2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
J Sex Med. 2014 Nov;11(11):2653-60. doi: 10.1111/jsm.12672. Epub 2014 Aug 14.
Sexual functioning may be notoriously affected in patients suffering from rheumatic diseases, yet the extent to which physical and/or psychological factors contribute to sexual dysfunction in this particular group of patients remains underinvestigated.
This cross-sectional study aimed at investigating whether an association exists between psychological status (anxiety, depression) and sexual dysfunction, independently of other physical factors, in patients with rheumatic disorders.
A total of 509 consecutive rheumatologic patients, aged 54.7 ± 14.2 years, 423 female and 86 male, were studied. Female and male sexual function was evaluated with the Female Sexual Dysfunction Index (FSFI) and the International Index of Erectile Function (IIEF) questionnaire, respectively. The Hamilton Anxiety Scale and the Zung Self-Rating Depression Scale were used to detect presence of anxiety and depression, respectively.
Sexual dysfunction affected 69.9%, anxiety 37.5%, and depression 22% of our patients.
A strong and negative correlation was found between anxiety and both FSFI (r = -0.169, P < 0.001) and IIEF score (r = -0.304, P = 0.004). Similarly, depressive symptomatology was strongly and negatively correlated with both FSFI (r = -0.178, P < 0.001) and IIEF score (r = -0.222, P = 0.04). In the logistic regression analysis, apart from increasing age and female sex, depression (P = 0.027) and anxiety (P = 0.049) were identified as the only predictors of sexual dysfunction, even after adjustment for a variety of physical factors.
Mental distress and sexual dysfunction are extremely common in rheumatologic patients. Sexual dysfunction is significantly associated with anxiety and depression in both men and women and may be independently predicted by their presence in this group of patients. Physicians dealing with rheumatologic patients should be aware of these results and incorporate screening and treatment of the above comorbidities in the global assessment of their patients, in order to alleviate the disease-emerging mental and physical burden and improve their quality of life.
患有风湿性疾病的患者的性功能可能会受到明显影响，但在这组特定患者中，身体和/或心理因素在多大程度上导致性功能障碍仍未得到充分研究。
本横断面研究旨在调查风湿性疾病患者的心理状况（焦虑、抑郁）是否与性功能障碍相关，而与其他身体因素无关。
共研究了 509 例连续就诊的风湿科患者，年龄 54.7±14.2 岁，其中女性 423 例，男性 86 例。女性和男性的性功能分别用女性性功能障碍指数（FSFI）和国际勃起功能指数（IIEF）问卷进行评估。汉密尔顿焦虑量表和 Zung 自评抑郁量表分别用于检测焦虑和抑郁的存在。
性功能障碍影响了我们患者的 69.9%、焦虑 37.5%和抑郁 22%。
发现焦虑与 FSFI（r=-0.169，P<0.001）和 IIEF 评分（r=-0.304，P=0.004）均呈强烈负相关。同样，抑郁症状与 FSFI（r=-0.178，P<0.001）和 IIEF 评分（r=-0.222，P=0.04）均呈强烈负相关。在逻辑回归分析中，除了年龄增加和女性性别外，抑郁（P=0.027）和焦虑（P=0.049）被确定为性功能障碍的唯一预测因素，即使在调整了多种身体因素后也是如此。
精神困扰和性功能障碍在风湿科患者中极为常见。性功能障碍与男性和女性的焦虑和抑郁显著相关，并且在这群患者中可能可以独立预测。处理风湿科患者的医生应该意识到这些结果，并在对患者进行全面评估时纳入对这些合并症的筛查和治疗，以减轻疾病带来的身心负担，提高他们的生活质量。
