Operational Stress Injury Clinic, Parkwood Institute, 550 Wellington Rd, London, ON, N6C 5J1 Canada.
MacDonald/Franklin OSI Research Centre, Parkwood Institute, 550 Wellington Rd, London, ON, N6C 5J1, Canada.
Mil Med. 2020 Feb 12;185(1-2):68-74. doi: 10.1093/milmed/usz163.
There is mixed evidence regarding how posttraumatic stress disorder (PTSD) symptom clusters are associated with sexual dysfunction (SD), and most studies to date have failed to account for potentially confounding variables. Our study sought to explore the unique contribution of PTSD symptom clusters on (a) lack of sexual desire or pleasure, and (b) pain or problems during sexual intercourse, after adjusting for comorbidities and medication usage.
Participants included 543 male treatment-seeking veterans and Canadian Armed Forces (CAF) personnel (aged <65 years), referred for treatment between September 2006 and September 2014. Each participant completed self-report measures of demographic variables, depressive symptom severity, chronic pain, alcohol misuse, and psychotropic medication usage as part of a standard clinical intake protocol. Hierarchical ordinal logistic regression analyses were used to determine the incremental contribution of PTSD symptom clusters on sexual dysfunction.
Nearly three-quarters (71.5%) of participants reported a lack of sexual desire or pleasure and 40.0% reported pain or problems during intercourse. Regression analyses suggested that avoidant/numbing symptoms were the only symptoms to be independently associated with lacking sexual desire or pleasure (AOR = 1.10; 95% CI 1.05-1.15). None of the PTSD symptom clusters were independently associated with pain or problems during intercourse.
Sexual dysfunction is prevalent among male treatment-seeking CAF personnel and veterans. Results suggest that PTSD symptoms are differentially associated with sexual desire or pleasure concerns. Assessing sexual function among CAF personnel and veterans seeking treatment for PTSD is critical in order to treat both conditions and improve overall functioning.
关于创伤后应激障碍（PTSD）症状群与性功能障碍（SD）的关系，证据不一，迄今为止的大多数研究都未能考虑到潜在的混杂变量。我们的研究旨在探讨 PTSD 症状群对（a）缺乏性欲或性快感，以及（b）性交时疼痛或问题的独特影响，同时调整了共病和药物使用情况。
参与者包括 543 名寻求治疗的男性退伍军人和加拿大武装部队（CAF）人员（年龄<65 岁），他们在 2006 年 9 月至 2014 年 9 月期间因治疗而被转介。每位参与者都完成了自我报告的人口统计学变量、抑郁症状严重程度、慢性疼痛、酒精滥用和精神药物使用情况的测量，作为标准临床摄入方案的一部分。使用分层有序逻辑回归分析来确定 PTSD 症状群对性功能障碍的增量贡献。
近四分之三（71.5%）的参与者报告缺乏性欲或性快感，40.0%的人报告性交时疼痛或问题。回归分析表明，回避/麻木症状是唯一与缺乏性欲或性快感独立相关的症状（优势比=1.10；95%置信区间 1.05-1.15）。没有一个 PTSD 症状群与性交时的疼痛或问题独立相关。
性功能障碍在寻求 CAF 人员和退伍军人治疗的男性中很普遍。结果表明，PTSD 症状与性欲或性快感问题的相关性不同。评估寻求 PTSD 治疗的 CAF 人员和退伍军人的性功能对于同时治疗这两种疾病并改善整体功能至关重要。
