采用 DSM-5 诊断标准评估妇科癌症幸存者的性功能障碍。
Evaluation of sexual dysfunction in gynecologic cancer survivors using DSM-5 diagnostic criteria.
机构信息
Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
Department of Obstetrics and Gynecology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC.
出版信息
BMC Womens Health. 2022 Jan 5;22(1):1. doi: 10.1186/s12905-021-01559-z.
BACKGROUND
In gynecologic cancer survivors, female sexual dysfunction (FSD) remains under-investigated. We attempted to estimate the prevalence of FSD associated with distress in gynecologic cancer survivors using diagnostic and statistical manual of mental disorders fifth edition (DSM-5) diagnostic criteria and to identify women at risk for FSD.
METHODS
We conducted a cross-sectional analysis of premenopausal women aged 20-50 with various gynecologic cancers at least one year after treatment between January 2017 and December 2019. Data of sociodemographics and physical conditions were collected via face-to-face interview during outpatient clinic visits. The domains we used to define FSD were based on DSM-5 diagnostic criteria. Statistical analysis was carried out using Student's t test, Chi-square test and multiple logistic regression.
RESULTS
A total of 126 gynecologic cancer survivors with a mean age of 42.4 years were included for analysis and 55 of them (43.7%) were diagnosed as having FSD associated with distress based on DSM-5 criteria. More than half of women (65.1%) reported decreased sexual satisfaction after cancer treatment. According to DSM-5 definition, the most common female sexual disorders were sexual interest/arousal disorder (70.9%), followed by genitopelvic pain/penetration disorder (60.0%), and orgasmic disorder (20.0%). In multiple logistic regression model, endometrial cancer diagnosis was the only independent factor predicting less influence of cancer treatment on FSD (OR 0.370; 95% CI 0.160, 0.856).
CONCLUSION
The first study to use DSM-5 criteria for estimation of FSD prevalence. This enables clinicians to identify which women are actually needed to seek medical help. A prevalence of 43.7% of FSD associated with distress was found in a group of gynecologic cancer survivors with the most common being sexual interest/arousal disorder. Endometrial cancer survivors were at low risk for developing FSD after treatment.
背景
在妇科癌症幸存者中，女性性功能障碍（FSD）仍然研究不足。我们试图使用精神障碍诊断与统计手册第五版（DSM-5）的诊断标准来估计与妇科癌症幸存者困扰相关的 FSD 的患病率，并确定患有 FSD 的风险女性。
方法
我们对 2017 年 1 月至 2019 年 12 月期间在门诊就诊的至少治疗 1 年后患有各种妇科癌症的 20-50 岁的绝经前女性进行了一项横断面分析。通过面对面访谈收集社会人口统计学和身体状况数据。我们用于定义 FSD 的领域基于 DSM-5 诊断标准。使用学生 t 检验、卡方检验和多因素逻辑回归进行统计分析。
结果
共纳入 126 名妇科癌症幸存者，平均年龄为 42.4 岁，其中 55 名（43.7%）根据 DSM-5 标准诊断为患有与困扰相关的 FSD。超过一半的女性（65.1%）报告在癌症治疗后性满意度下降。根据 DSM-5 定义，最常见的女性性功能障碍是性欲/唤起障碍（70.9%），其次是生殖器疼痛/插入障碍（60.0%）和性高潮障碍（20.0%）。在多因素逻辑回归模型中，子宫内膜癌诊断是预测癌症治疗对 FSD 影响较小的唯一独立因素（OR 0.370；95%CI 0.160，0.856）。
结论
这是第一项使用 DSM-5 标准估计 FSD 患病率的研究。这使临床医生能够确定哪些女性实际上需要寻求医疗帮助。在一组妇科癌症幸存者中，发现与困扰相关的 FSD 患病率为 43.7%，最常见的是性欲/唤起障碍。子宫内膜癌幸存者在治疗后发生 FSD 的风险较低。
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