Sexual dysfunction and its determinants in Moroccan women with rheumatoid arthritis

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Abstract

Introduction

To assess the prevalence of sexual dysfunction in married women with rheumatoid arthritis (RA) and compare it with a control group and to determine its association with clinical and disease activity factors.

Methods

We conducted a cross-sectional study including sixty married women with a confirmed diagnosis of Rheumatoid Arthritis according to the American College of Rheumatology (ACR)/ European League against Rheumatism (EULAR) 2010 Criteria, aged 18 or over and having sexual activity. Our controls were healthy volunteers women matched for age. Clinical and sociodemographic characteristics were collected. Sexual function was assessed by a self-reported questionnaire the index of female sexual function (FSFI). Sociodemographic and disease activity profiles were compared between those who had and did not have sexual dysfunction.

Results

The prevalence of female sexual dysfunction in women with rheumatoid arthritis attending El Ayachi hospital was 71.9%, it was 54% in controls. There was a significant difference in the total FSFI score between patients 18.29±9.09 and controls 23.05±7.91 (p=0.016). We found a statistically significant difference between the two groups in almost all dimensions of sexual function (desire, arousal, orgasm, satisfaction), except for pain and lubrication. In multivariate analysis, pain assessed by visual analogue scale (VAS) and depression assessed by hospital anxiety and depression score (HAD) were the independent determinants of sexual dysfunction.

Conclusion

Our study suggests that sexual dysfunction is more common among patients with RA compared to controls. These dysfunctions were related to desire, arousal, orgasm and satisfaction. Pain and depression appear to be the most important predictors of sexual dysfunction.

Most cited references 28

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Comparison of Disease Activity Score (DAS)28- erythrocyte sedimentation rate and DAS28- C-reactive protein threshold values.

Eisuke Inoue, Hisashi Yamanaka, Masako Hara … (2007)

To estimate the disease activity score (DAS)28-C-reactive protein (CRP) threshold values that correspond to DAS28-erythrocyte sedimentation rate (ESR) values for remission, low disease activity and high disease activity in patients with rheumatoid arthritis. DAS28 data were analysed using a large observational study (Institute of Rheumatology Rheumatoid Arthritis) database of 6729 patients with rheumatoid arthritis. Firstly, the relationship between the DAS28-ESR and the DAS28-CRP values was analysed. Secondly, the best DAS28-CRP trade-off values for each threshold were calculated using receiver operating characteristic (ROC) curves. The correlation coefficient of ESR versus CRP was 0.686, whereas that of DAS28-ESR versus DAS28-CRP was 0.946, showing the strong linear relationship between DAS28-ESR and DAS28-CRP values. DAS28-CRP threshold values corresponding to remission, low disease activity and high disease activity were 2.3, 2.7 and 4.1, respectively. The sensitivity and specificity from the ROC curves were gradually reduced as DAS28 values became lower. This study showed that DAS28-CRP and DAS28-ESR were well correlated, but the threshold values should be reconsidered. As the results were derived from only Japanese patients, it is essential to compare DAS28-CRP threshold values in people of other ethnic groups.

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Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms.

Uriel Halbreich, Sandhya Karkun (2006)

The prevalence of postpartum depression (PPD) is currently considered to be 10-15%. Most studies were performed with a brief unidimensional instruments (mostly the Edinburgh Postnatal Depression Scale-EPDS) with focus on depression and not on other symptoms and disorders. Most cited studies were conducted in Western economically developed countries. We reviewed the literature on prevalence of postpartum depression and depressive symptoms in a wide range of countries. 143 studies were identified reporting prevalence in 40 countries. It is demonstrated that there is a wide range of reported prevalence of PPD ranging from almost 0% to almost 60%. In some countries like Singapore, Malta, Malaysia, Austria and Denmark there are very few reports of PPD or postpartum depressive symptoms, whereas in other countries (e.g. Brazil, Guyana, Costa Rica, Italy, Chile, South Africa, Taiwan and Korea) reported postpartum depressive symptoms are very prevalent. We believe that the widely cited mean prevalence of PPD-10-15% is not representative of the actual global prevalence and magnitude of the problem, due to the wide range of reports. The variability in reported PPD might be due to cross-cultural variables, reporting style, differences in perception of mental health and its stigma, differences in socio-economic environments (e.g. poverty, levels of social support or its perception, nutrition, stress), and biological vulnerability factors. The elucidation of the underlying processes of this variability as well as the diversity of postpartum normal versus abnormal expressions of symptoms may contribute to better understanding of the diversified ante, peri- and postpartum phenomena.

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Report of the international consensus development conference on female sexual dysfunction: definitions and classifications.

R Basson, J Berman, A F Burnett … (2000)

Female sexual dysfunction is highly prevalent but not well defined or understood. We evaluated and revised existing definitions and classifications of female sexual dysfunction. An interdisciplinary consensus conference panel consisting of 19 experts in female sexual dysfunction selected from 5 countries was convened by the Sexual Function Health Council of the American Foundation for Urologic Disease. A modified Delphi method was used to develop consensus definitions and classifications, and build on the existing framework of the International Classification of Diseases-10 and DSM-IV: Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, which were limited to consideration of psychiatric disorders. Classifications were expanded to include psychogenic and organic causes of desire, arousal, orgasm and sexual pain disorders. An essential element of the new diagnostic system is the "personal distress" criterion. In particular, new definitions of sexual arousal and hypoactive sexual desire disorders were developed, and a new category of noncoital sexual pain disorder was added. In addition, a new subtyping system for clinical diagnosis was devised. Guidelines for clinical end points and outcomes were proposed, and important research goals and priorities were identified. We recommend use of the new female sexual dysfunction diagnostic and classification system based on physiological as well as psychological pathophysiologies, and a personal distress criterion for most diagnostic categories.

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Author and article information

Journal

Journal ID (nlm-ta): Pan Afr Med J

Journal ID (iso-abbrev): Pan Afr Med J

Journal ID (publisher-id): PAMJ

Title: The Pan African Medical Journal

Publisher: The African Field Epidemiology Network

ISSN (Electronic): 1937-8688

Publication date (Electronic): 06 May 2016

Publication date Collection: 2016

Volume: 24

Electronic Location Identifier: 16

Affiliations

[1 ]Mohammed V ^th University, Ibn Sina Universitary Hospitals, El Ayachi Hospital, Department of Rheumatology, Rabat-Salé, Maroc

[2 ]Laboratory of Biostatistical, Clinical and Epidemiological Research, Faculty of Medicine and Pharmacy, Mohammed V ^th University, Rabat, Maroc

Author notes

[& ]Corresponding author: Dina Khnaba, Mohammed V ^th University, Ibn Sina Universitary Hospitals, El Ayachi Hospital, Department of Rheumatology, Rabat-Salé, Maroc

Article

Publisher ID: PAMJ-24-16

DOI: 10.11604/pamj.2016.24.16.9081

PMC ID: 4992373

SO-VID: 125a87ab-f077-4fe1-8060-910cb574ff98

License:

The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Sexual dysfunction and its determinants in Moroccan women with rheumatoid arthritis

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Abstract

Introduction

Methods

Results

Conclusion

Most cited references 28

Comparison of Disease Activity Score (DAS)28- erythrocyte sedimentation rate and DAS28- C-reactive protein threshold values.

Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms.

Report of the international consensus development conference on female sexual dysfunction: definitions and classifications.

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