Psychiatry Unit, Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Pisa 56100, Italy.
J Sex Med. 2009 Nov;6(11):3063-70. doi: 10.1111/j.1743-6109.2009.01455.x. Epub 2009 Sep 1.
Impairment in sexual function is frequent and underestimated in patients with mental disorders, particularly in those with mood disorders. Few studies have examined the relationship between sexual dysfunctions and the clinical characteristics of mood disorders.
The aim of the present study was to explore the frequency of sexual dysfunctions in patients with bipolar I disorder (BD) and unipolar depression (UD) with respect to control subjects, as well as their relationship with suicidality.
Assessments included: the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (SCID-I/P), the 24-item Brief Psychiatric Rating Scale and the Mood Spectrum Self-Report, a questionnaire exploring lifetime mood spectrum symptomatology including symptoms of sexual functioning and suicidality.
A consecutive sample of 142 patients (60 BD and 82 UD) and a comparison group of 101 control subjects were recruited in a multicenter study involving 11 academic departments of psychiatry.
Lifetime impairment in the sexual response cycle, including desire, excitement, and ability to achieve orgasm, was significantly more common in patients with mood disorders compared with control subjects. Increase in sexual activity and promiscuity were significantly more common in patients with BD vs. the other two groups. Lifetime dysfunctions in all three phases of the sexual response cycle explored were significantly associated with lifetime suicide attempts in patients with BD and with thoughts of death in patients with UD. In BD patients, the lifetime presence of periods with frequent changes of sexual partners was significantly associated with thoughts of death.
Our findings suggest the importance of assessing sexual dysfunctions in patients with either BD or UD, as they may be clinically helpful in identifying phenotypes of mood disorders characterized by high suicidality.
性功能障碍在精神障碍患者中较为常见且常被低估，尤其是在心境障碍患者中。少数研究探讨了性功能障碍与心境障碍临床特征之间的关系。
本研究旨在探讨双相 I 型障碍（BD）和单相抑郁（UD）患者性功能障碍的发生率，并与对照组进行比较，同时探讨其与自杀的关系。
评估包括：精神障碍诊断与统计手册第四版（DSM-IV）结构临床访谈（SCID-I/P）、24 项简明精神病评定量表（BPRS-24）和心境谱自评问卷，该问卷探讨了包括性功能障碍和自杀症状在内的一生中心境谱症状学。
在涉及 11 个学术精神病学部门的多中心研究中，连续招募了 142 名患者（60 名 BD 和 82 名 UD）和 101 名对照组。
与对照组相比，心境障碍患者一生中性功能反应周期的各个阶段（包括欲望、兴奋和获得性高潮的能力）均明显受损。与其他两组相比，BD 患者的性活动和滥交增加更为明显。在 BD 和 UD 患者中，所有三个性功能反应周期阶段的终生性功能障碍与 BD 患者的自杀企图和 UD 患者的死亡念头显著相关。在 BD 患者中，一生中频繁更换性伴侣的存在与死亡念头显著相关。
我们的研究结果表明，评估 BD 或 UD 患者的性功能障碍具有重要意义，因为它可能有助于识别高自杀风险的心境障碍表型。
