Nature of Sexual Dysfunctions in Major Depressive Disorder and its Impact on Quality of Life

BACKGROUND: Adequate sexual expression is an essential part of many human relationships, and may enhance quality of life and provide a sense of physical, psychological, and social well-being. Epidemiological and clinical studies show that depression is associated with impairments of sexual function and satisfaction, even in untreated patients. Most antidepressant drugs have adverse effects on sexual function, but accurate identification of the incidence of treatment-emergent dysfunction has proved troublesome. However, few investigators have reported the base rate for disturbances in sexual desire, arousal, and orgasm or ejaculation in patients with major depressive disorder (MDD) prior to antidepressant treatment. The purpose of this study is to define the frequency of sexual dysfunction (SD) in 60 patients with MDD and examine the relationship between SD and quality of life enjoyment and satisfaction variables. MATERIALS AND METHODS: A consecutive series of 24 male and 36 female MDD patients diagnosed by SCID-DSM IV assessment completed a series of psychometric measures including a Sexual Function Questionnaire—Arizona Sexual Experience Scale (ASEX) which asked about change in sexual interest and function as well as quality of life of life enjoyment using QLESQ-SF. RESULTS: Over 33.33% of men and 42% of women reported decreased sexual interest. Reduced levels of arousal were more common in both men and women (8-22%) than ejaculatory or orgasm difficulties (11–16%). In women, SDs were more than males. Quality of life was more impaired in sample with SDs than those without dysfunction showing significant impact of SD on quality of life. LIMITATION AND CONCLUSION: Although limited by a relatively small sample of drug-free patients with MDD, and by the absence of a non-depressed comparison sample, these results emphasize the importance of factors beyond specific drug effects in the assessment of SD in drug naive-depressed patients.