Basson Rosemary, Gilks Thea
The University of British Columbia, Vancouver, BC, Canada.
Womens Health (Lond). 2018 Jan-Dec;14:1745506518762664. doi: 10.1177/1745506518762664.
Impairment of mental health is the most important risk factor for female sexual dysfunction. Women living with psychiatric illness, despite their frequent sexual difficulties, consider sexuality to be an important aspect of their quality of life. Antidepressant and antipsychotic medication, the neurobiology and symptoms of the illness, past trauma, difficulties in establishing relationships and stigmatization can all contribute to sexual dysfunction. Low sexual desire is strongly linked to depression. Lack of subjective arousal and pleasure are linked to trait anxiety: the sensations of physical sexual arousal may lead to fear rather than to pleasure. The most common type of sexual pain is 10 times more common in women with previous diagnoses of anxiety disorder. Clinicians often do not routinely inquire about their patients' sexual concerns, particularly in the context of psychotic illness but careful assessment, diagnosis and explanation of their situation is necessary and in keeping with patients' wishes. Evidence-based pharmacological and non-pharmacological interventions are available but poorly researched in the context of psychotic illness.
心理健康受损是女性性功能障碍最重要的风险因素。患有精神疾病的女性尽管经常存在性方面的困难,但仍将性视为其生活质量的重要方面。抗抑郁药和抗精神病药物、疾病的神经生物学和症状、过去的创伤、建立人际关系的困难以及污名化都可能导致性功能障碍。性欲低下与抑郁症密切相关。缺乏主观唤起和快感与特质焦虑有关:生理性唤起的感觉可能导致恐惧而非愉悦。最常见的性疼痛类型在先前被诊断患有焦虑症的女性中出现的频率要高10倍。临床医生通常不会常规询问患者的性问题,尤其是在精神病患者的情况下,但仔细评估、诊断并向患者解释其情况是必要的,且符合患者的意愿。有基于证据的药物和非药物干预措施,但在精神病患者的背景下研究较少。