Multipl sklerozda seksüel disfonksiyon ve ilişkili risk fakörleri

Öz

Amaç: Cinsel işlev bozukluğu (CİB), multipl sklerozda (MS) sık görülen multifaktöryel bir durumdur. Bu çalışma, MS’de CİB sıklığını değerlendirmek ve ilgili faktörleri araştırmak amacıyla düzenlenmiştir. Yöntemler: Kesitsel özellikteki bu çalışmaya, 2018-2019 yıllarında,18 ile 60 yaşları arasında Mc Donald kriterlerine göre kesin relapsing remitting multipl skleroz (RRMS) tanısı alan 96 hasta gönüllü olarak çalışmaya dahil edildi. Multiple sclerosis intimacy and sexuality questionnaire-19 (MSISQ-19), Arizona Sexual Experience Scale (ASEX), Multiple Sclerosis Inventory of Cognition (MUSIC) ve Beck Depresyon Ölçeği (BDI) anketleri uygulandı. Bulgular: Hastaların yaş ortalaması 38,46 (8,47) (min-maks: 20 - 60 yıl) yıldı; ortalama hastalık süresi 77,02 (70,62) (3 - 324 ay) aydı. Ortalama Genişletilmiş Özürlülük Durumu Ölçeği (EDSS) puanı 2,1 (1,33) (0-5) ve standart sapma %80,5 idi. MÜZİK bilişsel puanı ile EDSS puanı (P=0,017; r=-0,273) ve MÜZİK bilişsel ve BDÖ puanı arasında (P=0,003; r=-0,306) negatif bir korelasyon görüldü. Müzik yorgunluk testi sonuçlarında MSISQ skoru (P<0,001; r=0,476) ile BDÖ (P<0,001; r=0,529) arasında anlamlı ve pozitif bir ilişki tespit edildi. Müzik yorgunluğu ile müzik bilişsel puanı arasında negatif ve zayıf ilişki bulundu (P<0,001; r=-0,365). Ortalama MUZİK bilişsel puanı depresyonu olanlarda daha düşüktü (P=0,009); MÜZİK yorgunluk puanları depresyon grubunda daha yüksek saptandı (P<0,001). Yaş, eğitim durumu, ikincil seksüel disfonksiyon (SD) varlığı bağımsız risk faktörleriydi. Sonuç: SD, MS'te çok yaygındır. Kognitif durumla da ilişkili olan psikososyal faktörlerin tedavisi ile SD oranı azaltılarak hastaların yaşam kalitesi arttırılabilir.

Anahtar Kelimeler

• Multipl skleroz
• Seksüel disfonksiyon
• Kognitif bozukluk
• Depresyon

Sexual dysfunction and associated risk factors in multiple sclerosis

Abstract

Aim: Sexual dysfunction (SD) is quite common in multiple sclerosis (MS), and exhibits a multifactorial pattern. This study was set out to evaluate the frequency of SD and explore the related factors to support the quality of MS patients’ lives. Methods: This cross-sectional study included 96 volunteer RRMS patients between 18 and 60 years of age who were diagnosed with MS according to the Mc Donald criteria between 2018 and 2019 in our hospital. Multiple sclerosis intimacy and sexuality questionnaire-19 (MSISQ-19), Arizona Sexual Experience Scale (ASEX), Multiple Sclerosis Inventory of Cognition (MUSIC) and Beck Depression Inventory (BDI) questionnaires were used. Results: Mean age of the patients was 38.46 (8.47) (min-max:20 – 60 years) years, and mean disease period was 77.02 (70.62) (3–324 months) months. Mean Extended Disability Status Scale (EDSS) score was 2.1 (1.33) (0-5) with a standard deviation of 80.5%. A negative correlation was observed between MUSIC cognitive and EDSS (P=0.017; r=-0.273), and BDI scores (P=0.003; r=-0.306). A significant and positive correlation was detected between MSISQ score (P<0.001; r=0.476) and BDI (P<0.001; r=0.529) in MUSIC fatigue test results. A negative and poor correlation was found between MUSIC fatigue and MUSIC cognitive score (P<0.001; r=-0.365). In patients with depression, mean MUSIC cognitive scores were lower (P=0.009), while MUSIC fatigue scores were higher (P<0.001). Age, educational status, presence of secondary SD were independent risk factors. Conclusion: SD, a quite common condition in MS, may be decreased to increase the quality of lives of patients through treatment of psychosocial factors associated with cognitive state.

Keywords

• multiple sclerosis
• sexual dysfunction
• cognitive impairment
• depression

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