52 Informaciones Psiquiátricas 2025 - nº 259 these cases include, among other characteristics, denial of their “weak” state, as well as communicative “closure” (51), which will inevitably affect desire, seductiveness and sexuality. Related to seductive and sexual aptitudes, it can be added that rural men report lower levels of stress and depression, but paradoxically have much higher rates of suicide and problematic substance use. Suicide may represent an effective means of ending painful emotions while, in the more philosophical than empirically proven view of some authors, it may also constitute an alternative way of demonstrating masculinity (52). It is worth recalling the case of Jim Jones, who explicitly induced the collective suicide of some 900 people from the Peoples Temple religious community in November 1978 in Guyana, in the north-west of South America. Seduction is not exclusively a cultural or social phenomenon, even if these are powerful influencing conditions. On the sexological and reproductive level, seduction is the most widespread strategy to satisfy sexual desire, which, to some extent, could be a bodily structural phenomenon. It has been suggested that the cannabinoid heterotrimeric receptor type 2, or CB2, which is expressed on dopaminergic neurons in the ventral tegmental area (part of the brain’s reward circuitry) and is involved in addiction, orgasm and strong emotions such as feelings of love, could be a new target for stimulating sexual desire (53). Moreover, melanocortin 4 receptor (MC4R) agonists such as Bremelanotide, as well as the hormone Kisspeptin, have emerged as promising therapies for women with hypoactive sexual desire dysfunction, probably the most common female sexual health problem worldwide, which also affects men. It has been suggested that MC4R agonism improves sexual brain processing by reducing selfconsciousness, increasing sexual imagery and sensitising to erotic stimuli in women with sexual dysfunction (54-56). Flibanserin, a multifunctional serotonin agonist and antagonist and norepinephrine-dopamine disinhibitor, was approved in the US in 2015 as an oral treatment for acquired hypoactive sexual desire in pre-menopausal women. The importance of its side effects has made it advisable not to use it, although there are those who disagree (57). In specialised care practice it is common to find a considerable variety of the subgroup of dissociative disorders with neurological symptoms, as well as a large number of disorders related to sexuality, desire and seductive ability, such as delayed puberty or peripheral precocious puberty and sexual dysfunctions. In particular, high-resolution functional MRI has revealed abnormal connectivity and structural changes in child and adolescent patients with functional neurological symptoms of multiple types (58,59), included in ICD-11 in the group of dissociative disorders with unspecified neurological symptoms. They also have alterations in sexual functions and relationships, all of which are considered mental, behavioural José Manuel Bertolín-Guillén
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