University of Zagreb, School of Medicine (Medical Studies in English), Zagreb, Croatia (student).
Psychiatr Danub. 2019 Dec;31(Suppl 5):831-838.
Both depression and sexual dysfunction (SD) may be present in patients with multiple sclerosis (MS).
The aim of this study was to evaluate a possible association between SD and depression in patients with MS in Croatia.
This was a prospective cross-sectional study carried out in tertiary healthcare centre over 10 months, which included 101 consecutive pwMS (mean age 42.09 (range 19-77) years, 75 female, 26 male, EDSS score 3.1 (range 0.0-7.0)). SD was assessed using Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ), which was for this purpose successfully translated and validated into Croatian. Information on treatment for depression was obtained during the medical interview. Data were analysed and interpreted using parametric statistics (IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp.).
89 patients completed MSISQ. 25 patients were in treatment for depression, while 75 did not have depressive symptoms. On MSISQ 57 (43 women, 14 men) patients had responded with 'almost always/ always' suggestive of SD. Majority of patients reported primary SD, followed by secondary and tertiary SD. Most difficulties were found regarding difficulty in getting or keeping a satisfactory erection (34.6% (N=9) men), followed by 32.9% (N=27) reporting that it takes too long to orgasm or climax, followed with bladder or urinary symptoms in 32.6% (N=29). There were no significant differences between female and male patients regarding treatment for depression (χ=0.018, df=1, p>0.05). Results in all subcategories on t-test found that depressive patients had higher impact on SD when compared to non-depressive: overall (t=-2.691, df=87, p<0.01) and in regards to primary (t=-2.086, df=87, p<0.05), secondary (t=-2.608, df=87, p<0.05) and tertiary (t=-2.460, df=86, p<0.05) SD. Depressive patients on 7 questions showed significantly (p<0.05) higher SD symptoms: Muscle tightness or spasms in my arms, legs, or body; Tremors or shaking in hands or body; Pain, burning, or discomfort in their body; Feeling less attractive; Fear of being rejected sexually because of MS; Lack of sexual interest or desire; Less intense or pleasurable orgasms or climaxes.
This study gives insight into the presence of depression and SD in Croatian patients with MS for which purpose valid questionnaire for the assessment of SD in MS patients MSISQ was with permission successfully translated and validated into Croatian. The connection between depression and SD must be considered when managing patients with MS.
抑郁和性功能障碍（SD）可能同时存在于多发性硬化症（MS）患者中。
本研究旨在评估克罗地亚 MS 患者中 SD 和抑郁之间的可能关联。
这是一项在三级医疗中心进行的前瞻性横断面研究，历时 10 个月，共纳入 101 例连续 pwMS（平均年龄 42.09（范围 19-77）岁，75 名女性，26 名男性，EDSS 评分 3.1（范围 0.0-7.0））。SD 使用多发性硬化症亲密关系和性功能问卷（MSISQ）进行评估，该问卷已成功翻译并验证为克罗地亚语。在医学访谈中获得有关抑郁治疗的信息。使用参数统计分析（IBM Corp.2015 年发布。IBM SPSS Statistics for Windows，版本 23.0. Armonk，NY：IBM Corp.）对数据进行分析和解释。
89 名患者完成了 MSISQ。25 名患者正在接受抑郁治疗，而 75 名患者没有抑郁症状。在 MSISQ 上，57 名患者（43 名女性，14 名男性）回答“几乎总是/总是”，提示存在 SD。大多数患者报告存在原发性 SD，其次是继发性和继发性 SD。大多数患者在获得或保持令人满意的勃起方面存在困难（34.6%（N=9）男性），其次是 32.9%（N=27）报告说，达到性高潮或高潮需要太长时间，其次是 32.6%（N=29）报告膀胱或尿症状。在抑郁治疗方面，女性和男性患者之间没有统计学差异（χ=0.018，df=1，p>0.05）。在 t 检验的所有子类别中发现，与非抑郁患者相比，抑郁患者对 SD 的影响更高：总体（t=-2.691，df=87，p<0.01）和原发性（t=-2.086，df=87，p<0.05），继发性（t=-2.608，df=87，p<0.05）和继发性（t=-2.460，df=86，p<0.05）SD。在 7 个问题上，抑郁患者的 SD 症状明显（p<0.05）更高：手臂、腿部或身体肌肉紧张或痉挛；手部或身体震颤或颤抖；疼痛、灼热或不适；感觉不那么有吸引力；害怕因 MS 而被拒绝性；缺乏性兴趣或欲望；性高潮或高潮的强度或愉悦感降低。
本研究深入了解克罗地亚 MS 患者中抑郁和 SD 的存在情况，为此目的，我们获得了使用多发性硬化症患者 SD 评估问卷 MSISQ 的许可，并成功地将其翻译和验证为克罗地亚语。在管理 MS 患者时，必须考虑抑郁和 SD 之间的联系。
