The mediating role of sexual dysfunction knowledge in the association between sexual function and depression: a...

Sexual dysfunction (SD) and depression are prevalent issues that significantly affect both physical and mental health.

This study aimed to explore the association between sexual function (SF) and depression in reproductive-aged population and further examine the mediating role of knowledge regarding the effect of sexual dysfunction on fertility (KSDF).

This study enrolled a total of 10 761 participants aged 20-40 from 31 regions, including 5259 males and 5502 females, with a median age of 29.0 years. Basic demographic data were collected initially, followed by clinical data acquisition.

The International Index of Erectile Function 5 (IIEF5), the Premature Ejaculation Diagnostic Tool (PEDT), the Female Sexual Function Index-19 (FSFI-19), the Patient Health Questionnaire-9, and the Disease Knowledge Questionnaire.

The study revealed a significant bidirectional association between SF and depression among the population. Specifically, poorer SF was correlated with higher severity of depressive (IIEF5 [β = -0.155, P < .001], PEDT [β = 0.311, P < .001], and FSFI-19 [β = -0.059, P < .001]). Conversely, higher severity of depressive was associated with poorer SF (IIEF5 [β = -0.202, P < .001], PEDT [β = 0.249, P < .001], and FSFI-19 [β = -0.191, P < 0.001]). Furthermore, in males, the KSDF mediated the bidirectional associations between SF and depression. Specifically, the mediating proportions were as follows: KSDF mediated 3.00% of the association between IIEF5 and depression, and 2.20% of the association between PEDT and depression; similarly, for the association between depression and SF, KSDF mediated 2.50% of the association between depression and IIEF5 and 2.20% between depression and PEDT. However, no such mediation was observed in females.

This provides new insights for the clinical management of these issues in the male reproductive-aged population.

These findings suggest that enhancing this knowledge could interrupt bidirectional association between impaired SF and depression in this demographic, potentially alleviating both conditions without requiring additional interventions. However, cross-sectional study design does not allow us to draw corresponding causal conclusions.

The current study further demonstrated a significant bidirectional association between SF and depression among the reproductive-aged population, and importantly, the KSDF was found to mediate this association in males.