

• Ecstasy comes in pill form or liquid form "Liq.X".
• It is taken orally.

What are the effects?

Physical effects include:

• Ecstasy is a stimulant.
• It lasts for four to six hours.
• It increases heart rate and blood pressure.
• It causes muscle tension, involuntary teeth clenching, nausea, blurred vision, feeling faint, tremors, rapid eye movement, and sweating or chills.

Mental effects include:

• It creates feelings of euphoria, empathy and altered social perceptions.
• It causes a heightened sense of awareness.
• It causes feelings of increased empathy or emotional closeness to others.
• It induces a state characterized as "excessive talking" (loquacity).

What are the dangers?

• Anxiety.
• Hyperthermia.
• Memory loss.
• Cognitive impairment.
• Respiratory distress.
• Psychological dependency.
• Physical exertion (such as rave partying) that can lead to heat exhaustion.
• Long-term neurochemical and brain cell damage.
• Illegal to possess in the United States.

Is it addictive?

Repeated use of ecstasy can produce dependence and withdrawal symptoms. Several studies have shown that users of ecstasy may develop an addiction.

Do aphrodisiacs really work? Learn what foods are believed to have aphrodisiac qualities; learn about fast boosts and slow effects of aphrodisiacs. Also sexy food and a warning about Spanish Fly.

Aphrodisiacs

Certain special foods and drinks are said to enhance sexual desire but do they work? Sex and relationships counselor Suzie Hayman looks at the facts and fantasies behind aphrodisiacs - and warns that some could actually have far from the desired effect.

Foods believed to have aphrodisiac qualities

Rhino horn is said to make men sexually unstoppable, and asparagus, bananas, eels, oysters, figs and ginseng are all reputed to get you going.

Most of these foods are believed to have aphrodisiac qualities because of their smell, taste or appearance. This is based on the idea of 'sympathetic magic'. Rhino horn, asparagus, bananas, eels are all phallic in shape. Believers hope that, by eating them, they will make their members similarly firm, long and strong. Oysters and figs smell or look like a woman's vulva or vagina when she is aroused. By slurping and swallowing them, diners hope their sexual parts will become just as plump, slippery and tasty.

Hot foods such as onions, ginger and pepper are thought to be effective because they make you hot and sweaty, with the flushed appearance of sexual excitement. And any sweet or spicy taste puts you in a relaxed, pampered state of mind, ready for further indulgence.

So, do aphrodisiacs work?

In a word, no. None of these substances, nor any other you might hear of, works in the way aphrodisiacs are said to. They can't affect your sexual organs or sexual desires to make you more aroused, desiring, desirable or long-lasting in bed. But suggestion can be a powerful thing, and using aphrodisiac foods or drinks as part of your seduction technique can add to your sex life and spice up your relationship in several ways.

Fast boosts and slow effects

Some substances obviously have an immediate effect on our moods. A small amount of alcohol relaxes you emotionally and physically. It increases your confidence, as well as opening small blood vessels, making you feel flushed and warm. Caffeine and sugar will give you a quick boost, too, making you feel energetic and ready for action.

On the whole, however, what we eat and drink long-term has a greater effect. A healthy diet with plenty of fish and fresh vegetables will have a genuine benefit, increasing your well-being and so your sexual desires and abilities

Sexy food

If you really want to give your lover the message, invite them to prepare a meal with you. Choose foods you both like that you can eat by hand and feed each other across the table. (For more ideas see Make an aphrodisiac meal.)

A dozen oysters or quail's eggs with champagne, followed by asparagus and a platter of exotic fruit, vegetables and cheese, followed with figs and chocolate, can leave lovers feeling cherished and in the mood to carry on spoiling each other.

Ancient aphrodisiacs

Most of the ancient books on the arts of love include recipes that claim to make users "strong for the act of love and disposed to lying together".

'The Perfumed Garden', a 16th-century treatise, says onion seeds and honey, peas boiled with onions and spiced with cinnamon and ginger, cardamom, honey, almonds and pine nuts are all effective aphrodisiacs.

'The Kama Sutra' suggests a ram's or goat's testicle boiled in sweetened milk, and sparrows' eggs and rice with butter and honey.

A warning about Spanish fly

Spanish fly, a substance made from the dried-out bodies of beetles, is reputed to be a powerful sexual aid. Taken as a powder, solution or tablet, it's understood to heat up the sexual organs and make you insatiable. On the contrary, Spanish fly is toxic and can actually be dangerous.

Spanish fly works by irritating the water passages in the bladder. Instead of a nice feeling of warmth, it can cause an extremely unpleasant pain and the inflammation can lead to long-term damage.

Related Information:

• Make an Aphrodisiac Meal
• Have You Gone Off Sex?
• Get to Know Your Body
• Emergency Contraception
• Communicating About Sex

Prognosis is the expected outcome for someone living with schizoaffective disorder or any other illness. It’s a prediction of how well someone will do over time. If you’re living with schizoaffective disorder, you have a good chance of getting better.

Schizoaffective disorder prognosis is good. People with this psychotic disorder can and often do improve. In fact, a significant portion of people who have been diagnosed with this disorder and are receiving treatment improve. Nearly half of people with schizoaffective disorder are in remission approximately five years after diagnosis and about 25% function well socially for two-year stretches.

Prognosis is determined by comparing the outcome of one disorder to other, similar, disorders. There are other factors at work, too.

Prognosis of Schizoaffective Disorder vs. Other Disorders

Of all the psychotic disorders, schizoaffective disorder has one of the best outcomes. Among people living with other psychotic disorders, including schizophrenia, it is those with schizoaffective disorder that have the highest chance of regaining their previous level of functioning.

Part of the reason for this is that the entire course of schizoaffective disorder is intermediary. It involves periods of remission occurring between periods of symptoms. Schizophrenia, by contrast, isn’t as cyclical and the likelihood is less that someone will have significant periods of remission.

However, when broken down into components, the picture is not so clear. For example, looking at a single aspect of functioning, being able to hold stable employment, people with either schizoaffective disorder or schizophrenia have a less positive predicted outcome than anyone who doesn’t live with these disorders.

The prognosis for schizoaffective disorder is favorable when compared with other psychotic disorders. Because it has components of mood disorders though, it also must be compared to major depressive disorder and bipolar disorder. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), mood disorders have a better prognosis than schizoaffective disorder.

People experience schizoaffective disorder differently. Some have more psychotic symptoms than mood symptoms, while others have mood symptoms that are dominant (Symptoms of Schizoaffective Disorder). Whether mood symptoms or psychotic symptoms are stronger might play an important role in schizoaffective disorder prognosis.

The prognosis for schizoaffective disorder isn’t entirely random. There are factors at work that influence the outcome of this psychotic disorder with mood features.

Factors Which Influence the Prognosis of Schizoaffective Disorder

Like all illnesses, schizoaffective disorder is highly individualized. Within the framework of what makes schizoaffective disorder schizoaffective disorder, each person experiences it uniquely.

The personal nature of the disorder carries into its prognosis, too. Everyone’s outcome can be different. A big part of the reason for that involves specific prognostic factors:

• The way someone functioned before symptoms began
• How intense the symptoms are
• The nature and depth of the psychosis
• Whether psychotic and mood symptoms are congruent (do they cycle together, occurring simultaneously (better prognosis), or are they out of synch, one group beginning as the other group ends?)
• How persistent the symptoms are (how long they last)
• How negatively schizoaffective disorder affects cognitive functioning
• How many episodes does someone experience as time progresses (the total number as well as frequency per year)

While there isn’t a cure for schizoaffective disorder, at least not yet, this illness can go into remission, a period in which symptoms aren’t present and functioning is good. The more the factors can be answered positively, the better the chances are that the signs and symptoms will recede.

People often experience schizoaffective disorder in cycles of symptoms and remission. It’s possible to achieve an outcome in which periods of remission are long and periods of symptoms are relatively mild.

The key for the best possible schizoaffective disorder prognosis is to receive proper treatment and follow the treatment plan created for you. It might seem pointless to have doctor visits and take schizoaffective disorder medication when you’re in remission, but complying with treatment is one of the primary components of a good prognosis.

While there are no guarantees because this complex disorder is different for everyone and so many different factors are involved, if you are living with schizoaffective disorder, the prognosis is good for getting better.

article references

What are the psychological causes in men who don't want to make love?

Answer:

When talking about the psychological causes of not wanting sex, we refer to those thoughts, feelings or emotions that reduce the interest in sex. Because of fear and anger, sexual desire can disappear in certain situations. This may have several causes, e.g., fear of performance, fear of intimacy, fear of excitement, dissatisfaction with one's own body or suppression of events from childhood. Traumatic experiences can have a lot of influence on sexual desire. Sad experiences that haven't been dealt with, like the loss of a partner, nagging and conflicts in relationships can influence sexual desire negatively. Relational problems are often a cause.

For all sorts of reasons, partners may become physically and personally less attractive to each other. Differences in sexual needs and the refusal of partners to respond to advances can lead to doubts about the self-image of the man, the woman or the self-image as the beloved partner. Certain irrational thoughts, like refusing to have sex is the same as admitting an affair, can lead to a great disappointment or anger. A reduced interest in sex is also a frequent symptom of various psychiatric disorders. The most frequent one is depression.

Men and women experience sexual desire in a different way. Women see love, emotional intimacy and involvement as a goal, while men see sexual activity as the goal. Other factors can also negatively influence desire including psychological problems of the partner, stress and/ or relational problems. In the first meetings a sexologist will ask about these possible causes, so that your condition may be identified.

Written by: Wendy Moelker, psychologist in charge of Emergis, Goes, the Netherlands.

As the channel for semen and urine, the penis serves two important functions in men. But a disease described as early as the mid-18th century by a French physician, Francois Gigot de la Peyronie, which causes hardened patches on the penile shaft, can severely impact a man's sexual performance. If you have pain and penile curvature characteristic of Peyronie's disease, the following information should help you understand your condition.

What happens under normal conditions?

The penis is a cylindrical organ consisting of three chambers: paired corpora cavernosa that are surrounded by a protective tunica albuginea; a dense, elastic membrane or sheath under the skin; and the corpus spongiosum, a singular channel, located centrally beneath and surrounded by a thinner connective tissue sheath. It contains the urethra, the narrow tube that carries urine and semen out of the body.

These three chambers are made up of highly specialized, sponge-like erectile tissue filled with thousands of venous cavities, spaces that remain relatively empty of blood when the penis is soft. But during erection, blood fills the cavities, causing the corpora cavernosa to balloon and push against the tunica albuginea. While the penis hardens and stretches, the skin remains loose and elastic to accommodate the changes.

What is Peyronie's disease?

Peyronie's disease (also known as fibrous cavernositis) is an acquired inflammatory condition of the penis. It is the formation of a plaque or hardened scar tissue beneath the skin of the penis. This scarring is non-cancerous, but often leads to painful erection and curvature of the erect penis (a "crooked penis").

What are the symptoms of Peyronie's disease?

This scarring, or plaque, typically develops on the upper side of the penis (dorsum). It reduces the elasticity of the tunica albuginea in that area and, as a result, causes the penis to bend upward during an erection. Although Peyronie's plaque is most commonly located on the top of the penis, it may occur on the underside or on the lateral side of the penis, causing a downward or lateral bend. Some patients may even develop a plaque that goes all the way around the penis, causing a "waisting" or "bottleneck" deformity of the penile shaft. The majority of patients complain of generalized shrinkage or shortening of their penis.

Painful erections and difficulty with intercourse usually lead men with Peyronie's disease to seek medical help. Since there is great variability in this condition, sufferers may complain of any combination of symptoms: Penile curvature, obvious penile plaques, painful erection and diminished ability to achieve an erection.

Any of those physical deformities make Peyronie's disease a quality-of-life issue. Not surprisingly, it is linked to erectile dysfunction in 20 to 40 percent of sufferers. While studies have shown that 77 percent of men demonstrate significant psychological effects, the numbers, medical researchers believe, are under-reported. Instead, many men affected with this truly devastating condition suffer in silence.

How frequently does Peyronie's disease occur?

Peyronie's disease affects a reported one to 3.7 percent (about one to four in 100) of males between ages 40 and 70, even though severe cases have been reported in younger men. Medical researchers believe the actual prevalence may be higher due to patient embarrassment and limited reporting by physicians. Since the introduction of an oral therapy for impotence, doctors have reported an increased incidence of Peyronie's cases. With more men being treated successfully for erectile dysfunction in the future, an increasing number of cases presenting to urologists are anticipated.

What causes Peyronie's disease?

Ever since Francois Gigot de la Peyronie, personal physician to King Louis XV, first reported penile curvature in 1743, scientists have been mystified by the causes of this well-recognized disorder. Yet medical researchers have speculated on a variety of factors that might be at work.

Most experts believe that acute or short-term cases of Peyronie's disease are likely the consequence of a minor penile trauma, sometimes caused by sports injuries, but more often by vigorous sexual activity (e.g., the penis accidentally being jammed into a mattress). In injuring the tunica albuginea, that trauma triggers a cascade of inflammatory and cellular events resulting in the abnormal fibrosis (excess fibrous tissue), plaque and calcifications characteristic of this disease.

Such trauma, however, may not account for those Peyronie's cases that begin slowly and become so severe that they require surgery. Researchers believe genetics or relationship with other connective tissue disorders may play a role. Studies already suggest that if you have a relative with Peyronie's disease you have a greater risk of developing it yourself.

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How is Peyronie's disease diagnosed?

A physical examination is sufficient to diagnose curvature of the penis. The hard plaques can be felt with or without erection. It may be necessary to use injectable medications to induce an erection for proper evaluation of the penile curvature. The patient may also provide pictures of the erect penis for evaluation by the physician. Ultrasound of the penis may demonstrate the lesions in the penis but is not always necessary.

How is Peyronie's disease treated?

Because Peyronie's disease is a wound-healing disorder, changes are constantly occurring in the early stages. In fact, this disease can be classified into two stages: 1) an acute inflammatory phase persisting for six to 18 months during which men experience pain, slight penile curvature and nodule formations and 2) a chronic phase during which men develop a stable plaque, significant penile curvature and erectile dysfunction.

Occasionally the condition regresses spontaneously with symptoms resolving themselves. In fact, some studies show that approximately 13 percent of patients have complete resolution of their plaques within a year. There is no change in 40 percent of cases, with progression or worsening of symptoms in 40 to 45 percent. For these reasons, most physicians recommend a non-surgical approach for the first 12 months.

Conservative approaches: Instead of requiring invasive diagnostic procedures or treatments, men who experience only small plaques, minimal penile curvature and no pain or sexual limitations, need only be reassured that the condition will not lead to malignancy or another chronic disease. Pharmaceutical agents have shown promise for early-stage disease but there are drawbacks. Because of a lack of controlled studies, scientists have yet to establish their true effectiveness. For instance:

• Oral vitamin E: It remains a popular treatment for early-stage disease because of its mild side effects and low cost. While uncontrolled studies as far back as 1948 demonstrated decreases in penile curvature and plaque size, investigation continues concerning its effectiveness.

• Potassium aminobenzoate: Recent controlled studies have shown that this B-complex substance popular in Central Europe yields some benefits. But it is somewhat expensive, requiring 24 pills each day for three to six months. It is also often associated with gastrointestinal issues, making compliance low.

• Tamoxifen: This non-steroidal, antiestrogen medication has been used in the treatment of desmoid tumors, a condition with properties similar to Peyronie's disease. Researchers claim that inflammation and the production of scar tissue are inhibited. But early-stage disease studies in England have found only marginal improvement with tamoxifen. Like other research in this area, however, these studies include few patients, and no controls, objective improvement measures or long-term follow up.

• Colchicine: Another anti-inflammatory agent that decreases collagen development, colchicine has been shown to be slightly beneficial in a few small, uncontrolled studies. Unfortunately, up to 50 percent of patients develop gastrointestinal upset and must discontinue the drug early in treatment.

Injections: Injecting a drug directly into the penile plaque is an attractive alternative to oral medications, which do not specifically target the lesion, or invasive surgical procedures, which carry the inherent risks of general anesthesia, bleeding and infection. Intralesional injection therapies introduce drugs directly into the plaque with a small needle after appropriate anesthesia. Because they offer a minimally invasive approach, these options are popular among men with either early phase disease or who are reluctant to have surgery. Yet their effectiveness is also under investigation. For instance:

• Verapamil: Early uncontrolled studies demonstrated that this substance interferes with calcium, a factor shown by in vitro cattle connective tissue cell studies to support collagen transport. As such, intralesional verapamil reduced penile pain and curvature while improving sexual function. Other studies have concluded that it is a reasonable treatment in men with non-calcified plaques and penile angles of less than 30 degrees.

• Interferon:: The use of these naturally-occurring antiviral, antiproliferative and anti-tumorigenic glycoproteins to treat Peyronie's disease was born out of experiments demonstrating the antifibrotic effect on skin cells of two different disorders - keloids, overgrowth of collagenous scar tissue and scleroderma, a rare autoimmune disease affecting the body's connective tissue. In addition to inhibiting proliferation of fibroblast cells, interferons, such as alpha-2b, also stimulate collagenase, which breaks down collagen and scar tissue. Several uncontrolled studies have demonstrated intralesional interferon's effectiveness in reducing penile pain, curvature and plaque size while improving some sexual function. A current multi-institutional, placebo-controlled trial will hopefully answer many of the questions about intralesional therapy in the near future.

Other investigative therapies: The medical literature is replete with reports on less invasive methods for treating Peyronie's disease. But the effectiveness of treatments such as high-intensity focused ultrasound and radiation therapy, topical verapamil and iontophoresis, introducing soluble salt ions into the tissue via electric current, must still be investigated before these alternative therapies are considered clinically useful. Likewise, controlled studies using larger patient groups with longer follow ups are necessary to prove that the same high-energy shock waves used to break up kidney stones will have positive effects on Peyronie's disease.

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Surgery: Surgery is reserved for men with severe disabling penile deformities that prevent satisfactory sexual intercourse. But, in most cases, it is not recommended for the first six to 12 months, until the plaque has stabilized. Since a spin-off of this disease is an abnormal blood supply to the penis, a vascular evaluation using vasoactive agents (drugs that cause erections by opening the vessels) is done prior to any surgery. A penile ultrasound if performed can also illustrate the anatomy of the deformity. The images allow the urologist to determine which patients are most likely to benefit from reconstructive procedures versus a penile prosthesis. The three surgical approaches include:

• Nesbit procedure: First described to correct congenital penile curvature by cutting a portion of tissue from the tunica albuginea and shortening the unaffected side of the penis, this procedure is used by many surgeons today for Peyronie's disease. Variations on the approach include the plication technique, where sutured tucks are placed into the side of maximum curvature to shorten and straighten the penis and the corporoplasty technique, where a longitudinal or lengthwise incision is closed transversely to correct the curvature. Nesbit and its variations are simple to perform and involve limited risk. They are most beneficial in men with ample penile length and lesser degrees of curvatures. But they are not recommended in individuals with short penises or severe curvatures as this procedure is recognized to shorten the penis somewhat.

• Grafting procedures: When plaques are large and curvatures severe, the surgeon may choose to incise or cut out the hardened area and replace the tunica defect with a graft material of some type. While the choice of materials depends on the doctor's experience, preferences and what is available, some are more attractive than others. For instance:

  • Autograft tissue grafts: Taken from the patient's body during surgery and thus less likely to cause an immunologic reaction, these materials usually require a second incision. They are also known to undergo postoperative contracture or tightening and scarring.

  • Synthetic inert substances: Materials such as Dacron® mesh or GORE-TEX® can cause significant fibrosis, a spreading of connective tissue cells. Occasionally palpated or felt by the patient, these grafts may cause more scarring.

  • Allografts or xenografts: Harvested human or animal tissues are the focus of most grafting material today These substances are uniformly strong, easy to work with and readily available because they are "off-the-shelf" in the operating room, so to speak. They act as scaffolds for the tunica albuginea tissue to grow over as the graft is naturally dissolved by the patient's body.

• Penile prostheses: A penile prosthesis may be the only good option for Peyronie's disease patients with significant erectile dysfunction and insufficient blood vessels verified by ultrasound. In most cases, implanting such a device alone will straighten the penis, correcting its rigidity. But when that does not work, the surgeon may manually "model" the organ, bending it against the plaque to break the deformity, or the surgeon may need to remove the plaque over the prosthesis and apply a graft to completely straighten the penis.

What can be expected after treatment for Peyronie's disease?

Routinely, a light pressure dressing is applied for 24 to 48 hours after the surgery to prevent any accumulation of blood. The Foley catheter is removed after the patient recovers from anesthesia and most patients are discharged later the same day or the following morning. During the healing process, medications to counteract erections are usually prescribed. The patient is also asked to take antibiotics for seven to 10 days postoperatively to ward off infection, and analgesics for any discomfort. If patients have no penile pain or other complications, they can resume sexual intercourse in six to eight weeks.

Frequently asked questions:

What happens to the cells following penile trauma?

In theory, following any penile trauma, there is a release of growth factors and cytokines or daughter cells that activate fibroblasts, cells that produce connective tissue. They, in turn, cause abnormal collagen deposition or scarring, which damages the internal elastic framework of the penis. Similar wound-healing disorders are commonly seen in the practice of dermatology, with conditions such as keloids and hypertrophic scarring, both involving tissue overgrowth in wound healing.

Are Peyronie's disease sufferers prone to other related conditions?

About 30 percent of Peyronie's disease sufferers also develop other systemic fibrosis in other connective tissue in the body. Common sites are the hands and feet. In Dupuytren's contracture, scarring or thickening of the fibrosis tissue in the palm leads progressively to a permanent bending of the pinkie and ring fingers into the hand. While the fibrosis occurring in both diseases is similar, it is not clear yet what causes either plaque type or why men with Peyronie's disease are more likely to develop Dupuytren's contracture.

Will Peyronie's disease evolve into cancer?

No. There are no documented cases of progression of Peyronie's disease to malignancy. However, if your doctor observes other findings that are not typical with this disease-such as external bleeding, obstructed urination, prolonged severe penile pain - he or she may elect to perform a biopsy on the tissue for pathological examination.

What should men remember about Peyronie's disease?

Peyronie's disease is a well-recognized but poorly understood urological condition. Interventions need to be individualized to each patient, based on the timing and severity of the disease. The objective of any treatment should be on reducing pain, normalizing penile anatomy so that intercourse is comfortable and restoring erectile function in patients who suffer erectile dysfunction. Although surgical correction is ultimately successful in the majority of cases, the early acute phase of this disease is customarily treated by either oral and/or intralesional approaches. As medical researchers continue to develop basic and clinical research for a better understanding of this disease, more therapies and targets for intervention will become available.