The relation of sexual dysfunction to depression and anxiety in patients with Parkinson’s disease

Abstract

In this study, we aimed to find out whether sexual dysfunction in patients with Parkinson's Disease (PD) was associated to PD-related disability and whether this relationship was modulated by depressive and anxiety symptoms. Eighty-nine consecutive patients with idiopathic PD who attended to our movement disorders outpatient clinics between January 2011 and June 2014 were included in this study. The diagnosis of PD was confirmed by a movement disorders specialists in Neurology, according to UK Parkinson's Disease Society Brain Bank Criteria. The Unified PD Rating Scale (UPDRS) motor was used to assess motor disability and Hoehn and Yahr stage (H&Y) was used to establish disease severity. Cognitive function was assessed by the Mini-Mental State Examination. Patients were also administered the Hamilton depression (HAMD) and anxiety (HAMA) rating scales. The sexual functions of the patients were rated by applying the Turkish version of the Arizona Sexual Experiences Scale (ASEX). The mean age at the time of the study visit was 67.74±9.05. Male/female ratio was 1.87. Mean UPDRS total was 29.06±13.96 and mean UPDRS motor was 17.62±9.07. Mean HAMD score was 13.92±10.86, 58.4% of the patients had minor or major depression; and mean HAMA score was 7.94±6.49, 56.2% of the patients had minor or major anxiety. The mean ASEX score was 18.54±7.27 out of a maximum of 30. ASEX total scores were correlated with age, H&Y stage and HAMA scores. Age and also age at onset were correlated with ASEX subdomains except sexual desire. There was no correlation between disease duration and ASEX subdomains. UPDRS motor score was correlated with erection/lubrication. HAMD was only correlated with orgasm satisfaction. HAMA score was correlated with stimulation and orgasm. In patients with PD, there may be a common factor that modulates both depression, anxiety and sexual function. Further studies are needed to clarify the exact relationship.