Assari Shervin
Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA ; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA ; Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA.
Int Cardiovasc Res J. 2014 Dec;8(4):171-7. Epub 2014 Dec 1.
Poor sexual function is associated with impaired Health-Related Quality of Life (HRQoL), and patients with Coronary Artery Disease (CAD) are not exceptions. It is not known, however, if symptoms of depression mediate the effect of sexual function on HRQoL among men and women with CAD.
This study aimed to determine the mediating effect of depressive symptoms on the association between sexual function and HRQoL among men and women with CAD.
This cross-sectional study was conducted on 401 men and 156 women with CAD. Sexual function, measured by the Relation and Sexuality Scale (RSS), was the independent variable. In addition, physical and mental HRQoL measured using physical and mental health summary scores of Short Form 36 (SF-36) were dependent variables. Besides, the severity of depressive symptoms measured by the Hospital Anxiety and Depression Scale (HADS) was conceptualized as the mediator. Age, income, education, and medical comorbidities (Ifudu index) were control variables, and gender was the moderator. Multi-group path analysis was conducted using AMOS20.0 for data analysis.
When the effects of age, education, income, and comorbidities were controlled, sexual function was correlated with poor mental HRQoL in both genders. However, the association between sexual function and poor physical HRQoL could be found only among men but not women. Evidence also supported partial mediation of depressive symptoms on the effect of sexual function on mental HRQoL of both men and women. Nonetheless, the results suggested partial mediation of depressive symptoms on the effect of sexual function on physical HRQoL only among men but not women.
Symptoms of depression may not have a similar role in explaining the effect of sexual function on physical HRQoL of men and women with CAD. Our findings suggest that only among men, depressive symptoms might be the mechanism by which sexual function affects the CAD patients' physical HRQoL.
性功能障碍与健康相关生活质量（HRQoL）受损有关，冠状动脉疾病（CAD）患者也不例外。然而，尚不清楚抑郁症状是否介导了CAD男性和女性性功能对HRQoL的影响。
本研究旨在确定抑郁症状在CAD男性和女性性功能与HRQoL之间的关联中所起的中介作用。
本横断面研究对401名CAD男性和156名CAD女性进行。通过关系与性量表（RSS）测量的性功能为自变量。此外，使用简短健康调查问卷36项简表（SF-36）的生理和心理健康总结得分测量的生理和心理HRQoL为因变量。此外，通过医院焦虑抑郁量表（HADS）测量的抑郁症状严重程度被概念化为中介变量。年龄、收入、教育程度和合并症（Ifudu指数）为控制变量，性别为调节变量。使用AMOS20.0进行多组路径分析以进行数据分析。
在控制年龄、教育程度、收入和合并症的影响后，性功能与两性的心理HRQoL差相关。然而，性功能与生理HRQoL差之间的关联仅在男性中存在，女性中未发现。有证据还支持抑郁症状在性功能对男性和女性心理HRQoL的影响中起部分中介作用。尽管如此，结果表明抑郁症状仅在男性性功能对生理HRQoL的影响中起部分中介作用，女性中未发现。
抑郁症状在解释CAD男性和女性性功能对生理HRQoL的影响方面可能没有类似作用。我们的研究结果表明，仅在男性中，抑郁症状可能是性功能影响CAD患者生理HRQoL的机制。
