Hösl Katharina M, Deutsch Martina, Wang Ruihao, Roy Sankanika, Winder Klemens, Niklewski Günter, Lee De-Hyung, Linker Ralf A, Hilz Max J
Department of Psychiatry and Psychotherapy, Paracelsus Medical University, Nuremberg, Germany.
Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.
Eur Neurol. 2018;80(1-2):34-41. doi: 10.1159/000492126. Epub 2018 Aug 31.
In women with multiple sclerosis (MS), depression and sexual dysfunction (SD) are common. Whether SD promotes depression or vice versa remains unclear despite therapeutic relevance. Therefore, we aimed to assess whether SD more likely triggers depression or vice versa.
In 83 female MS patients and 21 age-matched healthy women, we assessed depression, using the Beck Depression Inventory-V (BDI-V), and SD using the Female Sexual Function Index (FSFI). We diagnosed depression with BDI-V-scores >35 and SD with FSFI scores < 26.55. We divided patients into groups with and without SD, with and without depression. Between groups, we compared prevalence of SD and depression (Fisher's-exact-test), age, MS-duration, MS-severity, BDI-V-, and FSFI scores (Mann-Whitney U-test; significance: p < 0.05).
A total of 37/83 MS patients and 1/21 controls had SD; 28/83 patients and 3/21 controls had depression; 51.4% patients with SD but only 19.6% without SD had depression (p = 0.003). SD was present in 67.9% depressed and 32.7% non-depressed patients. BDI-V-scores were higher in patients with SD than in patients without SD. FSFI scores were lower in depressed than non-depressed patients.
In conclusion, SD was more common than depression. SD afflicted 67.9% depressed MS patients and was also more common in non-depressed MS patients than controls. SD may occur independently from depression while increased depressiveness seems linked to coexistent SD.
在患有多发性硬化症（MS）的女性中，抑郁症和性功能障碍（SD）很常见。尽管具有治疗相关性，但SD是否会引发抑郁症，或者反之亦然，仍不清楚。因此，我们旨在评估SD是否更有可能引发抑郁症，或者反之亦然。
在83名女性MS患者和21名年龄匹配的健康女性中，我们使用贝克抑郁量表-V（BDI-V）评估抑郁症，并使用女性性功能指数（FSFI）评估SD。我们将BDI-V评分>35诊断为抑郁症，FSFI评分<26.55诊断为SD。我们将患者分为有或无SD、有或无抑郁症的组。在组间，我们比较了SD和抑郁症的患病率（Fisher精确检验）、年龄、MS病程、MS严重程度、BDI-V和FSFI评分（Mann-Whitney U检验；显著性：p<0.05）。
共有37/83名MS患者和1/21名对照有SD；28/83名患者和3/21名对照有抑郁症；有SD的患者中有51.4%患有抑郁症，而无SD的患者中只有19.6%患有抑郁症（p=0.003）。67.9%的抑郁症患者和32.7%的非抑郁症患者存在SD。有SD的患者BDI-V评分高于无SD的患者。抑郁症患者的FSFI评分低于非抑郁症患者。
总之，SD比抑郁症更常见。SD困扰着67.9%的抑郁症MS患者，并且在非抑郁症MS患者中也比对照组更常见。SD可能独立于抑郁症发生，而抑郁程度增加似乎与共存的SD有关。
