Bossini Letizia, Fortini Valentina, Casolaro Ilaria, Caterini Claudia, Koukouna Despoina, Cecchini Federica, Benbow Jim, Fagiolini Andrea
Psychiatr Pol. 2014 Jul-Aug;48(4):715-26.
Sexual dysfunctions may have a significant effect on the quality of life, but are unreported and under-diagnosed. A review of recent literature highlights the correlation between dysfunction and a decreased quality of life in people with psychiatric comorbidity, and explores several aspects impacting care, from following the patient to pharmacological and non-pharmacological treatments. Sexual dysfunctions (SD) have been shown to be prevalent, but under-diagnosed and un-dertreated because of communication barriers between patients and physicians. Pharmacogenic and morbogenic causes of sexual problems are often difficult to differentiate. Psychiatric diseases may increase the risk of SD, and SD may further exacerbate psychiatric problems, suggesting a bi-directional relationship. Their effective treatment frequently involves combination of elements from psychotherapy, and behavioral along with pharmacotherapeutic intervention, if needed. The persistence of sexual problems has significant negative impact on patient's satisfaction and adherence with the treatment, quality of life and partnership. Routine assessment of sexual functioning needs to be integrated into ongoing care to identify and address problems early. If sexual dysfunction is ignored it may maintain the psychiatric disorder, compromise treatment outcome and lead to non-adherence and compromise treatment outcome.
性功能障碍可能对生活质量产生重大影响，但却未得到报告和充分诊断。对近期文献的回顾突出了性功能障碍与合并精神疾病患者生活质量下降之间的相关性，并探讨了从关注患者到药物及非药物治疗等影响护理的几个方面。性功能障碍（SD）已被证明很普遍，但由于患者与医生之间的沟通障碍，其诊断不足且治疗不充分。性问题的药源性和致病源性原因往往难以区分。精神疾病可能会增加性功能障碍的风险，而性功能障碍可能会进一步加剧精神问题，这表明存在双向关系。其有效治疗通常需要将心理治疗、行为治疗以及必要时的药物治疗干预相结合。性问题的持续存在会对患者的满意度、治疗依从性、生活质量和伴侣关系产生重大负面影响。需要将性功能的常规评估纳入持续护理中，以便尽早发现和解决问题。如果忽视性功能障碍，可能会维持精神疾病、损害治疗效果并导致治疗不依从，进而损害治疗效果。
