Ali Metehan ÇALIŞKAN, Duygu GÖKTAŞ, Mehmet ARSLAN, İkbal İNANLI, Saliha ÇALIŞIR, İbrahim EREN

Sexual functions in women with bipolar disorder and their healthy spouses

Objective: The aim of this study was to compare the sexual problem levels of female patients with bipolar disorder (BD) and their healthy spouses with those of healthy couples and to investigate potential factors that predict sexual problems. Methods: Sixty female outpatients with BD in remission and their healthy spouses were included in the study. All patients were under medication. Forty-five healthy couples comprised the control group. All participants were examined on a variety of clinical measures, including depression, marital adjustment, and sexual satisfaction. Results: Sexual satisfaction, communication and anorgasmia problems were higher for patients than for female controls. Sexual intercourse frequency, communication and total sexual problems were higher for patients’ spouses than for male controls. Logistic regression analyses for females revealed that sexual satisfaction was associated with age, depressive symptoms, and marital adjustment rather than presence of disorder. The sexual satisfaction was associated with marital adjustment rather than being spouse of a patient for males. Conclusions: After controlling for confounding factors, sexual problems of patients and their spouses are similar to those of controls. Treating the subsyndromal depressive symptoms of patients and using interventions to increase marital adjustment may improve the sexual functions of both patients and their spouses. (Anatolian Journal of Psychiatry 2019; 20(1):68-75)

Bipolar bozukluk hastası kadınlarda ve sağlıklı eşlerinde cinsel işlevlerin değerlendirilmesi

Amaç: Bu çalışmanın amacı, bipolar bozukluk (BB) hastası kadınların ve sağlıklı eşlerinin cinsel işlev sorunlarını sağlıklı kontrollerle karşılaştırmak ve cinsel sorunları etkileyen olası öngördürücüleri belirlemektir. Yöntem: Çalışmaya BB’li 60 kadın hasta ve sağlıklı eşleri alındı. Tüm hastalar psikiyatrik tedavi görüyordu. Kontrol grubu olarak 45 sağlıklı çift alındı. Tüm katılımcılar sosyodemografik veriler, depresif belirtiler, evlilik uyumları ve cinsel işlevleri açısından değerlendirildi. Bulgular: Hastalarda cinsel doyum, iletişim ve orgazm sorunları sıklığı kadın kontrollerden daha yüksek saptandı. Hasta eşlerinde cinsel ilişki sıklığı, iletişim ve toplam cinsel sorun sıklığı erkek kontrollerden daha yüksek saptandı. Kadınlar için yapılan lojistik regresyon analizinde, cinsel sorunların yaş, depre- sif belirtiler ve evlilik uyumu ile ilişkili olduğu; ancak BB’nin olması ile ilişkili olmadığı saptandı. Erkekler için yapılan analizde, cinsel sorunların evlilik uyumu ile ilişkili olduğu, hasta eşi olmakla ilişkili olmadığı saptandı. Sonuç: Karış- tırıcı etkenler kontrol edildikten sonra, BB’li hastaların ve eşlerinin cinsel sorun sıklığının kontrollere benzer olduğu görülmüştür. Hastaların subsendromal depresif belirtilerinin tedavi edilmesi ve evlilik uyumunu artırmaya yönelik girişimlerde bulunulması hem hastaların, hem de eşlerinin cinsel işlevlerinde iyileşme sağlayabilir. (Anadolu Psikiyatri Derg 2019; 20(1):68-75)

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Sanchez-Moreno J, Martinez-Aran A, Tabarés-Seisdedos R, Torrent C, Vieta E, Ayuso-Mateos JL. Functioning and disability in bipolar disorder: an extensive review. Psychother Psychosom 2009;78(5):285-297.

Bauer M, Glenn T, Grof P, Schmid R, Pfennig A,Whybrow PC. Subsyndromal mood symptoms: A useful concept for maintenance studies of bipolar disorder? Psychopathology 2009;43(1):1-7.

Judd LL, Akiskal HS, Schettler PJ, Endicott J,Leon AC, Solomon DA, et al. Psychosocial Disa- bility in the Course of Bipolar I and II Disorders. Arch Gen Psychiatry 2005;62(12):1322-1330.

MacQueenGM,MarriottM,BeginH,RobbJ,JoffeRT, Young LT. Subsyndromal symptoms as- sessed in longitudinal, prospective follow-up of a cohort of patients with bipolar disorder. Bipolar Disord 2003; 5(5):349-355.

Dell’Osso L, Carmassi C, Carlini M, Rucci P,TorriP, Cesari D, et al. Sexual dysfunctions and suici- dalityinpatientswithbipolardisorderandunipolar depression. J Sex Med 2009;6(11):3063-3070. Vanwesenbeeck I, Have M, De Graaf R. Associa-tions between common mental disorders and sexualdissatisfactioninthegeneralpopulation.Br J Psychiatry 2014;205(2):151-157.

Hariri AG, Karadag F, Gurol DT, Aksoy UM,Tezcan AE. Sexual problems in a sample of the Turkish psychiatric population. Compr Psychiatry 2009;50(4):353-360.

SørensenT,GiraldiA,VinbergM.Sexualdistressand quality of life among women with bipolar disorder. Int J Bipolar Disord 2017;5(1):29.

Wirshing DA, Pierre JM, Marder SR, SaundersCS, Wirshing WC. Sexual side effects of novel antipsychotic medications. Schizophr Res 2002; 56(1-2):25-30.

La Torre A, Giupponi G, Duffy D, Pompili M,Grözinger M, Kapfhammer H, et al. Sexual dys- function related to psychotropic drugs: a critical review. Part III: Mood stabilizers and anxiolytic drugs. Pharmacopsychiatry 2013;47(1):1-6.

McCabe MP, Sharlip ID, Lewis R, Atalla E, BalonR, Fisher AD, et al. Risk factors for sexual dys- function among women and men: a consensus statement from the Fourth International Consul- tationonSexualMedicine2015.JSexMed2016; 13(2):153-167.

KopeykinaI,KimHJ,KhatunT,BolandJ,HaeriS,Cohen LJ, et al. Hypersexuality and couple rela- tionships in bipolar disorder: A review. J Affect Disord 2016; 195:1-14.

Montejo AI, Llorca G, Izquierdo JA, Ledesma A,Bousoño M, Calcedo A, et al. Sexual dysfunction secondarytoSSRIs.Acomparativeanalysisin 308 patients. Actas Luso Esp Neurol PsiquiatrCienc Afines 1996; 24(6):311-321.

Dossenbach M, Dyachkova Y, Pirildar S, AndersM, Khalil A, Araszkiewicz A, et al. Effects ofatypi- cal and typical antipsychotic treatments onsexual function in patients with schizophrenia: 12-month results from the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study. Eur Psychiatry 2006;21(4):251-258.

Zemishlany Z, Weizman A. The Impact of mentalıllnessonsexualdysfunction.SexualDysfunction, Basel: Karger, 2008,p.89-106.

Borowiecka-Karpiuk J, Dudek D, Siwek M,Jaeschke R. Spousal burden in partners of pa- tients with major depressive disorder and bipolar disorder. Psychiatr Pol 2014;48(4):773-787.

Tuğrul C, Öztan N, Kabakçı E. Golombok-Rustcinsel Doyum ölçeğinin standardizasyon çalışma- sı (The standardization of Golombok-Rust Sexual Satisfaction Inventory). Turk Psikiyatr Derg1993; 4:83-89.

AkdemirA,DönbakÖrselS,Dağİ,TürkçaparMH,İşcan N, Özbay H. Hamilton Depresyon Derece- lendirme Ölçeğinin geçerliliği, güvenilirliği ve klinikte kullanımı. 3P Dergisi 1996;4:251-259.

Tutarel-Kışlak Ş. Evlilik Uyum Ölçeği adaptasyonçalışması. 3P Derg 1999;7(1):50-57.

Karadağ F, Oral ET, Yalçın FA, Erten E. YoungMani Derecelendirme Ölçeğinin Türkiye’de GeçerlikveGüvenilirliği.TurkPsikiyatrDerg2001; 13(2):107-114. Locke HJ, Wallace KM. Short Marital-Adjustmentand Prediction Tests: Their reliability and validity. Marriage Fam Living 1959;21(3):251-255. Namlı Z, Karakuş G, Tamam L. Assessment ofdyadicadjustmentandsexualfunctionsinpatients with bipolar disorder. Arch Neuropsychiatry 2018; Article inpress.

Seidman SN, Roose SP. The relationship between depression and erectile dysfunction. Curr Psychiatry Rep 2000;2(3):201-205.

Clayton AH, El Haddad S, Iluonakhamhe J-P,Ponce Martinez C, Schuck AE. Sexual dysfunc- tion associated with major depressive disorder and antidepressant treatment. Expert Opin Drug Saf 2014;13(10):1361-1374.

Dunn KM, Croft PR, Hackett GI. Association ofsexual problems with social, psychological, and physical problems in men and women: a cross sectional population survey. J Epidemiol Commu- nity Health 1999;53(3):144-148.

Brezsnyak M, Whisman MA. Sexual Desire andRelationship Functioning: The Effects of Marital Satisfaction and Power. J Sex Marital Ther 2004; 30(3):199-217.

Strand J, Wise TN, Fagan PJ, Jr CWS. Erectiledysfunction and depression: category or dimen- sion? J Sex Marital Ther 2002;28(2):175-181.

Jern P, Gunst A, Sandnabba K, Santtila P. Areearly and current erectile problems associated with anxiety and depression in young men? A retrospective self-report study. J Sex Marital Ther 2012;38(4):349-364.

Lam D, Donaldson C, Brown Y, Malliaris Y.Burden and marital and sexual satisfaction in the partners of bipolar patients. Bipolar Disord 2005; 7(5):431-440.