Altmann Patrick, Leutmezer Fritz, Leithner Katharina, Monschein Tobias, Ponleitner Markus, Stattmann Miranda, Rommer Paulus Stefan, Zrzavy Tobias, Zulehner Gudrun, Berek Klaus, Berger Thomas, Bsteh Gabriel
Department of Neurology, Medical University of Vienna, Vienna, Austria.
Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Front Neurol. 2021 Feb 9;12:618370. doi: 10.3389/fneur.2021.618370. eCollection 2021.
Sexual dysfunction (SD) in people with multiple sclerosis (pwMS) has a detrimental impact on individual health-related quality of life (HRQoL). It is not clear whether SD in multiple sclerosis (MS) is an independent symptom or merely a byproduct of other symptoms such as depression or anxiety. This cross-sectional study of 93 pwMS determines risk factors for SD in MS based on prevalence, HRQoL, and associated disease outcomes. Diagnosis of SD was determined based on the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) and correlated with physical disability (measured by Expanded Disability Status scale, EDSS), depression and anxiety [Hospital Anxiety and Depression Scale (HADS)], and HRQoL [Multiple Sclerosis Quality of Life-54 (MSQoL-54)]. Multivariate regression models were performed to determine independent risk factors for SD in pwMS. Almost half of the participants in this study (46%) reported SD. HRQoL was significantly poorer in patients with MS suffering from SD (median [IQR] MSQoL-54 scores: physical subscale 52 [41-68] vs. 81 [69-89], < 0.001; mental subscale 50 [38-82] vs. 86 [70-89], < 0.001). In the multivariate model, EDSS was the only independent risk factor for SD (OR 18.1 for EDSS ≥4 [95% CI 3.3-31.4, < 0.001]), while depression and anxiety were not. We conclude that the risk for SD is growing with increasing EDSS and is independent of depression or anxiety. Screening for SD becomes particularly relevant in patients with growing disability.
多发性硬化症患者（pwMS）的性功能障碍（SD）会对个体的健康相关生活质量（HRQoL）产生不利影响。目前尚不清楚多发性硬化症（MS）中的SD是一种独立症状，还是仅仅是抑郁或焦虑等其他症状的副产品。这项对93名pwMS患者的横断面研究基于患病率、HRQoL和相关疾病结局确定了MS中SD的危险因素。SD的诊断基于多发性硬化症亲密关系与性问卷-19（MSISQ-19），并与身体残疾（用扩展残疾状态量表，EDSS测量）、抑郁和焦虑[医院焦虑抑郁量表（HADS）]以及HRQoL[多发性硬化症生活质量-54（MSQoL-54）]相关。进行多变量回归模型以确定pwMS中SD的独立危险因素。本研究中几乎一半的参与者（46%）报告有SD。患有SD的MS患者的HRQoL明显较差（MSQoL-54评分中位数[四分位间距]：身体亚量表52[41-68]对81[69-89]，<0.001；心理亚量表50[38-82]对86[70-89]，<0.001）。在多变量模型中，EDSS是SD的唯一独立危险因素（EDSS≥4时的OR为18.1[95%CI 3.3-31.4，<0.001]），而抑郁和焦虑则不是。我们得出结论，SD的风险随着EDSS的增加而增加，且独立于抑郁或焦虑。对于残疾程度不断增加的患者，筛查SD变得尤为重要。
