Faculty of Psychology, Open University, Heerlen, Netherlands.
Faculty of Psychology, Open University, Heerlen, Netherlands.
J Sex Med. 2021 Mar;18(3):582-614. doi: 10.1016/j.jsxm.2020.12.009. Epub 2021 Feb 2.
The objective of this study was to assess the efficacy of bibliotherapy for sexual dysfunctions, when compared with no treatment and compared with other interventions.
MEDLINE, EMBASE, and PsycINFO were searched from 1970 to January 2020. Selection criteria were randomized controlled trials evaluating assisted or unassisted bibliotherapy for all types of sexual dysfunctions compared with no treatment (wait list or placebo) or with other psychological interventions. Bibliotherapy is defined as psychological treatment using printed instruction to be used by the individual or couple suffering from sexual dysfunction. Primary outcome measures were male and female sexual functioning level and continuation/remission of sexual dysfunction. Secondary outcomes were sexual satisfaction and dropout rate. Sexual functioning and sexual satisfaction were self-reported by participants using validated questionnaires.
Fifteen randomized controlled trials with a total of 1,113 participants (781 women; 332 men) met inclusion criteria. Compared with no treatment, unassisted bibliotherapy resulted in larger proportions of female participants reporting remission of sexual dysfunction, and sexual satisfaction was higher in treated participants, both female and male participants. Compared with no treatment, assisted bibliotherapy had significant positive effects on female sexual functioning; no effects on male sexual functioning were found. Results of unassisted and assisted bibliotherapy did not differ from those of other intervention types on any outcome. Throughout, no differences between study conditions were found regarding dropout rates. The certainty of the evidence for all outcomes was rated as very low.
We found indications of positive effects of bibliotherapy for sexual dysfunctions. Across studies, more significant effects were found for women than for men. However, owing to limitations in the study designs and imprecision of the findings, we were unable to draw firm conclusions about the use of bibliotherapy for sexual dysfunction. More high quality and larger trials are needed. Relevant outcome measures for future studies should be defined as well as unified grading systems to measure these endpoints. In addition, future studies should report on treatment acceptability and adherence. van Lankveld JJDM, van de Wetering FT, Wylie, K et al. Bibliotherapy for Sexual Dysfunctions: A Systematic Review and Meta-Analysis. J Sex Med 2021;18:582-614.
本研究旨在评估与不治疗相比，与其他干预措施相比，阅读疗法治疗性功能障碍的疗效。
从 1970 年到 2020 年 1 月，我们在 MEDLINE、EMBASE 和 PsycINFO 上进行了搜索。纳入标准为评估所有类型性功能障碍的辅助或非辅助阅读疗法与不治疗（等待名单或安慰剂）或与其他心理干预措施相比的随机对照试验。阅读疗法被定义为使用印刷说明书对患有性功能障碍的个体或夫妇进行的心理治疗。主要结局指标为男性和女性性功能水平以及性功能障碍的持续/缓解。次要结局指标为性满意度和辍学率。参与者使用经过验证的问卷报告性功能和性满意度。
共有 15 项随机对照试验，共纳入 1113 名参与者（781 名女性；332 名男性）符合纳入标准。与不治疗相比，非辅助阅读疗法使更多的女性参与者报告性功能障碍缓解，治疗组的性满意度更高，女性和男性参与者均如此。与不治疗相比，辅助阅读疗法对女性性功能有显著的积极影响；但对男性性功能没有影响。在任何结果上，未发现非辅助和辅助阅读疗法与其他干预类型的结果有差异。总之，在辍学率方面，研究条件之间没有差异。所有结局的证据确定性均评定为极低。
我们发现阅读疗法治疗性功能障碍有积极效果的迹象。在各项研究中，对女性的影响比男性更显著。然而，由于研究设计的局限性和研究结果的不准确性，我们无法对阅读疗法治疗性功能障碍得出明确的结论。需要更多高质量和更大规模的试验。未来研究应确定相关的结局测量指标，并制定统一的分级系统来测量这些结局。此外，未来的研究应报告治疗的可接受性和依从性。
