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Prevalence of sexual dysfunction in depressive and persistent depressive disorders: a systematic review and meta-analysis

International Journal of Impotence Research volume 35, pages 340–349 (2023)Cite this article

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Abstract

The aim of this study was to estimate the prevalence of sexual dysfunction in depressive disorders in individuals not in pharmacological treatment. For this purpose, we performed a systematic review and meta-analysis using the PRISMA guidelines, and the review was registered in PROSPERO (registration number CRD42020179709). Studies that evaluated sexual function and dysfunction in major depressive disorder (MDD) and persistent depressive disorder (PDD) were identified through searches in PubMed/Medline, Web of Science, PsychINFO, Scopus, and Scielo. Twelve cross-sectional studies were eligible. In women with MDD, the pooled prevalence rates of sexual impairment were: 47.22% (95% CI: 34.86–59.58) for arousal; 65.30% (95% CI: 45.86–84.73) for desire; 36.98% (95% CI: 28.42–45.54) for lubrication; 34.17% (95% CI: 17.87–50.46) for orgasm; and 33.91% (95% CI: 17.48–50.34) for sexual satisfaction. In men, the sexual impairment prevalence rates were: 26.45% (95% CI: 12.26–40.63) for arousal; 40.32% (95% CI: 22.19–58.46) for desire; 32.07% (95% CI: 26.14–37.99) for erection; 35.27% (95% CI: 5.13–65.41) for orgasm; and 23.05% (95% CI: 13.60–32.51) for sexual satisfaction. Overall sexual dysfunction was found in 82.75% of women (95% CI: 74.71–90.78) and 63.26% of men (95% CI: 52.83–73.69). Our results show that various sexual functions are impaired in MDD, making imperative the systematic evaluation of these alterations by clinicians. Future studies should be conducted, especially in PDD, to elucidate the role of these disorders in sexual function.

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Fig. 3: Forest plot.

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References

  1. Kessler RC, Ormel J, Petukhova M, Katie A, Green JG, Russo LJ, et al. Development of lifetime comorbidity in the WHO World Mental Health (WMH) Surveys. Arch Gen Psychiatry. 2011;68:90–100.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lai C-H. Major depressive disorder. J Clin Psychopharmacol. 2011;31:39–44.

    Article  PubMed  Google Scholar 

  3. Gonçalves WS, Gherman BR, Abdo CHN, Nardi AE, Appolinário JCB. Função e disfunção sexual na depressão: uma revisão sistemática. J Bras Psiquiatr. 2019;68:110–20.

    Article  Google Scholar 

  4. Lamont J, Bajzak K, Bouchard C, Burnett M, Byers S, Cohen T, et al. Female sexual health consensus clinical guidelines. J Obstet Gynaecol Can. 2018;40:e451–503.

    Article  PubMed  Google Scholar 

  5. Goldstein I, Kim NN, Clayton AH, DeRogatis LR, Giraldi A, Parish SJ, et al. Hypoactive sexual desire disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) Expert Consensus Panel Review. Mayo Clin Proc Mayo Found Med Educ Res. 2017;92:114–28.

    Article  Google Scholar 

  6. Salonia A, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz NC, et al. European Association of Urology Guidelines on Sexual and Reproductive Health—2021 Update: male sexual dysfunction. Eur Urol 2021;80:333–57.

    Article  PubMed  Google Scholar 

  7. Atlantis E, Sullivan T. Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. J Sex Med. 2012;9:1497–507.

    Article  PubMed  Google Scholar 

  8. Rizvi SJ, Yeung NW, Kennedy SH. Instruments to measure sexual dysfunction in community and psychiatric populations. J Psychosom Res 2011;70:99–109.

    Article  PubMed  Google Scholar 

  9. Sungur MZ, Gündüz A. A comparison of DSM-IV-TR and DSM-5 definitions for sexual dysfunctions: critiques and challenges. J Sex Med. 2014;11:364–73.

    Article  PubMed  Google Scholar 

  10. Balon R. The DSM criteria of sexual dysfunction: need for a change. J Sex Marital Ther. 2008;34:186–97.

    Article  PubMed  Google Scholar 

  11. Hendrickx L, Gijs L, Enzlin P. Distress, sexual dysfunctions, and DSM: dialogue at cross purposes? J Sex Med. 2013;10:630–41.

    Article  PubMed  Google Scholar 

  12. Moher D, Liberati A, Tetzlaff J, Altman DG, Altman D, Antes G, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264–9.

    Article  PubMed  Google Scholar 

  13. Cook DA, Reed DA. Appraising the quality of medical education research methods: the medical education research study quality instrument and the Newcastle-Ottawa Scale-Education. Acad Med. 2015;90:1067–76.

    Article  PubMed  Google Scholar 

  14. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kachouchi A, Akammar S, Salim S, Adali I, Manoudi F, Asri F. First major depressive disorder and sexual dysfunctions. Sexologies. 2019;28:211–7.

    Article  Google Scholar 

  16. El Yazidi FE, Boualame A, Akammar S, Zahrae Elfahiri F, Aitbenlaassel O, Adali I, et al. Prevalence and characteristics of sexual dysfunction among Moroccan patients consulting for a first depressive episode. Encephale. 2019;45:501–5.

    Article  CAS  PubMed  Google Scholar 

  17. Fabre LF, Smith LC. The effect of major depression on sexual function in women. J Sex Med. 2012;9:231–9.

    Article  PubMed  Google Scholar 

  18. Kendurkar A, Kaur B. Major depressive disorder, obsessive-compulsive disorder, and generalized anxiety disorder: do the sexual dysfunctions differ? Prim Care Companion J Clin Psychiatry. 2008;10:299–305.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Thakurta RG, Singh OP, Bhattacharya A, Mallick AK, Ray P, Sen S, et al. Nature of sexual dysfunctions in major depressive disorder and its impact on quality of life. Indian J Psychol Med. 2012;34:365–70.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Abhivant NN, Sawant NS. Sexual dysfunction in depressed Indian women attending a hospital out patient department in Mumbai. Sri Lanka J Psychiatry. 2013;4:10.

    Article  Google Scholar 

  21. Fabre LF, Clayton AH, Smith LC, Goldstein IM, Derogatis LR. Association of major depression with sexual dysfunction in men. J Neuropsychiatry Clin Neurosci. 2013;4:308–18.

    Article  Google Scholar 

  22. Hamzaoui S, Maamri A, Ouanes S, Meziou O, Zalila H. Évaluation De La Fonction Sexuelle Chez Les Femmes Consultant Pour Un Premier Épisode Dépressif Majeur. Sexologies. 2016;25:166–72. French

    Article  Google Scholar 

  23. Sreelakshmy K, Velayudhan R, Kuriakose D, Nair R. Sexual dysfunction in females with depression: a cross-sectional study. Trends Psychiatry Psychother. 2017;39:106–9.

    Article  PubMed  Google Scholar 

  24. Kennedy SH, Dickens S, Eisfeld B. Sexual dysfunction before antidepressant therapy in major depression. J Affect Disord. 1999;56:201–8.

    Article  CAS  PubMed  Google Scholar 

  25. Bonierbale M, Lan C, Tignol J. The ELIXIR study: evaluation of sexual dysfunction in 4557 depressed patients in France. Curr Med Res Opin. 2003;19:114–24.

    Article  PubMed  Google Scholar 

  26. Carter FA, Carter JD, Luty SE, Jordan J, McIntosh VVW, Bartram AF, et al. What is worse for your sex life: starving, being depressed, or a new baby? Int J Eat Disord. 2007;40:664–7.

    Article  PubMed  Google Scholar 

  27. Kennedy SH, Rizvi S. Sexual dysfunction, depression, and the impact of antidepressants. J Clin Psychopharmacol. 2009;29:157–64.

    Article  CAS  PubMed  Google Scholar 

  28. Waldinger MD. Psychiatric disorders and sexual dysfunction. In: Vodušek DB, Boller F, editors. Handbook of clinical neurology. 1 st ed. Amsterdam: Elsevier; 2015. p. 469–89.

  29. Angst J. Sexual problems in healthy and depressed persons. Int Clin Psychopharmacol. 1998;13:s1–4.

    Article  PubMed  Google Scholar 

  30. Mathew RJ, Weinman ML. Sexual dysfunctions in depression. Arch Sex Behav. 1982;11:323–8.

    Article  CAS  PubMed  Google Scholar 

  31. Ioannidis JPA, Trikalinos TA. The appropriateness of asymmetry tests for publication bias in meta-analyses: a large survey. CMAJ. 2007;176:1091–6.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We especially thank Anna Carolina Martins Haddad for all the support and writing assistance in this work.

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Authors and Affiliations

  1. Treatment-Resistant Depression Group, Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil

    Walter Santos Gonçalves, Bruno Rabinovici Gherman, Antonio Egidio Nardi & Jose Carlos Appolinario

  2. Department of Psychiatry, School of Medicine, University of São Paulo (FMUSP), São Paulo, Brazil

    Carmita Helena Najjar Abdo

  3. Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil

    Evandro Silva Freire Coutinho

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  1. Walter Santos Gonçalves
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Contributions

W.S.G. – Designed the study, undertook the literature searches, extracted and analyzed the data, and wrote the paper. B.R.G. – Undertook the literature searches and extracted and analyzed the data. C.H.N.A. – Contributed to the conception of the work and critically reviewing/editing the manuscript. E.S.F.C. – Performed statistical analyses and critically reviewed/edited the manuscript. A.E.N. – Contributed to the conception of the work and critically reviewed/edited the manuscript. J.C.A. – Designed the study, guided the article´s development, and critically reviewed the writing process. All authors approved the final version of the manuscript.

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Correspondence to Walter Santos Gonçalves.

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Gonçalves, W.S., Gherman, B.R., Abdo, C.H.N. et al. Prevalence of sexual dysfunction in depressive and persistent depressive disorders: a systematic review and meta-analysis. Int J Impot Res 35, 340–349 (2023). https://doi.org/10.1038/s41443-022-00539-7

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