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BACKGROUND: The primary care setting has been regarded in government policy and the scientific literature as an ideal setting for the work needed to meet the Health of the Nation drug and alcohol targets. Although studies have pointed to the negative attitudes held by general practitioners (GPs) towards alcohol- and drug-misusing patients, there has been no direct comparison of the work and attitudes of the GP towards these patients. AIM: To compare the work and attitudes of GPs towards alcohol- and drug-misusing patients. METHOD: All GPs in an outer London area (157 doctors) were surveyed, using an eight-page postal questionnaire, collecting clinical and attitudinal data alongside demographics and practice information. A response rate of 52% was achieved. RESULTS: General practitioners reported working with only 3.5 patients drinking above recommended guidelines in the previous four working weeks, and even fewer drug-using patients (0.75). While they viewed the alcohol-misusing patients negatively, the drug misuser elicited substantially more negative attitudes. The primary care setting was seen as appropriate to work with the alcohol-misusing patient but not with drug users. Training and support from local services would encourage substantially more GPs to work with alcohol misusers but not with drug misusers. CONCLUSIONS: Our findings indicate that there are some cautious grounds for optimism that GPs are willing to work with alcohol misusers; however, with regard to drug misusers, we find a GP workforce that is only minimally involved with this group and would not be greatly encouraged by the provision of additional training, support, or incentives. The Health of the Nation targets are not being met, and GPs are not detecting adequate numbers of the patients at whom these targets are aimed. Emphasis has been placed on the role of primary care, but the real achievements that can be made require detection of the less severe drinkers and injecting drug misusers.

Somnophilia is an under-researched paraphilia. Consequently, there are discrepancies in its definition and conceptual understanding. Also, literature regarding the sexual interest in being asleep during sexual activity (dormaphilia) is even more limited. As such, there is a need to understand these paraphilias more deeply. This study recruited 232 participants online to discuss the content, origin, sexual appeal, emotional appraisal, and behavioural enactment of their somnophilic and dormaphilic interests and fantasies. A Thematic Analysis led to the identification of four main themes: (1) Relevance of Sleep State; (2) Roles within Sleep Sex; (3) Enactment of Sleep Paraphilia and (4) Lack of Consent and Awareness. These four themes spanned across both those reporting somnophilic and dormaphilic fantasies. The Discussion explores the multi-faceted nature of the interests, and implications for the understanding of somnophilia and dormaphilia. This study provides the first qualitative exploration of sleep-related paraphilias, opening avenues for future research and practice.

Somnophilia refers to the interest in having sex with a sleeping person. Using an online sample of 437 participants, the present study provides the first empirical examination of somnophilia, its various forms, and theorized correlates. Participants completed the newly developed Somnophilia Interest and Proclivity Scale, which comprises three subscales (active consensual, passive consensual, and active nonconsensual somnophilia). To test hypotheses about the convergent and divergent validity of different paraphilic interests, participants also completed scales measuring necrophilic, rape-related, and sadistic/masochistic sexual fantasies, rape proclivity, and the need for sexual dominance/submission. Male participants scored higher than females on all scales except the passive subscale. For both males and females, each subscale was associated most strongly with conceptually congruent variables. These results support existing theoretical assumptions about somnophilia, as well as offering newer insights, such as distinguishing between active and passive somnophilia. Limitations and implications for further research are discussed.