Lehrner Amy, Flory Janine D, Bierer Linda M, Makotkine Iouri, Marmar Charles R, Yehuda Rachel
James J. Peters Veterans Affairs Medical Center, Mental Health Patient Care Center, Bronx, NY, USA; Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, NY, USA.
James J. Peters Veterans Affairs Medical Center, Mental Health Patient Care Center, Bronx, NY, USA; Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, NY, USA.
Psychoneuroendocrinology. 2016 Jan;63:271-5. doi: 10.1016/j.psyneuen.2015.10.015. Epub 2015 Oct 23.
Sexual dysfunction is not a symptom of PTSD but is a common clinical complaint in trauma survivors with this disorder. In that there are biological parallels in the neuroendocrine processes underlying both PTSD and sexual behavior, we conducted an exploratory investigation of the relationship of PTSD and related neuroendocrine indicators with sexual dysfunction in armed service veterans. Major Depressive Disorder, highly comorbid with PTSD and sexual dysfunction, was also assessed. In veterans with PTSD, sexual problems were associated with plasma DHEA and cortisol, urinary catecholamines, and glucocorticoid sensitivity, even when controlling for the effects of comorbid depression. In a subsample analysis, testosterone levels did not distinguish PTSD or sexual dysfunction, suggesting that sexual problems reported by veterans in this sample were not the result of organic disorder. PTSD did predict higher dihydrotestosterone (DHT) levels, which were associated with sexual problems. More detailed assessment of sexual dysfunction in biologically informed studies of PTSD is warranted to clarify the relationships of PTSD symptomatology and related neurobiology with sexual dysfunction.
性功能障碍并非创伤后应激障碍（PTSD）的症状，而是患有这种疾病的创伤幸存者常见的临床主诉。鉴于PTSD和性行为背后的神经内分泌过程存在生物学上的相似之处，我们对武装部队退伍军人中PTSD及相关神经内分泌指标与性功能障碍之间的关系进行了探索性调查。同时也评估了与PTSD和性功能障碍高度共病的重度抑郁症。在患有PTSD的退伍军人中，即使在控制了共病抑郁症的影响后，性问题仍与血浆脱氢表雄酮（DHEA）和皮质醇、尿儿茶酚胺以及糖皮质激素敏感性相关。在一个子样本分析中，睾酮水平无法区分PTSD或性功能障碍，这表明该样本中的退伍军人报告的性问题并非器质性疾病所致。PTSD确实预示着更高的双氢睾酮（DHT）水平，而这与性问题相关。有必要在对PTSD进行生物学研究时对性功能障碍进行更详细的评估，以阐明PTSD症状学及相关神经生物学与性功能障碍之间的关系。
