Department of Twin Research and Genetic Epidemiology, King's College London, UK.
Psychol Med. 2011 Nov;41(11):2435-45. doi: 10.1017/S0033291711000493. Epub 2011 Jun 14.
The DSM-V Working Group is currently re-evaluating distress as a primary diagnostic criterion for female sexual dysfunction (FSD). Here, for the first time, we explored the epidemiology of sexual distress and its putative aetiological relationship to FSD by estimating the influence of genetic and environmental risk factors.
Questionnaire data on a representative sample of 930 British female twins using validated scales of FSD and sexual distress were subject to variance components analyses to quantify latent genetic and environmental factors influencing phenotypic variation and covariation. Multiple regression analyses were used to identify other potential risk factors of sexual distress.
Of 319 women with any sexual problems, only 36.5% reported distress. Of women classified as functional, 16.5% felt sexual distress. Sexual distress had a heritability of 44% [95% confidence interval (CI) 0.33-0.54]. Bivariate analysis suggested that the majority (91% CI 86-99%) of the covariance between sexual distress and FSD was due to unique environmental effects common to both traits. Associations were found between sexual distress and other risk variables, including relationship dissatisfaction [odds ratio (OR) 1.6, p<0.001], anxiety sensitivity and obsessive-compulsive symptomatology (OR 1.2, p<0.01, for both).
There seems to be a weak phenotypic and genetic basis for including sexual distress as a diagnostic indicator of FSD. Instead, the data indicate that unrelated psychological factors play an important role in sexual distress and tentatively suggest that sexual distress is less a consequence of FSD and more related to general anxiety among women.
DSM-V 工作组目前正在重新评估困扰作为女性性功能障碍（FSD）的主要诊断标准。在这里，我们首次通过估计遗传和环境风险因素的影响，探讨了性困扰的流行病学及其与 FSD 的潜在病因关系。
使用经过验证的 FSD 和性困扰量表，对 930 名英国女性双胞胎的代表性样本进行问卷调查，采用方差成分分析来量化影响表型变异和协变的潜在遗传和环境因素。使用多元回归分析来确定性困扰的其他潜在风险因素。
在 319 名有任何性问题的女性中，只有 36.5%报告有困扰。在被归类为功能性的女性中，有 16.5%感到性困扰。性困扰的遗传率为 44%[95%置信区间（CI）0.33-0.54]。双变量分析表明，性困扰和 FSD 之间的大部分（91%CI 86-99%）协方差是由于两个特征共有的独特环境效应。还发现性困扰与其他风险变量之间存在关联，包括关系不满意[比值比（OR）1.6，p<0.001]、焦虑敏感性和强迫症状（OR 1.2，p<0.01，均如此）。
似乎有一个薄弱的表型和遗传基础，将性困扰作为 FSD 的诊断指标。相反，数据表明，无关的心理因素在性困扰中起着重要作用，并初步表明性困扰与其说是 FSD 的结果，不如说是与女性普遍焦虑有关。
