Jiang Fugui, Liu Zenghui, Wu Xianglong, Tan Arui, Qin Xiaohong, Su Rong Cheng, Li Hui, Wang Huan, Xiao Jun, Zhou Bo
Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China.
Front Psychiatry. 2023 Dec 7;14:1291988. doi: 10.3389/fpsyt.2023.1291988. eCollection 2023.
Sexual dysfunction is commonly observed in individuals with Major Depressive Disorder (MDD), along with various psychological symptoms such as anxiety, somatic complaints, interpersonal sensitivity, and obsessive-compulsive tendencies. However, there is a research gap in understanding the impact of these psychological symptoms on sexual functioning in MDD. Furthermore, there is limited data on the incidence of sexual dysfunction among drug-naive MDD patients in West China. This study aims to determine the prevalence of sexual dysfunction in this patient population and explore its association with other psychological indicators.
We conducted a retrospective analysis of patient data from October 2020 to September 2022 using propensity score matching. A focused group of 165 males and 490 females was selected from a total of 1941 MDD patients. This allowed for a comparative analysis of demographic data, as well as scores from the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Symptom Checklist-90 (SCL-90), the Arizona Sexual Experience Scale (ASEX).
Our findings reveal that 46.2% of drug-naive MDD patients experienced sexual dysfunction. Notably, there was a higher prevalence of sexual dysfunction among female patients (50.3%) compared to males (37.5%). MDD patients without sexual dysfunction consistently exhibited higher SDS scores than those with sexual dysfunction ( < 0.01), There were no statistically significant differences between male and female MDD patients with or without concomitant sexual dysfunction in terms of Somatic complaints, Obsessive-compulsive, Interpersonal sensitivity, Anxiety, Phobic anxiety, Paranoid ideation, Psychoticism and Diet/sleep difficulties ( > 0.05). In addition, male MDD patients with sexual dysfunction showed a emerging trend towards elevated Hostility scores on the SCL-90 ( = 0.058), male MDD patients with sexual dysfunction showed an increasing trend in hostility scores on the SCL-90, whereas female MDD patients with sexual dysfunction did not show such a trend.
The study highlights a significant gender difference in the prevalence of sexual dysfunction among MDD patients, with females being more susceptible than males. There is a positive correlation between the severity of depression and sexual dysfunction in both genders. Interestingly, male MDD patients demonstrated a potential protective effect of hostility against sexual dysfunction, which was not observed in female patients.
性功能障碍在重度抑郁症（MDD）患者中普遍存在，同时伴有各种心理症状，如焦虑、躯体不适、人际敏感和强迫倾向。然而，在理解这些心理症状对MDD患者性功能的影响方面存在研究空白。此外，关于中国西部未服用过药物的MDD患者中性功能障碍发生率的数据有限。本研究旨在确定该患者群体中性功能障碍的患病率，并探讨其与其他心理指标的关联。
我们使用倾向得分匹配法对2020年10月至2022年9月的患者数据进行了回顾性分析。从总共1941名MDD患者中选取了165名男性和490名女性组成重点研究组。这使得我们能够对人口统计学数据以及自评抑郁量表（SDS）、自评焦虑量表（SAS）、症状自评量表90（SCL - 90）、亚利桑那性体验量表（ASEX）的得分进行比较分析。
我们的研究结果显示，46.2%未服用过药物的MDD患者存在性功能障碍。值得注意的是，女性患者（50.3%）性功能障碍的患病率高于男性（37.5%）。无性功能障碍的MDD患者的SDS得分始终高于有性功能障碍的患者（<0.01），在有无性功能障碍的男性和女性MDD患者之间，在躯体不适、强迫、人际敏感、焦虑、恐惧焦虑、偏执观念、精神病性和饮食/睡眠困难方面没有统计学显著差异（>0.05）。此外，有性功能障碍的男性MDD患者在SCL - 90上的敌对得分有上升趋势（=0.058），有性功能障碍的男性MDD患者在SCL - 90上的敌对得分呈上升趋势，而有性功能障碍的女性MDD患者未表现出这种趋势。
该研究突出了MDD患者性功能障碍患病率存在显著的性别差异，女性比男性更易患病。抑郁症严重程度与两性性功能障碍之间存在正相关。有趣的是，男性MDD患者表现出敌对情绪对性功能障碍有潜在的保护作用，而女性患者未观察到这一现象。
