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Sexual Dysfunction in Female Patients with Primary Sjögren’s Syndrome and Effects of Depression: Cross-Sectional Study

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Abstract

Primary Sjögren’s syndrome causes disability and impaired quality of life. However, unlike other rheumatological diseases, primary Sjögren’s syndrome affects the exocrine glands and can impact on sexual health. Primary Sjögren’s syndrome is also associated with depression. Two groups of female patients were included in the present study; one group comprised patients with primary Sjögren’s syndrome and the second group consisted of healthy women. The two groups were compared in terms of female sexual dysfunction using the Female Sexual Function Index and depression using the Beck Depression Inventory. Path analysis was used to show the relationship between primary Sjögren’s syndrome, depression and female sexual dysfunction. Depression and female sexual dysfunction were higher in the group with primary Sjögren’s syndrome than in the group of healthy women. Path analysis confirmed that primary Sjogren’s syndrome itself and primary Sjögren’s syndrome induced depression may lead to female sexual dysfunction. Both female sexual dysfunction and depression are common in primary Sjögren’s syndrome. Therefore, it is important to consider the broad clinical picture for patients with primary Sjögren’s syndrome, as both female sexual dysfunction and depression can be treated with education, psychotherapy, or medicine.

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References

  1. Peri, Y., Agmon-Levin, N., Theodor, E., Shoenfeld, Y.: Sjogren’s syndrome, the old and the new. Best Pract. Res. Clin. Rheumatol. 26, 105–117 (2012)

    Article  PubMed  Google Scholar 

  2. Mavragani, C.P., Moutsopoulos, H.M.: The geoepidemiology of Sjogren’s syndrome. Autoimmun. Rev. 9, A305–A310 (2010)

    Article  PubMed  Google Scholar 

  3. Ramos-Casals, M., Brito-Zeron, P., Siso-Almirall, A., Bosch, X.: Primary Sjogren syndrome. BMJ (Clinical research ed.) 344, e3821 (2012)

    Google Scholar 

  4. Haga, H.J., Gjesdal, C.G., Irgens, L.M., Ostensen, M.: Reproduction and gynaecological manifestations in women with primary Sjogren’s syndrome: a case-control study. Scand. J. Rheumatol. 34, 45–48 (2005)

    Article  PubMed  Google Scholar 

  5. Tristano, A.G.: The impact of rheumatic diseases on sexual function. Rheumatol. Int. 29, 853–860 (2009)

    Article  PubMed  Google Scholar 

  6. Basson, R., Schultz, W.W.: Sexual sequelae of general medical disorders. Lancet 369, 409–424 (2007)

    Article  PubMed  Google Scholar 

  7. Abdel-Nasser, A.M., Ali, E.I.: Determinants of sexual disability and dissatisfaction in female patients with rheumatoid arthritis. Clin. Rheumatol. 25, 822–830 (2006)

    Article  PubMed  Google Scholar 

  8. van Berlo, W.T., van de Wiel, H.B., Taal, E., Rasker, J.J., Weijmar Schultz, W.C., van Rijswijk, M.H.: Sexual functioning of people with rheumatoid arthritis: a multicenter study. Clin. Rheumatol. 26, 30–38 (2007)

    Article  PubMed  Google Scholar 

  9. Raina, R., Pahlajani, G., Khan, S., Gupta, S., Agarwal, A., Zippe, C.D.: Female sexual dysfunction: classification, pathophysiology, and management. Fertil. Steril. 88, 1273–1284 (2007)

    Article  PubMed  Google Scholar 

  10. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders-IV-TR. American Psychiatric Association, Washington, DC (2003)

  11. Amato, P.: Categories of female sexual dysfunction. Obstet. Gyn. Clin. N Am. 33, 527–534 (2006)

    Article  Google Scholar 

  12. Mimoun, S., Wylie, K.: Female sexual dysfunctions: definitions and classification. Maturitas 63, 116–118 (2009)

    Article  PubMed  Google Scholar 

  13. Valtysdottir, S.T., Wide, L., Hallgren, R.: Mental wellbeing and quality of sexual life in women with primary Sjogren’s syndrome are related to circulating dehydroepiandrosterone sulphate. Ann. Rheum. Dis. 62, 875–879 (2003)

    Article  PubMed Central  PubMed  Google Scholar 

  14. Maddali Bongi, S., Del Rosso, A., Orlandi, M., Matucci-Cerinic, M.: Gynaecological symptoms and sexual disability in women with primary Sjogren’s syndrome and sicca syndrome. Clin. Exp. Rheumatol. 31, 683–690 (2013)

    PubMed  Google Scholar 

  15. Vitali, C., Bombardieri, S., Jonsson, R., Moutsopoulos, H.M., Alexander, E.L., Carsons, S.E., Daniels, T.E., Fox, P.C., Fox, R.I., Kassan, S.S., Pillemer, S.R., Talal, N., Weisman, M.H.: Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann. Rheum. Dis. 61, 554–558 (2002)

    Article  PubMed Central  PubMed  Google Scholar 

  16. Oksuz, E., Malhan, S.: Reliability and validity of the female sexual function ındex in Turkish population. Syndrome 17, 54–60 (2005)

    Google Scholar 

  17. Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., Ferguson, D., D’Agostino Jr, R.: The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J. Sex Marital Ther. 26, 191–208 (2000)

    Article  PubMed  Google Scholar 

  18. Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., Erbaugh, J.: An inventory for measuring depression. Arch. Gen. Psychiatry 4, 561–571 (1961)

    Article  PubMed  Google Scholar 

  19. Hisli, N.: Beck Depresyon Envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi 7, 3–13 (1989)

    Google Scholar 

  20. Oktay, E., Akinci, M.M., Karaaslan, A.: Research on the interaction of statistics with the courses in business administration curriculum with using path analysis. J. Grad. School Soc. Sci. 16 (2012)

  21. Şimşek, Ö.: Yapısal Eşitlik Uygulamalarına Giriş. Ekinoks Yayınları. In, Ankara (2007)

    Google Scholar 

  22. Lleras, C.: Path analysis. Encycl. Soc. Meas. 3, 25–30 (2005)

    Article  Google Scholar 

  23. Suhr, D.: Step your way through path analysis. In: Western users of SAS software conference proceedings 2008

  24. Elst, P., Sybesma, T., van der Stadt, R.J., Prins, A.P., Muller, W.H., den Butter, A.: Sexual problems in rheumatoid arthritis and ankylosing spondylitis. Arthritis Rheum. 27, 217–220 (1984)

    Article  PubMed  Google Scholar 

  25. Helland, Y., Dagfinrud, H., Kvien, T.K.: Perceived influence of health status on sexual activity in RA patients: associations with demographic and disease-related variables. Scand. J. Rheumatol. 37, 194–199 (2008)

    Article  PubMed  Google Scholar 

  26. Panush, R.S., Mihailescu, G.D., Gornisiewicz, M.T., Sutaria, S.H., Wallace, D.J.: Sex and arthritis. Bull. Rheum. Dis. 49, 1–4 (2000)

    PubMed  Google Scholar 

  27. Graziottin, A.: Medical and sexual comorbidities: when the integrative approach is key. Sexologies 17, S21–S22 (2008)

    Article  Google Scholar 

  28. Mavragani, C.P., Fragoulis, G.E., Moutsopoulos, H.M.: Endocrine alterations in primary Sjogren’s syndrome: an overview. J. Autoimmun. 39, 354–358 (2012)

    Article  PubMed  Google Scholar 

  29. Ferraccioli, G., De Santis, M., Peluso, G., Inzitari, R., Fanali, C., Bosello, S.L., Iavarone, F., Castagnola, M.: Proteomic approaches to Sjogren’s syndrome: a clue to interpret the pathophysiology and organ involvement of the disease. Autoimmun. Rev. 9, 622–626 (2010)

    Article  PubMed  Google Scholar 

  30. Marchesoni, D., Mozzanega, B., De Sandre, P., Romagnolo, C., Gambari, P.F., Maggino, T.: Gynaecological aspects of primary Sjogren’s syndrome. Eur. J. Obstet. Gynecol. Reprod. Biol. 63, 49–53 (1995)

    Article  PubMed  Google Scholar 

  31. DeVellis, B.M.: Depression in rheumatological diseases. Bailliere’s Clin. Rheumatol. 7, 241–257 (1993)

    Article  Google Scholar 

  32. Hawley, D.J., Wolfe, F.: Depression is not more common in rheumatoid arthritis: a 10-year longitudinal study of 6,153 patients with rheumatic disease. J. Rheumatol. 20, 2025–2031 (1993)

    PubMed  Google Scholar 

  33. Pelizza, L., Bonacini, F., Ferrari, A.: Psychiatric disorder as clinical presentation of primary Sjogren’s syndrome: two case reports. Ann. Gen. Psychiatry 9, 12 (2010)

    Article  PubMed Central  PubMed  Google Scholar 

  34. Ampelas, J.F., Wattiaux, M.J., Van Amerongen, A.P.: Psychiatric manifestations of lupus erythematosus systemic and Sjogren’s syndrome. Encephale 27, 588–599 (2001)

    PubMed  Google Scholar 

  35. McFarlane, A.C., Brooks, P.M.: Determinants of disability in rheumatoid arthritis. Br. J. Rheumatol. 27, 7–14 (1988)

    Article  PubMed  Google Scholar 

  36. Newman, S., Mulligan, K.: The psychology of rheumatic diseases. Baillieres Best Pract. Res. Clin. Rheumatol. 14, 773–786 (2000)

    Article  PubMed  Google Scholar 

  37. Helland, Y., Kjeken, I., Steen, E., Kvien, T.K., Hauge, M.I., Dagfinrud, H.: Rheumatic diseases and sexuality: disease impact and self-management strategies. Arthr Care Res. 63, 743–750 (2011)

    Article  Google Scholar 

  38. Alexander, E.L.: Neurologic disease in Sjogren’s syndrome: mononuclear inflammatory vasculopathy affecting central/peripheral nervous system and muscle. A clinical review and update of immunopathogenesis. Rheum Dis. Clin. N Am. 19, 869–908 (1993)

    Google Scholar 

  39. Esch, T.R.: Pathogenetic factors in Sjogren’s syndrome: recent developments. Crit. Rev. Oral. Biol. Med. 12, 244–251 (2001)

    Article  PubMed  Google Scholar 

  40. Baldwin, D.S.: Depression and sexual dysfunction. Br. Med. Bull. 57, 81–99 (2001)

    Article  PubMed  Google Scholar 

  41. Harvey, K.V., Balon, R.: Clinical implications of antidepressant drug effects on sexual function. Ann. Clin. Psychiatry 7, 189–200 (1995)

    Article  PubMed  Google Scholar 

  42. Johnson, S.D., Phelps, D.L., Cottler, L.B.: The association of sexual dysfunction and substance use among a community epidemiological sample. Arch. Sex. Behav. 33, 55–63 (2004)

    Article  PubMed  Google Scholar 

  43. Casper, R.C., Redmond Jr, D.E., Katz, M.M., Schaffer, C.B., Davis, J.M., Koslow, S.H.: Somatic symptoms in primary affective disorder. Presence and relationship to the classification of depression. Arch. Gen. Psychiatry 42, 1098–1104 (1985)

    Article  PubMed  Google Scholar 

  44. Dunn, K.M., Croft, P.R., Hackett, G.I.: Association of sexual problems with social, psychological, and physical problems in men and women: a cross sectional population survey. J. Epidemiol. Commun. Health 53, 144–148 (1999)

    Article  Google Scholar 

  45. Frohlich, P., Meston, C.: Sexual functioning and self-reported depressive symptoms among college women. J. Sex. Res. 39, 321–325 (2002)

    Article  PubMed  Google Scholar 

  46. Cyranowski, J.M., Bromberger, J., Youk, A., Matthews, K., Kravitz, H.M., Powell, L.H.: Lifetime depression history and sexual function in women at midlife. Arch. Sex. Behav. 33, 539–548 (2004)

    Article  PubMed  Google Scholar 

  47. Laurent, S.M., Simons, A.D.: Sexual dysfunction in depression and anxiety: conceptualizing sexual dysfunction as part of an internalizing dimension. Clin. Psychol. Rev. 29, 573–585 (2009)

    Article  PubMed  Google Scholar 

  48. Haugen, A.J., Peen, E., Hulten, B., Johannessen, A.C., Brun, J.G., Halse, A.K., Haga, H.J.: Estimation of the prevalence of primary Sjogren’s syndrome in two age-different community-based populations using two sets of classification criteria: the Hordaland Health Study. Scand. J. Rheumatol. 37, 30–34 (2008)

    Article  PubMed  Google Scholar 

  49. Goransson, L.G., Haldorsen, K., Brun, J.G., Harboe, E., Jonsson, M.V., Skarstein, K., Time, K., Omdal, R.: The point prevalence of clinically relevant primary Sjogren’s syndrome in two Norwegian counties. Scand. J. Rheumatol. 40, 221–224 (2011)

    Article  PubMed  Google Scholar 

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The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Psychiatry, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey

    Gorkem Karakas Ugurlu & Ali Caykoylu

  2. Department of Rheumatology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey

    Sukran Erten

  3. Department of Psychiatry, Ankara Ataturk Training and Research Hospital, Ankara, Turkey

    Mustafa Ugurlu

  4. Department of Nephrology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey

    Alpaslan Altunoğlu

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  1. Gorkem Karakas Ugurlu
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  2. Sukran Erten
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  3. Mustafa Ugurlu
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  4. Ali Caykoylu
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  5. Alpaslan Altunoğlu
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Correspondence to Gorkem Karakas Ugurlu.

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Ugurlu, G.K., Erten, S., Ugurlu, M. et al. Sexual Dysfunction in Female Patients with Primary Sjögren’s Syndrome and Effects of Depression: Cross-Sectional Study. Sex Disabil 32, 197–204 (2014). https://doi.org/10.1007/s11195-014-9352-x

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