Zavoreo Iris, Gržinčić Tihana, Preksavec Marina, Madžar Tomislav, Bašić Kes Vanja
Neurology Department, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Neurology Department, General Hospital Bjelovar, Bjelovar, Croatia
Acta Clin Croat. 2016 Sep;55(3):402-406. doi: 10.20471/acc.2016.55.03.08.
Multiple sclerosis (MS) is one of the most common diseases of the central nervous system and usually occurs at the age when people would be expected to be in the prime of their sexual lives. In everyday practice, sexual dysfunction is underestimated because clinicians mostly concentrate on the classic neurologic deficits and often overlook symptoms that can seriously affect the quality of life. Our study included 98 patients (42 men and 56 women, mean age 35±12 years) with relapse from our MS register, with established diagnosis of relapsing remitting multiple sclerosis according to McDonald criteria. Patients completed the questionnaires (Sexual Satisfaction Scale, SSS and Beck Depression Scale BDS), and underwent neurological assessment (Expanded Disability Status Scale, EDSS). All patients were in the group with EDSS 2 to 4 points (mobile patients). There was no statistically significant difference in BDS and SSS values according to EDSS score. Correlation coefficients were calculated (BDS and SSS) for men (p=0.42) and women (p=0.44), yielding positive correlation. There was no statistically significant difference in BDS and SSS values according to gender, disease duration or immunomodulatory therapy. In our group of patients, despite low EDSS score (fully ambulatory without aid, self sufficient patients) we found positive correlation between sexual dysfunction and depression, showing that even in such patients the quality of life can be decreased. In conclusion, sexual dysfunction and depression are mostly under-recognized by neurologists because they are not part of routine testing; therefore, some additional questionnaires should be used in the evaluation in MS patients, even those with low EDSS score, in order to improve their quality of life.
多发性硬化症（MS）是中枢神经系统最常见的疾病之一，通常发生在人们预期处于性生活黄金期的年龄。在日常临床实践中，性功能障碍往往被低估，因为临床医生大多专注于经典的神经功能缺损，常常忽略那些会严重影响生活质量的症状。我们的研究纳入了98例来自我们多发性硬化症登记册的复发患者，根据麦克唐纳标准确诊为复发缓解型多发性硬化症。患者完成了问卷调查（性满意度量表，SSS和贝克抑郁量表，BDS），并接受了神经学评估（扩展残疾状态量表，EDSS）。所有患者均处于EDSS评分为2至4分的组（可活动患者）。根据EDSS评分，BDS和SSS值无统计学显著差异。计算了男性（p = 0.42）和女性（p = 0.44）的相关系数（BDS和SSS），结果呈正相关。根据性别、疾病持续时间或免疫调节治疗，BDS和SSS值无统计学显著差异。在我们的患者组中，尽管EDSS评分较低（无需辅助可完全行走，生活自理的患者），但我们发现性功能障碍与抑郁之间存在正相关，这表明即使是这类患者，生活质量也可能会下降。总之，性功能障碍和抑郁大多未被神经科医生充分认识，因为它们不是常规检查的一部分；因此，在评估MS患者时，即使是EDSS评分低的患者，也应使用一些额外的问卷，以提高他们的生活质量。
