Nazareth Irwin, Boynton Petra, King Michael
Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London NW3 2PF.
BMJ. 2003 Aug 23;327(7412):423. doi: 10.1136/bmj.327.7412.423.
To assess sexual behaviour, prevalence of ICD-10 diagnosed sexual dysfunction, associations between sexual and psychological problems, and help seeking for sexual problems in people attending general practice; to assess predictors of ICD-10 diagnosis of sexual dysfunction.
Cross sectional study.
13 general practices in London.
1065 women and 447 men attending general practices.
Prevalence and predictors of ICD-10 diagnoses of sexual dysfunction.
97 (22%, 95% confidence interval 18% to 25%) men and 422 (40%, 37% to 43%) women received at least one ICD-10 diagnosis, but only 3-4% had an entry relating to sexual problems in their general practice notes. The most common problems were erectile failure and lack or loss of sexual desire in men and lack or loss of sexual desire and failure of orgasmic response in women. Increasing age and being unemployed predicted sexual problems in women, and bisexual orientation, being non-white, and being unemployed were demographic predictors in men. No practice note factors predicted sexual problems in women, but high consulting rate predicted problems in men. The main clinical predictors were poor physical function and dissatisfaction with current sex life in both sexes and higher psychological morbidity in women. When all factors were considered, increasing age (odds ratio 1.01, 1.00 to 1.02), physical subscale score on the SF-12 (0.98, 0.97 to 0.99), sexual dissatisfaction (1.9, 1.5 to 2.4), and scoring over a 3/4 threshold score on the general health questionnaire (1.5, 1.1 to 1.9) independently predicted an ICD-10 sexual dysfunction diagnosis in women. Being bisexual (4.1, 1.3 to 12.8) was the only independent predictor of an ICD-10 diagnosis in men.
Sexual difficulties are common in people attending general practitioners, and many people are prepared to talk about them with their doctors.
评估性行为、国际疾病分类第10版（ICD - 10）诊断的性功能障碍患病率、性与心理问题之间的关联以及在全科医疗就诊人群中寻求性问题帮助的情况；评估ICD - 10诊断性功能障碍的预测因素。
横断面研究。
伦敦的13家全科医疗机构。
1065名女性和447名男性到全科医疗机构就诊。
ICD - 10诊断性功能障碍的患病率及预测因素。
97名（22%，95%置信区间18%至25%）男性和422名（40%，37%至43%）女性至少获得一项ICD - 10诊断，但在其全科医疗记录中仅有3 - 4%有与性问题相关的记录。男性最常见的问题是勃起功能障碍以及性欲缺乏或丧失，女性则是性欲缺乏或丧失以及性高潮反应障碍。年龄增长和失业是女性性问题的预测因素，双性恋取向、非白人以及失业是男性性问题的人口统计学预测因素。没有全科医疗记录因素可预测女性的性问题，但高就诊率可预测男性的性问题。主要的临床预测因素是两性的身体功能差和对当前性生活不满意，以及女性较高的心理发病率。综合考虑所有因素后，年龄增长（比值比1.01，1.00至1.02）、SF - 12身体分量表得分（0.98，0.97至0.99）、性不满意（1.9，1.5至2.4）以及在一般健康问卷上得分超过3/4阈值（1.5，1.1至1.9）可独立预测女性的ICD - 10性功能障碍诊断。双性恋（4.1，1.3至12.8）是男性ICD - 10诊断的唯一独立预测因素。
在全科医生就诊人群中，性困难很常见，且许多人愿意与医生谈论这些问题。
