|Year : 2018 | Volume
| Issue : 2 | Page : 84-86
Sexual dysfunction among drug-naïve depressive disorder patient in a multidisciplinary teaching hospital
Rajkumar Lenin Singh, Lalhriat Puia, Senilo Magh
Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur, India
|Date of Web Publication||25-Oct-2018|
Dr. Senilo Magh
Room 9, PG Gents Hostel-1, Regional Institute of Medical Sciences, Lamphelpat, Imphal West - 795 004, Manipur
Source of Support: None, Conflict of Interest: None
Background: Little is known about the prevalence, typology and natural course of non-drug-induced sexual dysfunction in patients with depressive disorders. The degree of sexual dysfunction and its prevalence appears to be correlated with the severity of disease.
Aims: The aim of the study is to find the prevalence and pattern of sexual dysfunction among drug naïve patient having depressive disorder and its correlation.
Settings and Design: 2 years (September 2013- August 2015), cross-sectional study, out-patient department, Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur.
Materials and Methods: Depressive disorder was established according to ICD-10 criteria. Patients fulfilling inclusion criteria were subjected to Hamilton Rating Scale for Depression to assess the severity of their depression and Arizona Sexual Experience Scale questionnaire to assess sexual dysfunction if any in confidentiality.
Statistical Analysis Used: statistical package for the social sciences (SPSS) version 21. Chi square test was used and p value of less than 0.05 was taken as statistically significant.
Result: 50 patients with depressive disorder were enrolled for the study. 44 percent of them were found to have sexual dysfunction. More problems were found with sexual desire and arousal phases of sexual life. A positive correlation was established between the severity of illness and the degree of sexual dysfunction.
Conclusion: This study showed that majority of such patients has sexual problems especially with regard to desire for sex and arousability. The degree of sexual dysfunction was found to be proportional to the severity of depression and hence maybe an important predictor of sexual dysfunction among depressed patients.
Keywords: Depressive disorder, sex, sexual dysfunction
|How to cite this article:|
Singh RL, Puia L, Magh S. Sexual dysfunction among drug-naïve depressive disorder patient in a multidisciplinary teaching hospital. J Med Soc 2018;32:84-6
|How to cite this URL:|
Singh RL, Puia L, Magh S. Sexual dysfunction among drug-naïve depressive disorder patient in a multidisciplinary teaching hospital. J Med Soc [serial online] 2018 [cited 2018 Nov 17];32:84-6. Available from: http://www.jmedsoc.org/text.asp?2018/32/2/84/236149
| Introduction|| |
Interest in human sexual function has increased considerably in the recent years, and this shift in social attitudes has increased the number of people who wonder whether their sexual performance is less than ideal and has consequently increased the need to consult a health professional. The introduction of sildenafil (Viagra), the first orally active drug for male erectile disorder, created a widespread comment and increased public awareness of sexual dysfunction, which is now often regarded as a medical condition that is treatable. Epidemiological and clinical studies show that untreated depressive disorder is associated with impairment of sexual function and satisfaction. The normal sexual response is conventionally divided into the three or four phases (namely, libido, arousal, orgasm, and resolution), and the Diagnostic and Statistical Manual of Mental Disorders-5 defines sexual dysfunction as disturbances in one or more of these phases.,
Depressive disorders are among the most prevalent psychiatric disorder. Sexual dysfunction is commonly associated with depression, and loss of libido is frequently associated with major depression. Sexual dysfunction is a source of additional suffering for depressed patients and may contribute to poor compliance. The relationship between sexual dysfunction and depression seems to be bidirectional, the presence of either one of these conditions may trigger or exacerbate the other, and the treatment of one condition may improve the other. Although sexual dysfunction and depression are highly comorbid, the causal relationship is unclear. Men who have depression have a nearly 2-fold greater likelihood of having erectile dysfunction compared with nondepressed men. Several studies have determined that major depressive disorder is associated with decreased libido, erectile dysfunction, and decreased sexual activity.
| Materials and Methods|| |
The study was conducted in a multispecialty teaching cum tertiary care hospital of Northeast India. It was a cross-sectional study over 2 years (September 2013–August 2015) aimed to document the prevalence and pattern of sexual dysfunction among patients with depressive disorder. Patients diagnosed with depressive disorder according to the International Classification of Diseases-10 for the first time and fulfilling the inclusion criteria were enrolled for the study.
Patients were subjected to the Hamilton Rating Scale for Depression (HRSD) to assess the severity of depression. Sexual functioning was then evaluated using the Arizona Sexual Experiences Scale (ASEX) in local language translated from the original English version., Reliability of the translated version was established by doing a pilot study. Collected data were analyzed using Statistical Package for Social Sciences version 21 (Armonk, NY, IBM Corp). The association between the variables was calculated using the Chi-square test. P < 0.05 was considered as statistically significant.
| Results|| |
A total of 50 newly diagnosed patients with depressive disorder were enrolled for the study. The age of the study population ranged from 23 to 55 years. The mean age was 38.2 years with a standard deviation of 8.1 years. Majority of them were females (52%) and belonged to the Hindu religion (70%). Eighty-eight percent of depressed patients belonged to the reproductive age group of 20–50 years [Table 1].
The duration of illness ranged from 1 to 24 months. Forty-eight percent of them had been suffering from depression for more than a year. A majority of them were found to have sexual dysfunction (52%). Majority of those suffering from depression for <6 months were found to be have sexual dysfunction (71.4% vs. 28.6%), while a majority of those who had been depressed for more than a year did not have any sexual dysfunction (57.3% vs. 42.7%). However, statistically, no significant association was found between duration of depression and sexual dysfunction (P = 0.206) [Table 2].
|Table 2: Duration of illness and its correlation with sexual dysfunction (n=50)|
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Considering separately on the pattern of sexual dysfunction on individual score (i.e. score >3 in ASEX in the particular area), 38% had problems in desire and arousal phases while 26% had problems in achieving orgasm and 22% were not satisfied with sex [Table 3].
|Table 3: Pattern of sexual dysfunction on the four phases of sexual cycle (n=50)|
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Among depressed patients, 24% were mildly depressed according to the HRSD while 30% had a moderate level of depression, 26% had very severe depression, and 20% had severe depression. A majority (69.23%) of those with very severe depression had sexual dysfunction, while half of those with severe depression had sexual dysfunction. Less than half of those who were moderately depressed and 8.8% of those with mild depression had sexual dysfunctions. The severity of depression was statistically found to be significantly associated with sexual dysfunction (P = 0.002) [Table 4].
|Table 4: Association between severity of depression and sexual dysfunction (n=50)|
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| Discussion|| |
The prevalence of sexual dysfunction among depressive disorder patients was found to be 44%. This finding is consistent with the findings reported by Bonierbale et al. and Kennedy et al. which reported the prevalence of sexual dysfunction between 40% and 52.8% among patients with depressive disorder.
Considering separately on the pattern of sexual dysfunction on individual score, our finding is consistent with the findings of Seidman and Roose et al., Araujo et al., and Kennedy and Rizvi who reported a higher prevalence of loss of interest and arousal problems in untreated patients with depressive disorder.
Sexual dysfunction was found to be more common among those who were severely depressed, and this association was found to be statistically significant. The studies conducted by Cyranowski et al. and Schreiner-Engel and Schiavi et al. also reported a higher prevalence of sexual dysfunction with greater levels of depression.
Limitations of the study
The sample size and cross-sectional nature of the study are limiting factors. In addition, the study was conducted in a hospital setting with no sample from community or control group for comparison. The above limitations may act as a bias in our results.
| Conclusion|| |
Little is known about the prevalence, typology, and the natural course of sexual dysfunction among the drug-naïve depressed patients. This study showed that majority of such patients has sexual problems, especially with regard to the desire for sex and arousability. The degree of sexual dysfunction was found to be proportional to the severity of depression and hence may be an important predictor of sexual dysfunction among depressed patients. Future research needs to explore the various biological, psychological, and social factors that are likely to be involved for its high prevalence.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4]