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      Sleep Quality and Sexual Function in Patients Under Methadone Maintenance Treatment

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          Abstract

          Background:

          Methadone maintenance has remained the main modality of treatment for opioid dependent subjects. Side effects of methadone treatment may be potential obstacles to its continuation. Sleep quality and sexual function are two culture-based concerns, directly related to patients’ compliance with methadone maintenance treatment (MMT) program.

          Objectives:

          This research was conducted to examine the frequency of sleep disparity and sexual dysfunction in patients under MMT referring to MMT clinics of Kerman, Iran.

          Patients and Methods:

          In this cross-sectional study, 198 adult subjects under MMT for more than 6 months were enrolled. Measurement tool consisted of Pittsburgh sleep quality index (PSQI), Arizona sexual experience scale (ASEX), the 12-item general health questionnaire (GHQ-12), and a demographic questionnaire. The questionnaires were self-completed, except where individuals were illiterate.

          Results:

          Mean ± SD age of the subjects was 41.2 ± 7.9 years and 93.4% of them were male. More than half of them used heroin. Prevalence of poor sleeping and sexual dysfunction in patients under MMT were 67.7% and 18.2%, respectively. There was no association between sleep quality or sexual dysfunction and demographics or methadone dose. However, a significant correlation was observed between mental health and sleep quality (r =0.16, P = 0.033), and sexual function (r = 0.18, P = 0.011).

          Conclusions:

          Sleep quality showed a poorer profile than sexual function. Therefore, more emphasis should be laid on treatment of sleep disparity during follow up of MMT patients comparing to their sexual function. Patients should be reassured that probable sexual dysfunctions should not be regarded as a consequence of MMT.

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          Most cited references20

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          Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P).

          There is a high worldwide prevalence of sleep quality disturbances, and sleep disturbances have been associated with numerous diseases. Thus, it is important to assess sleep quality. The Pittsburgh Sleep Quality Index (PSQI) is a self-rating questionnaire that can be completed within 5 min, but no Persian language version is available. We translated the PSQI into Persian and then back into English to ensure the accuracy of the translation. A total of 125 psychiatric patients (generalized anxiety disorder, n = 37; major depression, n = 35; schizophrenia, n = 28; primary insomnia, n = 25) and 133 controls completed our Persian version of this questionnaire. Internal consistency, construct validity, and sensitivity and specificity of the PSQI were assessed. The mean ages (±SD) of the patient and control groups were 36.8 years (±13.9) and 34.2 years (±9.8), respectively (p = 0.08). Cronbach's alpha coefficient for all subjects was 0.77 and was 0.52 for the patient group and 0.78 for the control group. The corrected item-total correlations ranged from 0.30 to 0.75 for the seven component scores of the PSQI. When the general health questionnaire-12 was used as a measure of psychiatric morbidity, it was well correlated with the PSQI scores (r = 0.54, p < 0.001). The sensitivity and specificity of discrimination of insomniac patients from control subjects were 94% and 72% for a PSQI cutoff value of 5 and 85% and 84% for a PSQI cutoff value of 6. The psychometric properties of the Persian version of the PSQI were acceptable.
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            The Arizona Sexual Experience Scale (ASEX): reliability and validity.

            Although sexual dysfunction is common in psychiatric patients, quantification of sexual dysfunction is limited by the paucity of validated, user-friendly scales. In order to address this problem, the authors have developed the Arizona Sexual Experiences Scale (ASEX), a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. Possible total scores range from 5 to 30, with the higher scores indicating more sexual dysfunction. This study assesses the internal consistency, test-retest reliability, and convergent and discriminant validity of the ASEX.
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              The 12-item General Health Questionnaire (GHQ-12): translation and validation study of the Iranian version

              Background The objective of this study was to translate and to test the reliability and validity of the 12-item General Health Questionnaire (GHQ-12) in Iran. Methods Using a standard 'forward-backward' translation procedure, the English language version of the questionnaire was translated into Persian (Iranian language). Then a sample of young people aged 18 to 25 years old completed the questionnaire. In addition, a short questionnaire containing demographic questions and a single measure of global quality of life was administered. To test reliability the internal consistency was assessed by Cronbach's alpha coefficient. Validity was performed using convergent validity. Finally, the factor structure of the questionnaire was extracted by performing principal component analysis using oblique factor solution. Results In all 748 young people entered into the study. The mean age of respondents was 21.1 (SD = 2.1) years. Employing the recommended method of scoring (ranging from 0 to 12), the mean GHQ score was 3.7 (SD = 3.5). Reliability analysis showed satisfactory result (Cronbach's alpha coefficient = 0.87). Convergent validity indicated a significant negative correlation between the GHQ-12 and global quality of life scores as expected (r = -0.56, P < 0.0001). The principal component analysis with oblique rotation solution showed that the GHQ-12 was a measure of psychological morbidity with two-factor structure that jointly accounted for 51% of the variance. Conclusion The study findings showed that the Iranian version of the GHQ-12 has a good structural characteristic and is a reliable and valid instrument that can be used for measuring psychological well being in Iran.
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                Author and article information

                Journal
                Int J High Risk Behav Addict
                Int J High Risk Behav Addict
                10.5812/ijhrba
                Kowsar
                International Journal of High Risk Behaviors & Addiction
                Kowsar
                2251-8711
                2251-872X
                01 December 2015
                December 2015
                : 4
                : 4
                : e23550
                Affiliations
                [1 ]Department of Psychiatry, Behavioral Sciences Research Center, Taleghani Hospital, Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
                [2 ]Research Center for Social Determinants of Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran
                [3 ]Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR Iran
                Author notes
                [* ]Corresponding author: Nouzar Nakhaee, Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR Iran. Tel: +98-3432264196, Fax: +98-3432264198, E-mail: nakhaeen@ 123456kmu.ac.ir
                Article
                10.5812/ijhrba.23550
                4744905
                26870710
                edfe94d7-eb7e-4b96-aa1f-acb8c6047c5f
                Copyright © 2015, Zahedan University of Medical Sciences.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                History
                : 11 September 2014
                : 02 February 2015
                : 15 February 2015
                Categories
                Research Article

                methadone,sexual dysfunction,opiate substitution treatment,substance-related disorders

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