Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
Rheumatology (Oxford). 2011 Jun;50(6):1125-30. doi: 10.1093/rheumatology/keq443. Epub 2011 Jan 27.
Pain and body image distress are common among women with SSc, but their relative associations with reduced sexual function have not been assessed. The objective of this study was to assess the independent associations of pain and body image distress with reduced sexual function in women with SSc.
Female SSc patients completed measures of sexual function (sexual relationships subscale of the Psychosocial Adjustment to Illness Scale-Self-Report), body image dissatisfaction (Satisfaction with Appearance Scale) and pain (visual analogue scale). Multiple regression analysis was used to assess the associations of body image dissatisfaction and pain with reduced sexual function, controlling for sociodemographic and disease variables.
The sample included 117 female SSc patients [33 (28.2%) diffuse; mean age 51.4 (11.9) years; mean time since diagnosis 9.1 (8.5) years]. Unadjusted analyses found that reduced sexual function was associated with pain (r = 0.44, P < 0.001), body image dissatisfaction (r = 0.35, P < 0.001) and being married (r = 0.34, P < 0.001). In multivariate linear regression, disease duration (β = 0.17, P = 0.046), pain (β = 0.29, P = 0.001) and unmarried status (β = -0.23, P = 0.006) were independently associated with reduced sexual function. Dissatisfaction with appearance was not significantly associated with reduced sexual function (β = 0.16, P = 0.067).
Pain is an important indicator of sexual function among women with SSc. Body image dissatisfaction was not independently associated with sexual impairment and appears to be less important factor than pain in determining sexual function. Future research should focus on isolating specific sources of pain that may be amenable to intervention in order to improve sexual function.
疼痛和身体形象困扰在系统性硬化症（SSc）女性中很常见，但它们与性功能降低的相对关联尚未得到评估。本研究的目的是评估疼痛和身体形象困扰与 SSc 女性性功能降低的独立关联。
女性 SSc 患者完成了性功能评估（疾病影响量表-自我报告的性生活子量表）、身体形象不满（外貌满意度量表）和疼痛（视觉模拟评分）。使用多元回归分析评估身体形象不满和疼痛与性功能降低的关联，同时控制社会人口统计学和疾病变量。
该样本包括 117 名女性 SSc 患者[33 名（28.2%）弥漫性；平均年龄 51.4（11.9）岁；平均诊断后时间 9.1（8.5）年]。未调整分析发现，性功能降低与疼痛（r = 0.44，P < 0.001）、身体形象不满（r = 0.35，P < 0.001）和已婚状况（r = 0.34，P < 0.001）相关。在多元线性回归中，疾病持续时间（β = 0.17，P = 0.046）、疼痛（β = 0.29，P = 0.001）和未婚状态（β = -0.23，P = 0.006）与性功能降低独立相关。对外貌的不满与性功能降低没有显著关联（β = 0.16，P = 0.067）。
疼痛是 SSc 女性性功能的一个重要指标。身体形象不满与性功能障碍没有独立关联，而且在确定性功能方面似乎不如疼痛重要。未来的研究应侧重于分离可能干预的特定疼痛源，以改善性功能。
