Presence Of Sexual Dysfunction Research Articles

EPA-0915 – Sexuality of patients with affective disorders: a survey of polish patients

Objective The aim of the hereby-presented multi research center studies is the description of how frequent sexual impairments touch the patients with affective disorders in diagnosis, as well as the assessment of illness’ and pharmacotherapy's influence on their occurrence. 207 patients aged 18-65 have been examined. Design and Method The research was based on a number of standardized questionnaires: The BSP Questionnaire (Pole's Sexuality Research), Female Sexual Functioning, Male Sexual Functioning, the Hamilton Rating Scale for Depression and the Young Mania Rating Scale. The above-mentioned questionnaires were then supplemented with data on patients’ social and economic status (education, professional activity) as well as a number of other health conditions that might influence the quality of sexual life (associated somatic diseases, drugs influencing the cycle of sexual responses). Additionally information was gathered on the course of illness itself, duration of episodes and types of pharmacological treatment. Conclusions The presence of sexual dysfunction in patients should encourage therapists to answer the question to what extent are they caused by the disease or antidepressant drug administrated. The issue of sexual dysfunction should play a greater role in the course of therapy. All patients in the course of the study were taking antidepressants. A significant difference between the percentage of patients reporting directly to their doctors the presence of sexual dysfunction and the results carried out on the basis of questionnaires should encourage therapists to direct questions about the presence of the disorder in this sphere of life.

SAT0075 Prevalence of Sexual Dysfunction Among Moroccan Women with Rheumatoid Arthritis: Case-Control Study

ObjectivesTo assess the prevalence of sexual dysfunction in married women with rheumatoid arthritis (RA) and comparing with a control group.MethodsWe conducted a cross-sectional study including 31 case-control patients with rheumatoid...

Hypogonadotropic hypogonadism among a population of obese men: Prevalence, risk factors and reversibility after weight loss induced by bariatric surgery

Background and aims: Obesity in men is frequently associated with low levels of testosterone, loss of libido and/or erectile dysfunction. Our goal was to estimate the prevalence of hypogonadism among obese men and to determine its risk factors and reversibility after bariatric surgery. Methods: Seventy-five obese men were studied at baseline. Metabolic and hormonal parameters were measured, body composition was assessed by bioelectrical impedance and hypogonadism was evaluated by the ADAM (Androgen Deficiency in Aging Males) questionnaire. Twenty-one patients were re-evaluated after bariatric surgery. Results: At baseline, 39% of obese men had hypotestosteronemia, while symptoms of androgen deficiency were present in 93%. Total Testosterone (TT) was inversely related to body mass index (BMI) (. P<. 0.05), waist circumference (. P=. 0.012) and body fat mass (. P=. 0.022). Bariatric surgery was associated with an increase in TT (. P=. 0.001) and decreases in estradiol (E2) (. P=. 0.008) and in the E2/TT ratio (. P=. 0.001). Conclusions: Low testosterone levels are frequently observed among morbidly obese men and are correlated with the degree of abdominal adiposity, but not strongly with the presence of sexual dysfunction. Bariatric surgery leads to normalized TT and to decreased E2 and E2/TT ratio, suggesting a role of excessive aromatization in the hypotestosteronemia associated with obesity.

1298 – Analysis of sexual dysfunctions in patients with psoriasis compared with patients with other chronic dermatological diseases

Introduction Psoriasis is a chronic disease with major importance for society. The extent of impaired functioning of patients with psoriasis is comparable with the extent of impairment of patients with cancer or heart disease. Patients with this illness show the highest intensification of various psychiatric disorders among patients suffering from dermatological diseases. Objectives To estimate the prevalence of sexual dysfunction among patients with psoriasis compared with patients with other chronic dermatological diseases. An attempt to link sexual dysfunction with selected factors. Methods The study included 32 patients diagnosed with psoriasis. A questionnaire, consisting of four parts, has been used: I- used for the assessment of dermatological condition of patient, II - Questionnaire for the valuation of the indicator of the impact of skin conditions on quality of life (DLQI), III - Beck Scale - for the assessment of depression (BDI), IV - Mell-Krat Scale for the assessment of sexual disorders. Part I has been filled by the interviewer, other - by the tested person independently. The results were compared with the control group (people suffering from other chronic dermatological diseases), matched in terms of sex and age. Results None of the persons belonging to the control or tested group has declared taking advice from a sexologist, despite the presence of sexual dysfunction in both groups (identified by Mell-Krat scale). Conclusions The above findings are results of a pilot study and it is needed to confirm them in a larger group of patients.

Prevalence and risk factors for female sexual dysfunction among Egyptian women

To assess sexual function among married women and determine associated risk factors for sexual dysfunction. Cross-sectional hospital-based study involving 509 non-pregnant married females 20-59 years old who were enrolled into the study after approval of the ethics committee. The study population was recruited among women attending gynecology outpatient clinic or their relatives visiting inpatients of obstetrics and gynecology department at Suez Canal University Hospital. Female and male partner-related data were collected using an interview questionnaire. Sexual dysfunction was assessed using female sexual function index (FSFI). Mean female age was 39.5 years. About half of the participants were premenopausal (48.7 %). Most of the females were circumcised (71.7 %). Desire and Orgasm domains were the most affected with 52.8 % of the participants having sexual dysfunction. Total FSFI score of ≤26.55 was the cutoff value for diagnosis of FSD and female age, postmenopausal status, duration of marriage, circumcision, partner's age, and the presence of male sexual dysfunction were found to be significant associated factors with FSD. FSD is highly prevalent in Egypt and orgasm and desire scores were the most affected domains. Several personal (female age, postmenopausal status, duration of marriage and circumcision) and male partner (age, and the presence of sexual dysfunction) factors were significantly associated.

The Impact of Sexual Functioning Problems on Mental Well-Being In U.S. Veterans from the Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Conflicts

ABSTRACT Substantial literature currently exists linking medically-related sexual problems and Health Related Quality of Life (HRQoL). This study explores the impact of global/non-medically linked sexual functioning problems and HRQoL in United States (U.S.) Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans. A total of 415 veterans newly registered to the Veterans Health Administration (VA) completed measures of demographic, mental health and physical health-related diagnoses and symptoms, including questions specific to sexual functioning. A multiple linear regression analysis was performed to examine associations between mental and physical component scores and sexual functioning problems. Age, hypertension, pain, depression, anxiety disorder, post-traumatic stress disorder, and substance abuse were included as covariates. Findings indicated that sexual dysfunction had a strong negative effect on the SF-36 Mental Component Summary (MCS) scale after adjusting for multiple physical and mental health characteristics. Although a number of covariates were significantly related to the MCS scale, sexual functioning problems exhibited a unique contribution to mental wellbeing. This study highlights the presence of sexual dysfunction in this rather young veteran cohort and its significant negative overall impact on wellbeing. Consequently, provider screening of sexual health needs within the VA system as part of holistic and veteran-centric healthcare model should be considered.

Premature ejaculation and other sexual dysfunctions in opiate dependent men receiving methadone substitution treatment

Background A significant number of men with opiate misuse have sexual problems. Premature ejaculation (PE) occurs predominantly on discontinuation of the opiate but seems to persist in some cases. The aims of this study were to determine the rates of PE and other sexual dysfunctions in patients maintained on methadone; to determine the time of onset of PE in relation to onset of opiate misuse; and to look at the patients' perception of the effect of heroin and methadone on PE. Methods Sixty five men attending a tertiary referral clinic for methadone maintenance treatment were assessed cross-sectionally using a semi-structured questionnaire, clinical interview, review of clinical records and the International Index of Erectile Function (IIEF). Results Thirty eight (58.5%) subjects reported a “lifetime” history of PE. Twenty (30.76%) of them reported “current” history of PE. Eleven (16.9%) people reported that PE preceded opiate misuse. Twenty four (63.2%) felt that heroin helped their PE and 7 (18.4%) felt that heroin worsened it. Fourteen (36.8%) felt that methadone helped PE, while 10 (26.3%) felt methadone worsened PE. Only 2 out of 65 (3.07%) reported that they had been asked about their sex life by the addiction services. Conclusion Prevalence of “current” premature ejaculation was almost 3 times greater than reported in the general population. A significant number of patients perceived heroin to be beneficial on PE. Presence of sexual dysfunction could therefore be a risk factor for relapse into heroin misuse. Most clinicians avoid asking patients questions of a sexual nature. Nevertheless, managing sexual difficulties among patients with opiate misuse could be a significant step in relapse prevention.

Risk Factors for Low Sexual Function Among Urban Chinese Women: A Hospital‐Based Investigation

Sexual dysfunction is a common problem affecting women's quality of life. However, reports on sexual dysfunction and its risk factors in Chinese women are scarce in the literature. To identify the potential risk factors for low sexual function in urban Chinese women. A cross-sectional hospital-based survey was conducted in Nanjing, China. Data on sexual function and related variables of 1,457 women from the urban district of Nanjing city were obtained. Potential risk factors for low sexual function were determined using multiple logistic regression analysis. The Female Sexual Function Index (FSFI) was used to evaluate sexual function, and the median of the FSFI score was used as a cutoff to define women with low sexual function. The mean FSFI total score was 23.25 ± 4.00 (median = 22.8). Multivariate analysis showed that age (odds ratio [OR] 1.840 for 40-49 years; 5.006 for 50-60 years), depression (OR 1.896), low education level (primary or secondary school only, OR 1.450), alcohol use (OR 2.671), menopause or postmenopause (OR 3.157), chronic medical disease (OR 1.605), poor health status of partner (OR 3.358), presence of sexual dysfunction in partner (OR 4.604), dystocia (OR 3.109), and living apart from the partner (OR 1.316) were independent risk factors for low sexual function of women in urban China. By contrast, better communication with the partner regarding sex (OR 0.531) was a protective factor. Low sexual function for urban Chinese women was associated with multiple variables. Women who communicated more frequently with their partner were less likely to have low sexual function.

Sexual dysfunction among married couples living in Kumasi metropolis, Ghana

BackgroundSexuality and its manifestation constitute some of the most complex of human behaviour and its disorders are encountered in community. Sexual dysfunction is more prevalent in women than in men. While studies examining sexual dysfunction among males and females in Ghana exist, there are no studies relating sexual problems in males and females as dyadic units. This study therefore investigated the prevalence and type of sexual disorders among married couples.MethodThe study participants consisted of married couples between the ages of 19 and 66 living in the province of Kumasi, Ghana. Socio-demographic information and Golombok-Rust Inventory of Sexual Satisfaction (GRISS) questionnaires were administered to 200 couples who consented to take part in the study. All 28 questions of the GRISS are answered on a five-point (Likert type) scale from "always", through "usually', "sometimes", and "hardly ever", to "never". Responses are summed up to give a total raw score ranging from 28-140. The total score and subscale scores are transformed using a standard nine point scale, with high scores indicating greater problems. Scores of five or more are considered to indicate SD. The study was conducted between July and September 2010.ResultsOut of a total of 200 married couples, 179 completed their questionnaires resulting in a response rate of 89.5%. The mean age of the participating couples as well as the mean duration of marriage was 34.8 ± 8.6 years and 7.8 ± 7.6 years respectively. The husbands (37.1 ± 8.6) were significantly older (p < 0.0001) than their corresponding wives (32.5 ± 7.9). After adjusting for age, 13-18 years of marriage life poses about 10 times significant risk of developing SD compared to 1-6 years of married life among the wives (OR: 10.8; CI: 1.1 - 49.1; p = 0.04). The total scores (6.0) as well as the percentage above the cut-off (59.2) obtained by the husbands compared to the total score (6.2) and the percentage above cut-off (61.5) obtained by the wives, indicates the likely presence of sexual dysfunction. The prevalence of impotence and premature ejaculation were 60.9% and 65.4% respectively from this study and the prevalence of vaginismus and anorgasmia were 69.3% and 74.9% respectively. The highest prevalence of SD subscales among the men was dissatisfaction with sexual act followed by infrequency, whereas the highest among the women was infrequency followed by anorgasmia. Dissatisfaction with sexual intercourse among men correlated positively with anorgasmia and wife's non-sensuality and infrequency of sex.ConclusionThe prevalence of sexual dysfunction in married couples is comparable to prevalence rates in the general male and female population and is further worsened by duration of marriage. This could impact significantly on a couple's self-esteem and overall quality of life.

Sexual Dysfunction Among Secondary School Teachers in Ilorin, Nigeria

There is an increasing emphasis on human sexuality, which may reflect cultural and scientific development in recent years. To determine the prevalence, pattern of sexual dysfunction, and its associated factors among secondary school teachers in Ilorin, Kwara State, Nigeria. Four hundred fifty consenting teachers were invited to complete an anonymous self administered questionnaire on demography as well as two to three other instruments for the assessment of human sexuality and general mental health status. This was thereafter collected by hand. The International Index of Erectile Function (IIEF), a modified Sexual Activity Questionnaire (SAQ) and the General Health Questionnaire-30 (GHQ-30). The following prevalence rates were found: female anorgasmia (40%), lubrication failure (30%); dyspareunia (12%); erectile dysfunction, premature ejaculation, and male orgasmic disorder (23% each); loss of sexual desire (24%); sexual life dissatisfaction and relationship dissatisfaction 6 months prior to interview (10% each). Age was a significant factor in sexual dysfunction in males (erectile dysfunction, premature ejaculation, and male anorgasmia), also in females (lubrication failure, superficial dyspareunia, anorgasmia). Marital status was found to be significant in relationship satisfaction, overall sexual satisfaction and presence of sexual dysfunctions whereas GHQ-30 scores were significant in sexual dysfunction in both genders, except for female anorgasmia and premature ejaculation in males. However, a presence of psychiatric "caseness" was significantly found in overall sexual life dissatisfaction as well as relationship dissatisfaction. The extent and pattern of sexual dysfunctions found in this study is comparable with those reported in earlier Nigerian studies. Despite this, there is apparently no health services specially designed to address sexual dysfunction among the teacher's group or the general population at large. This study thus draws attention to the urgent need for services geared towards alleviating sexual problems in our society.

Imagem corporal e comportamento sexual de mulheres obesas com e sem transtorno da compulsão alimentar periódica

CONTEXTO: A maioria dos estudos que relacionam transtornos alimentares com sexualidade diz respeito a anorexia nervosa e a bulimia nervosa, sendo escassos aqueles que estudam conjuntamente a sexualidade com o comer compulsivo. OBJETIVO: Verificar a presenca de disfuncoes sexuais, impulso sexual excessivo e alteracoes na percepcao da imagem corporal de mulheres obesas, alem de comparar portadoras a nao portadoras de transtorno da compulsao alimentar periodica (TCAP) quanto a esses aspectos. METODOS: Participaram do estudo dois grupos de 20 mulheres obesas cada, com as nao portadoras apresentando media etaria de 29,80 ± 6,15 anos e de IMC de 35,12 ± 4,59 kg/m², e as portadoras apresentando 34,70 ± 9,62 anos e 37,27 ± 2,89 kg/m². RESULTADOS: Em relacao a imagem corporal, os dois instrumentos utilizados mostraram diferenca significante entre os grupos, com as portadoras de TCAP sentindo-se menos atraentes (13,6 ± 3,2 vs. 15,6 ± 2,3; p = 0,047), mais gordas (55,2 ± 4,6 vs. 50,0 ± 3,6; p = 0,001) e menos aptas fisicamente (14,1 ± 2,3 vs. 16,5 ± 3,9; p = 0,036), conforme resultados do Body Attitudes Questionnaire (BAQ). O escore do Body Shape Questionnaire (BSQ) tambem mostrou pior condicao para as portadoras de TCAP (146,05 ± 22,63 vs. 114,47 ± 19,50; p = 0,000). Ja o comportamento sexual nao mostrou associacao com a obesidade nem diferenca estatisticamente significante entre os grupos, apontando apenas uma tendencia de maior risco para disfuncao sexual entre as portadoras de TCAP, conforme resultados obtidos pelo Golombok-Rust Inventory of Sexual Satisfaction (GRISS). CONCLUSAO: Obesas portadoras de TCAP apresentaram mais frequentemente alteracoes de imagem corporal e devem ser mais bem investigadas quanto a presenca de disfuncoes sexuais.

Sexual function in women receiving maintenance dialysis

While substantial attention has been paid to the issue of sexual dysfunction in men on chronic dialysis, less is known about this problem in women with end-stage renal disease. We sought to assess sexual dysfunction in women on chronic dialysis and determine whether patients discuss this problem with their providers and receive treatment. We prospectively enrolled women receiving chronic hemodialysis or peritoneal dialysis in Pittsburgh, PA. We asked patients to complete the 19-item Female Sexual Function Index (FSFI) to assess sexual function and a 5-item survey that assessed whether patients had discussed sexual dysfunction with their providers and/or received treatment for this problem in the past. We enrolled 66 patients; 59 (89%) on hemodialysis and 7 (11%) on peritoneal dialysis. All patients completed the FSFI, of whom 53 (80%) had FSFI scores <26.55, consistent with the presence of sexual dysfunction. Of 37 patients who were married or residing with a significant other, 27 (73%) had sexual dysfunction. Among 24 participants who reported having been sexually active over the previous 4 weeks, 11 (46%) had sexual dysfunction. Only 21% of patients with sexual dysfunction had discussed this problem with their gynecologist, renal or primary provider, and 3 (6%) reported having received treatment. Sexual dysfunction is common in women on dialysis, even among patients who are married or residing with a significant other and those who are sexually active. However, few women discuss this issue with their providers or receive treatment.

Sexual Dysfunction in Women With Type 1 Diabetes

OBJECTIVEThis study aimed to investigate the prevalence and risk factors associated with sexual dysfunction in a well-characterized cohort of women with type 1 diabetes.RESEARCH DESIGN AND METHODSThe study was conducted in women enrolled in the long-term Epidemiology of Diabetes Interventions and Complications (EDIC) study, a North American study of men and women with type 1 diabetes. At year 10 of the EDIC study, 652 female participants were invited to complete a validated self-report measure of sexual function, standardized history and physical examinations, laboratory testing, and mood assessment.RESULTSOf the sexually active women with type 1 diabetes in the EDIC study, 35% met criteria for female sexual dysfunction (FSD). Women with FSD reported loss of libido (57%); problems with orgasm (51%), lubrication (47%), and arousal (38%); and pain (21%). Univariate analyses revealed a positive association between FSD and age (P = 0.0041), marital status (P = 0.0016), menopausal status (P = 0.0019), microvasculopathy (P = 0.0092), and depression (P = 0.0022). However, in a multivariate analysis, only depression (P = 0.004) and marital status (P = 0.003) were significant predictors of FSD.CONCLUSIONSFSD is common in women with type 1 diabetes and affects all aspects of sexual function and satisfaction. Depression is the major predictor of sexual dysfunction in women with type 1 diabetes. These findings suggest that women with type 1 diabetes should be routinely queried about the presence of sexual dysfunction and possible co-association with depression.

P01-153 Sexual dysfunctions in anxious depressive disorders

Background:The ethiopathogenic mechanisms of depression and anxiety overlap at a certain moment on most part of those of the sexual dysfunction. Hypercorticolezemia from the anxious depressive disorders, with direct impact on the hypocampus (reducing the volume), through the two mechanisms (biological and organic) may generate and especially accentuate the dysfunctions in the sexual activity.Objectives:In more than few cases, the anxious depressive disorders are accompanied by sexual dysfunctions, whDuring antidepressant therapy, especially with inhibitors specific for recapturing serotonine, different types of sexual dysfunctions may appear.Methods:In a retrospective examination, out of 420 patients fulfilling the DSM IV R criteria for the anxious and depressive with anxious and depressive disorder, the presence of sexual dysfunction was highlighted in 340 patients (80,9%). In 260 patients (76,47%) the sexual dysfunction was present in the clinical board of anxiety and depression; in 78 patients (30%) the sexual dysfunction accentuated during antidepressant therapy (predominantly with specific inhibitors for recapturing serotonin). In 80 patients (23,53%), the anxious depressive symptomatology was preceded by sexual dysfunctions in various clinical forms. ich accentuate the anxiety and the depression.Conclusions:The presence of sexual dysfunction in an anxious depressive board represents a negative predictive factor in the evolution of the affective disorder, delaying remission. The use of the mood stabilizer, by increasing GABA in the mezocortical circuit and equilibrating the GABA/DOPAMINE, can be beneficial for the improvement of the sexual dysfunction in the anxious depressive disorders.

Prevalence and Risk Factors for Low Sexual Function in Women: A Study of 1,009 Women in an Outpatient Clinic of a University Hospital in Istanbul

Sexual functioning is a common and multidimensional problem, associated with multiple biological, medical, psychological, sociocultural, political, economic, and interpersonal factors. The study was planned to determine the prevalence and risk factors for low sexual function in women in an outpatient clinic of a university hospital in Istanbul. Totally, 1,009 women over 20 years of age or their healthy female companions were interviewed in the outpatient clinics of the Department of Internal Medicine in a university hospital in Istanbul. Female Sexual Function Index (FSFI) was used to evaluate sexual function. The mean age of women was 38.62 +/- 12.82 and 22.2% of women were postmenopausal. The mean FSFI score was found to be 24.25 +/- 9.50 out of a maximum total score of 36. Based on the total FSFI score, 43.4% of the women had scores less then 26. The mean domain scores were: desire 3.14 +/- 1.47, arousal 3.60 +/- 1.85, lubrication 4.53 +/- 2.01, orgasm 4.02 +/- 1.97, satisfaction 4.27 +/- 1.64, and pain 4.69 +/- 1.96 out of a maximum domain score of six. The rate of low sexual function by the age groups were 22% for those 20-29 years, 39.7% for those 30-39 years, 50.2% for those 40-49 years, 71.3% for those 50-59 years, 82.9% for those 60-64 years, and 87.8% for those 65 and over. Lower educational level, menopause, depression, presence of sexual dysfunction in their partner, and contraceptive use were found to be significantly associated with low sexual function in women. The prevalence of low sexual function in women was found to significantly increase with age. The most significantly affected domains were desire and arousal followed by orgasmic problems, satisfaction, and pain, respectively.

The impact of psychosocial factors on the risk of erectile dysfunction and inhibition of sexual desire in a sample of the Brazilian population

Sexual dysfunctions can have origins in physical, psychological and psychosocial factors. To describe the frequency of erectile dysfunction (ED) and female inhibition of sexual desire (ISD) in a Brazilian sample, and to estimate the risks of these dysfunctions. Non-random survey. Ten Brazilian cities. 2,835 subjects (53% women) aged over 18 years answered a questionnaire about their general health and sex life. The chi-squared test and multivariate logistic regression were used. Values of p < or = 0.05 were considered significant. The women's average age was 36.6 years (+/- 13.3) and the men's was 39.5 (+/- 13.3). 14.7% of men presented moderate/complete ED and 34.6% of women presented ISD. Depression was mentioned by 16.8% of men and 29.7% of women. The chances of having ED and ISD were higher for subjects who had had lower school attainment. Lack of a job and depression gave rise to 1.5 times (95% CI: 1.0 - 2.3) and 1.9 times (95% CI: 1.2 - 3.0) greater chances of ED respectively. Compared with men aged up to 25 years, those aged 41-60 had 1.9 times (95% CI: 1.0 - 3.4) and those aged 61 and over had 5.4 times (95% CI: 2.3 - 12.6) greater risk of ED. For women, lack of a job gave rise to 1.5 times (95% CI: 1.1 - 1.9) greater chance of ISD; depression was not associated with higher risk. Compared with women aged up to 25 years, those aged 41-60 and 61 or over had, respectively, 2.9 times (95% CI: 2.0 - 4.1) and 7.5 times (95% CI: 3.0 -18.6) greater risk of ISD. Increasing unemployment has affected the whole population, but especially those with lower levels of school attainment. Such levels are positively linked with presence of sexual dysfunctions. Lack of jobs, age and low school attainment are risks for the sexual dysfunctions studied. Depression increased the risk of ED but not female ISD.

PMH4 Quality of Life And Adverse Reactions in Depressed Patients Receiving Antidepressant Drugs

OBJECTIVE: The purpose of this ongoing prospective study was to document the quality of life and adverse reactions reported by ambulatory patients receiving pharmaceutical care from the Community Pharmacist Research Network. METHODS: Pharmacists collected demographic and prescription data, and verified that each patient was treated for depression for at least three months and received no other medications. Patients completed the SF-36 questionnaire and a symptoms checklist. RESULTS: Thirty-one white patients, 20 females and 11 males, completed study instruments. Twenty-seven patients were receiving selective serotonin reuptake inhibitors (SSRIs), including fluoxetine (13), paroxetine (8), and sertraline (6); four patients were receiving non-SSRIs. The mean age of patients receiving. SSRIs was 45 years, and patients receiving non-SSRIs was 41 years. Twenty-three patients received antidepressants prescribed by non-psychiatrists. Mean transformed scale scores from the SF-36 were calculated for patients receiving SSRIs and non-SSRIs, respectively, as: physical functioning 87.59 vs. 72.5; role (physical) 83.33 vs. 50; bodily pain 75.88 vs. 68.3; general health 71.29 vs. 47.25; vitality 52.77 vs. 51.25; social functioning 76.92 vs. 71.87; role (emotional) 70.35 vs. 66.6; and mental health 66.96 vs. 59. Six patients reported the presence of sexual dysfunction; seven reported nervousness; seven reported diarrhea; seven reported difficulty falling asleep; eight reported changes in sexual interests; eight reported blurred vision; eight reported constipation; nine reported weight gain; nine reported drowsiness; and sixteen reported dry mouth. CONCLUSION: Based upon these real world findings, similar studies are warranted. Although patients receiving SSRIs experienced clinically significant side effects, health-related quality of life in all SF-36 domains was better for these patients compared to patients receiving non-SSRI drugs. These findings have great relevance for the care of depressed patients.

Multiple sclerosis. Sexual dysfunction and its response to medications.

To determine the frequency and nature of sexual dysfunction, as well as its response to medications, in a sample of patients with multiple sclerosis (MS). Retrospective and prospective survey of 65 female and 36 male patients with MS. Sixty-three percent of patients reported that they had less sexual activity, and 35% said that they had less interest in lovemaking than before their diagnosis of MS. Fifty-seven patients reported that they had problems with sexual dysfunction. Sexual dysfunction preceded the diagnosis of MS in only 10 of these patients. A higher percentage of men (78%) than women (45%) reported that they experienced sexual dysfunction (P = .002). Men had prominent erectile dysfunction, women had problems with vaginal lubrication, and both sexes had problems with decreased sensation and achieving orgasm. The presence of sexual dysfunction was associated with the presence of urinary problems (P = .02) and with a history of treatment of (P = .04) or a current report of (P = .02) depression. No association could be found between sexual dysfunction and duration of disease, type of disease, disability score, or presence of fatigue. Twenty of 57 patients with sexual dysfunction reported that they had associated marital problems. Forty-three of 60 patients who discussed sexual problems with their spouses and four of six who tried formal counseling found it helpful. Surprisingly, corticosteroid treatments that were started for problems other than sexual dysfunction resulted in improved sexual functioning in many patients. Sexual dysfunction is common in patients with MS. Determining the frequency and nature of problems allows issues of sexual dysfunction to be addressed as part of comprehensive care of patients with MS and suggests treatments that could improve their quality of life.

Sexual dysfunction and signs of gynecologic cancer

Forty-one women recently diagnosed with early-stage cervical or endometrial cancer and a matched group of healthy women in no gynecologic distress, participated in a detailed assessment of their sexual functioning. Data included the range and frequency of sexual behavior, level of sexual responsiveness, and the presence of sexual dysfunction. Multivariate analyses of variance indicated that prior to the onset of cancer signs/symptoms the gynecologic cancer patients reported similar patterns of sexual activity and responsiveness as the healthy sample. With the appearance of disease signs, however, the gynecologic cancer patients reported experiencing significant sexual dysfunction symptoms. While sexual morbidity is typically conceptualized as occurring after the diagnosis and treatment of cancer, these data indicate that such changes are a major source of variation in describing the prediagnosis sexual status of the gynecologic cancer patient.

Functional correlates of reduced central conduction velocity in diabetic subjects.

In a previous publication, we presented evidence of slowed conduction speed in the central nervous systems of insulin-dependent diabetic subjects, manifest in a delay in the latency of the brainstem auditory-evoked response (BAER). In this article, we present the results of a multivariate study conducted on a larger sample of 50 insulin-dependent, adult diabetic subjects. The purpose of the study was to determine some of the functional correlates of the BAER delay; each patient received an assessment of the BAER, the late auditory-evoked potential (EP), the conduction velocities of the sural, median, and common peroneal nerves, and intellectual and emotional function, in addition to neurologic and audiologic examinations. A nondiabetic control group was matched with the diabetic group as to age and sex. The results indicated a delay in the latency of wave V, and in interpeak latencies I-III and I-V, of the BAER. The most reliable effect was on interpeak latency I-V; this suggested that the locus of the delay was in the central auditory projections, rather than in the acoustic nerve. In addition, BAER waves I, II, III, IV, and V were reduced in amplitude, as was the N1 component of the late auditory EP; the most reliable reduction in amplitude was in wave V. The effect was similar in magnitude for males and females, relative to their counterparts in the control group. The slowed BAER response appeared early in the disease and was not related to the duration of insulin treatment. It was correlated with a chronic loss of energy and the presence of sexual dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)