Letica-Crepulja Marina, Stevanović Aleksandra, Protuđer Marina, Popović Božidar, Salopek-Žiha Darija, Vondraček Snježana
Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.
Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center of the Ministry of Health of the Republic of Croatia, 51000 Rijeka, Croatia.
J Clin Med. 2019 Mar 29;8(4):432. doi: 10.3390/jcm8040432.
The problems in sexual functioning among patients with post-traumatic stress disorder (PTSD) are often overlooked, although scientific research confirms high rates of sexual dysfunctions (SD) particularly among veterans with PTSD. The main objective of this study was to systematically identify predictors of SD among veterans with PTSD.
Three hundred veterans with PTSD were included in the cross-sectional study. The subjects were assessed by the Mini-International Neuropsychiatric Interview (MINI) and self-report questionnaires: PCL-5, i.e., PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) with Criterion A, International Index of Erectile Function (IIEF), Premature Ejaculation Diagnostic Tool (PEDT), and Relationship Assessment Scale (RAS). Several hierarchical multiple regressions were performed to test for the best prediction models for outcome variables of different types of SD.
65% of participants received a provisional diagnosis of SD. All tested prediction models showed a good model fit. The significant individual predictors were cluster D (Trauma-Related Negative Alterations in Cognition and Mood) symptoms (for all types of SD) and in a relationship status/relationship satisfaction (all, except for premature ejaculation (PE)).
The most salient implication of this study is the importance of sexual health assessment in veterans with PTSD. Therapeutic interventions should be focused on D symptoms and intended to improve relationship functioning with the aim to lessen the rates of SD. Psychotropic treatment with fewer adverse sexual effects is of utmost importance if pharmacotherapy is applied. Appropriate prevention, screening, and treatment of medical conditions could improve sexual functioning in veterans with PTSD.
创伤后应激障碍（PTSD）患者的性功能问题常常被忽视，尽管科学研究证实性功能障碍（SD）的发生率很高，尤其是在患有PTSD的退伍军人中。本研究的主要目的是系统地确定患有PTSD的退伍军人中SD的预测因素。
300名患有PTSD的退伍军人纳入了这项横断面研究。通过迷你国际神经精神访谈（MINI）和自我报告问卷对受试者进行评估：PCL-5，即《精神障碍诊断与统计手册》第五版（DSM-5）中符合A标准的PTSD检查表、国际勃起功能指数（IIEF）、早泄诊断工具（PEDT）和关系评估量表（RAS）。进行了几次分层多元回归分析，以测试不同类型SD结果变量的最佳预测模型。
65%的参与者被初步诊断为SD。所有测试的预测模型都显示出良好的模型拟合度。显著的个体预测因素是D簇（与创伤相关的认知和情绪负面改变）症状（对所有类型的SD）以及恋爱状况/恋爱满意度（除早泄（PE）外的所有情况）。
本研究最显著的意义在于对患有PTSD的退伍军人进行性健康评估的重要性。治疗干预应集中在D症状上，并旨在改善关系功能，以降低SD的发生率。如果采用药物治疗，具有较少不良性副作用的精神药物治疗至关重要。对医疗状况进行适当的预防、筛查和治疗可以改善患有PTSD的退伍军人的性功能。
