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Sexual dysfunction before antidepressant therapy in major depression.

S H Kennedy1, S E Dickens, B S Eisfeld

  • 1Department of Psychiatry, University of Toronto, Ontario, Canada. kennedys@cs.clarke-inst.on.ca

Journal of Affective Disorders
|March 4, 2000
PubMed
Summary

Sexual dysfunction is common in major depression (MD) patients before treatment, affecting over 40% of men and 50% of women. These issues are linked to personality and depression history, not just medication side effects.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Antidepressant medications, particularly serotonin reuptake inhibitors (SRIs), are known to cause sexual dysfunction.
  • Limited data exists on the prevalence of sexual dysfunction in patients with major depression (MD) before initiating antidepressant treatment.
  • Understanding baseline sexual function is crucial for assessing drug-induced sexual dysfunction.

Purpose of the Study:

  • To determine the frequency of sexual dysfunction (SD) in a sample of drug-free patients with MD.
  • To examine the relationship between SD and demographic, clinical, and personality variables in MD patients.

Main Methods:

  • 134 patients with MD (55 male, 79 female) diagnosed via SCID-DSM IV were assessed.
  • Participants completed psychometric measures, including a Sexual Function Questionnaire.

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  • The questionnaire assessed changes in sexual interest, function, and activity in the preceding month.

    • Main Results:

    • Sexual activity was reported by 50% of women and 75% of men.
    • Decreased sexual interest affected over 40% of men and 50% of women.
    • Arousal difficulties were common (40-50%), while ejaculatory/orgasm issues were less frequent (15-20%).
    • In women, arousal and orgasm problems correlated with higher neuroticism and lower extraversion.
    • No correlation was found between SD and personality measures in men.
    • SD showed a modest correlation with age at onset and number of prior depressive episodes, but not with depression severity.

    Conclusions:

    • Sexual dysfunction is prevalent in major depression patients prior to antidepressant treatment.
    • Factors beyond medication, such as personality and illness history, may contribute to sexual dysfunction.
    • Further research with larger samples and non-depressed controls is needed to fully understand antidepressant-related sexual dysfunction.