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What Effects Can Expressive Writing Have on Sexual Dysfunction in Women with Multiple Sclerosis? A Randomized Controlled Trial. Acta Neurol Scand 2023. [DOI: 10.1155/2023/6754178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Background. Sexual dysfunction is a common complication in women with multiple sclerosis due to limitation in physical and mental functioning. Expressive writing as a psychological intervention can significantly improve sexual dysfunction in women with other diseases. Aim. The aim of the current study was to determine the effect of expressive writing on sexual dysfunction in Iranian women with multiple sclerosis. Methods. A randomized controlled trial with a Solomon four-group design was conducted on 116 Iranian women with MS in February 2021. Participants were randomly assigned into two control subgroups of A1 (without pretest) and A2 (with pretest) and two intervention subgroups of B1 (without pretest) and B2 (with pretest). Expressive writing was conducted for six weeks at home including morning pages (writing three pages about everything that comes to mind everyday), date with inner child (once a week), and performing weekly creative assignments. Sexual dysfunction was assessed using MSISQ-19 before the intervention in two groups of A2 and B2 and follows in immediately, four weeks and eight weeks after the intervention in all subgroups. The control group was provided with routine care of treatment. Data were analyzed using the intention to treat method.
was considered significant. Results. Twenty-nine women were analyzed in each subgroup. Although expressive writing had a positive and significant effect on primary, tertiary, and overall sexual dysfunction in B2 intervention subgroup compared with A2 control subgroup (
), it could not improve secondary sexual dysfunction. Since tertiary sexual dysfunction was related to psychological aspects and the present intervention was also a subset of psychotherapy, most of the changes were observed at this level, which included a decrease of 7-8 points. Comparison between the two groups of with and without pretest in each of the control and intervention groups revealed that completing the pretest questionnaire did not have a significant impact on sexual dysfunction score. Conclusion. As a cost-effective and noninvasive intervention, expressive writing can be used along with the main treatment for women suffering from multiple sclerosis to improve sexual dysfunction.
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Esteve Ríos A, Cabañero-Martínez MJ, Escribano S, Foley F, García-Sanjuán S. Validation and cross-cultural adaptation of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15) into Spanish. PeerJ 2023; 11:e15138. [PMID: 37138819 PMCID: PMC10150713 DOI: 10.7717/peerj.15138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/07/2023] [Indexed: 05/05/2023] Open
Abstract
Background The Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15) is a valid and reliable tool to assess the sexuality of people with multiple sclerosis. The objectives of this study were: 1) to cross-culturally adapt and examine the psychometric properties of the MSISQ-15 in the Spanish context and 2) to examine the association between sexual dysfunction and other related factors. Methods We conducted a instrumental study. People diagnosed with multiple sclerosis and members of multiple sclerosis associations in Spain were included. The linguistic adaptation of the questionnaire was performed through a translation-back translation procedure. For the psychometric validation, the confirmatory factor analysis was used while the internal consistency was examined by the ordinal alpha test. The construct validity was examined by correlating the results with the Male Sexual Function (FSH), Female Sexual Function-2 (FSM-2), Dyadic Adjustment Scale-13 (EAD-13) and Multiple Sclerosis International Quality of Life Questionnaire (MusiQoL) questionnaires. Results A total of 208 participants were included. Both the fit of the Spanish version of the MSISQ-15 to the original scale and the internal consistency were adequate (α = 0.89). The construct validity showed correlations with the FSH, FSM-2, and MusiQoL but not with the EAD-13. Conclusions The Spanish version of the MSISQ-15 is a valid and reliable tool to assess the sexuality of people with multiple sclerosis in the Spanish context.
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Affiliation(s)
- Antonio Esteve Ríos
- Department of Nursing/Faculty of Health Science, University of Alicante, San Vicente del Raspeig, Alicante, Spain
| | - María José Cabañero-Martínez
- Department of Nursing/Faculty of Health Science, University of Alicante, San Vicente del Raspeig, Alicante, Spain
| | - Silvia Escribano
- Department of Nursing/Faculty of Health Science, University of Alicante, San Vicente del Raspeig, Alicante, Spain
| | - Frederick Foley
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States of America
| | - Sofía García-Sanjuán
- Department of Nursing/Faculty of Health Science, University of Alicante, San Vicente del Raspeig, Alicante, Spain
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Baghbanian SM, Khalili B, Bakhshi A, Azizi H, Ghazaeian M. The effects of bupropion on sexual dysfunction in female patients with multiple sclerosis: A double-blind randomized clinical trial. Mult Scler Relat Disord 2023; 69:104399. [PMID: 36410223 DOI: 10.1016/j.msard.2022.104399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/08/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Sexual dysfunction (SD) is one of the most common complications of multiple sclerosis (MS). The aim of this study was to evaluate the effects of bupropion on SD among female patients with MS. METHODS This double-blind placebo-control randomized clinical trial was conducted on MS patients with SD complaint. Diagnosis was based on the secondary SD subscale scores of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19). Accordingly, individuals scoring above 27 based on this scale were diagnosed with SD. The subjects were randomly assigned to the bupropion and placebo groups. Bupropion was administered 75 mg twice daily for twelve weeks. As for the study outcomes, besides MSISQ-19, quality of life (Multiple Sclerosis Quality Of Life-54 (MSQOL-54)), fatigue (Multidimensional Fatigue Inventory (MFI)), depression and anxiety (Hospital Anxiety and Depression Scale), and bupropion tolerability were assessed at baseline as well as at weeks 6 and 12. RESULTS From 84 patients who met the inclusion criteria, 64 patients completed the trial and were analyzed. Demographics and baseline clinical characteristics were not significantly differed between the two groups. The results showed the mean score of MSISQ-19 from baseline to the end of the study period significantly improved in the bupropion group compared with the placebo (week 6: P: 0.03; week 12: P: 0.03). Similarly, MFI scores showed significant improvement in the bupropion group compared with the placebo group (P: 0.001). Both anxiety and depression scores showed significant alterations at study interval between the two groups (Anxiety: weeks 6 and 12: P:0.04; depression: week 6: 0.01, week 12: 0.02). However, there was no significant change in the MSQOL-54 score between the two groups. CONCLUSION The results of the study substantiated that bupropion can be an effective agent for SD improvement in female patients with MS. Further clinical trials with larger sample sizes can more accurately evaluate the observed findings.
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Affiliation(s)
| | - Behnam Khalili
- Department of Neurology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Atieh Bakhshi
- Department of Neurology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hanieh Azizi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Monireh Ghazaeian
- Pharmaceutical Sciences Research Center, Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
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Devis M, Stoquart G, Géonet M, London F, van Pesch V. Validation of the French version of the Multiple Sclerosis Intimacy And Sexuality Questionnaire-19: A preliminary study. Mult Scler Relat Disord 2022; 65:103986. [DOI: 10.1016/j.msard.2022.103986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/30/2022] [Accepted: 06/17/2022] [Indexed: 10/18/2022]
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Lefebvre S, Houot M, Delgadillo D, Cantal Dupart MD, Varin D, Papeix C, Sevin M, Bourmaleau J, Laigle‐Donadey F, Jovic L. Validation of the French version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 Tools which help nurse for assessing the effect of perceived multiple sclerosis symptoms on sexual activity and satisfaction. Nurs Open 2022; 10:570-578. [PMID: 36054641 PMCID: PMC9834499 DOI: 10.1002/nop2.1323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 11/30/2021] [Accepted: 07/29/2022] [Indexed: 01/16/2023] Open
Abstract
AIM To validate a French version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 which examines patients' perception of the effect of multiple sclerosis symptoms on their sexual activity. METHODS After completing a translation/re-translation process to ensure linguistic and content validity, the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 French (MSISQ-15Fr) was completed by patients with multiple sclerosis. The validity of the construction, reliability, stability and reproducibility of the translation was evaluated. EXPLANATORY MIXED OBSERVATIONAL STUDY Validation of a French assessment tool for sexual disorders (borrowed theoretical framework): the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 (MSISQ 15) RESULTS: The normed χ2 was 1.21, the root mean square error of approximation was 0.046 [0.00; 0.07], the comparative fit index was 0.974, and the standardized root mean square was 0.065. The calculated Cronbach's coefficients indicated strong internal coherence, and the intraclass correlation coefficient was satisfactory at 0.9. Translations of the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 (MSISQ-15) have already been validated in five languages. This French version is valid, stable and reproducible. It provides French-speaking nurses an accessible and appropriate tool that will enable them to play an active role in the sexual health strategy recommended by the World Health Organization.
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Affiliation(s)
- Sandrine Lefebvre
- University of Paris Cité, ECEVE UMR 1123, InsermParisFrance,AP‐HPSorbonne University, GHU Pitié‐SalpêtrièreParisFrance
| | - Marion Houot
- AP‐HPSorbonne University, GHU Pitié‐SalpêtrièreParisFrance
| | - Daniel Delgadillo
- APHPSorbonne University, GHU Pitié SalpêtrièreDepartment 2‐MazarinParisFrance
| | | | | | - Caroline Papeix
- APHPSorbonne University, GHU Pitié SalpêtrièreDepartment of neurologyParisFrance
| | | | - Julie Bourmaleau
- APHPSorbonne University, GHU Pitié SalpêtrièreDepartment of neurologyParisFrance,EHESPParisFrance
| | | | - Ljiljana Jovic
- University of Paris Cité, ECEVE UMR 1123, InsermParisFrance,ARS Ile‐de‐FranceParisFrance
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Dogan H, Abakay H, Tekin G, Saçmaci H, Goksuluk MB, Ozengin N. The Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ): Validation of the Turkish version in patient with multiple sclerosis. Mult Scler Relat Disord 2022; 64:103965. [PMID: 35728434 DOI: 10.1016/j.msard.2022.103965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/04/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022]
Abstract
This study aimed to psychometrically evaluate the Turkish version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-15) in women with MS. The study included 130 women with MS. The Turkish linguistic validation process of the original English MSISQ-15 was performed according to standardized guidelines. Reliability analysis was evaluated with test-retest analysis and intra-class correlation (ICC). Internal consistency between the items was analyzed using the Cronbach's alpha coefficient. Item analysis results were used to assess the contribution of the items to the scale. In evaluating the validity of the scale, the relationship between the MSISQ and the Female Sexual Function Index (FSFI), the Multiple Sclerosis Quality of Life Questionnaire-54 (MSQOL-54), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PSIQ-12) was investigated. Psychometric properties were analyzed using internal consistency, test-rest reliability, construct validity, and floor-ceiling effect. The internal consistency of the Turkish MSISQ-15 was strong in terms of both sub-dimension score and the total score (Cronbach's a coefficient > 0.80). The test-retest reliability of the scale was very strong (ICC > 0.90). A medium-high correlation was found between the MSISQ-15 and the MSQOL-54, the FSFI, and the PSIQ-12 (between r = -0.448 and r = -0.798, p < 0.001, respectively). The MSISQ-15 is a comprehensive, reliable, and valid inventory to obtain information about the cause of sexual dysfunction in Turkish women with MS and to evaluate the level of sexual dysfunction. In future studies, it is recommended to examine the sensitivity of the Turkish MSISQ-15 to treatment-related changes.
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Affiliation(s)
- Hanife Dogan
- Sarıkaya School of Physiotherapy and Rehabilitation, Bozok University, Yozgat, Turkey.
| | - Hanife Abakay
- Sarıkaya School of Physiotherapy and Rehabilitation, Bozok University, Yozgat, Turkey
| | - Gözde Tekin
- Vocational School of Health Services, Muş Alparslan University, Muş, Turkey
| | - Hikmet Saçmaci
- Faculty of Medicine, Department of Neurology, Bozok University, Yozgat, Turkey
| | - Merve Basol Goksuluk
- Faculty of Medicine, Basic Medical Sciences, Erciyes University, Kayseri, Turkey
| | - Nuriye Ozengin
- Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Bolu Abant İzzet Baysal University, Bolu, Turkey
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Tools for comprehensive evaluation of sexual function in patients with multiple sclerosis. NEUROLOGÍA (ENGLISH EDITION) 2022; 38:197-205. [PMID: 35260364 DOI: 10.1016/j.nrleng.2020.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 04/15/2020] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) that affects young adults, causing a variety of symptoms (motor alterations, visual alterations, loss of sphincter control, gait alterations) that impair the patient's functional status. However, other symptoms, such as sexual dysfunction, can also have an effect on quality of life. DEVELOPMENT Sexual dysfunction can occur at any time during the course of the disease; its prevalence varies between 50% and 90%, and it can be secondary to demyelinating lesions in the spinal cord and/or brain or caused by symptoms that do not directly involve the nervous system (fatigue; psychological, social, and cultural factors; etc.). Although its prevalence and impact on quality of life are well known, sexual dysfunction is still frequently underestimated. Therefore, in this article we review the different scales for assessing presence or severity of sexual dysfunction, in order to offer early multidisciplinary management. CONCLUSION We evaluated 5 questionnaires that could identify the presence of sexual dysfunction in patients with MS and determine its aetiology, assisting in treatment decision making. MS must be understood as a complex disease that encompasses and compromises different aspects of patients' health, and goes beyond simply measuring disability.
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Ahmed HEDH, GamalEl Din SF, Oraby MI, Elhameed HMA, Ahmed AR. Drug-naïve Egyptian females with migraine are more prone to sexual dysfunction than those with tension-type headache: a cross-sectional comparative study. Acta Neurol Belg 2021; 121:1745-1753. [PMID: 32975730 DOI: 10.1007/s13760-020-01504-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/15/2020] [Indexed: 12/01/2022]
Abstract
Headache is one of the chronic disorders that can trigger sexual dysfunction due to complex mechanisms. This study recruited 120 consecutive patients from our outpatient clinics with migraine (n = 60), TTH (n = 60) as well as healthy age-matched controls (n = 60) for a total of 180 patients. All the participants were evaluated by the Arabic version of the female sexual function index (ArFSFI: 19 items), the abridged 5-item version of the international index of erectile function (IIEF-5), hospital anxiety and depression scale (HADS: 14 items), visual analog scale (VAS) score, and the headache impact test questionnaire (HIT-6TM: 6 items). A significant correlation was noticed between scores of total ArFSFI in women with TTH and their partners' IIEF-5 scores (r = 0.773, p < 0.001). In contrast, significant negative correlations were also found between scores of total ArFSFI in women with migraine(r - 0.327, p 0.011), HADS-A scores (r - 0.504, p < 0.001), HADS-D scores (r - 0.579, p < 0.001), HITS scores (r - 0.413, p 0.001), VAS scores (r 0.737, p < 0.001), and their partners' IIEF-5 scores (r - 0.839, p < 0.001). Interestingly, our study had shown a bidirectional relation between SD, anxiety, and depression subscales of HADS in females with migraine only (28.49 ± 9.46, 13.54 ± 4.44, 15.17 ± 7.73 respectively, p 0.009), while females with migraine and SD reported statistical higher scores of anxiety and depression (25.21 ± 11.70, 12.71 ± 4.20, 17.95 ± 8.05, respectively, p 0.006). This study had demonstrated that drug-naïve Egyptian females with migraine are more prone to SD than those with TTH.
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Affiliation(s)
- Hossam El Din Hosni Ahmed
- Andrology and STDs Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Al-Saray Street, El Manial, Cairo, 11956, Egypt
| | - Sameh Fayek GamalEl Din
- Andrology and STDs Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Al-Saray Street, El Manial, Cairo, 11956, Egypt.
| | | | | | - Ahmed Ragab Ahmed
- Andrology and STDs Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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The Effect of Sexual Health Promotion Package on Sexual Life in Women with Multiple Sclerosis: Designed Based on the Results of a Mixed Method Study. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-021-09697-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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10
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Przydacz M, Golabek T, Dudek P, Chlosta P. The Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-15): translation, adaptation and validation of the Polish version for patients with multiple sclerosis and spinal cord injury. BMC Neurol 2021; 21:103. [PMID: 33685399 PMCID: PMC7938601 DOI: 10.1186/s12883-021-02132-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 03/01/2021] [Indexed: 11/24/2022] Open
Abstract
Background Polish physicians and researchers lack an extensive and precise instrument in their native language for evaluating sexual dysfunction in individuals with neurogenic disorders. The aim of this study was to create a culturally adapted, validated, Polish language version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-15) for persons with multiple sclerosis (MS) and spinal cord injury (SCI). Methods International recommendations and standardized methods for instrument validation were followed. Sexually active patients with MS and SCI completed the MSISQ-15, International Index of Erection Function (IIEF-15, men), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-31, women). IIEF-15 and PISQ-31 were used as reference questionnaires. Responses were collected at baseline (test) and after 2 weeks (re-test). Results We recruited 299 Polish-speaking patients with MS or SCI. Interviews disclosed that the translated questionnaire had optimal content validity/cross-cultural adaptation. MSISQ-15 scores correlated significantly with the severity of sexual dysfunction as evaluated by IIEF-15 (r = − 0.487) and PISQ-31 (r = − 0.709). These correlations substantiated the high quality construct/criterion validity. An analysis of reliability presented good internal consistency (Cronbach’s alpha of 0.93 for the total score of MS patients and 0.86 for the total score of SCI patients) and reproducibility (intraclass correlation coefficients of 0.91 for the total score of MS patients and 0.92 for the total score of SCI patients). There were no ceiling or floor effects. Conclusions The Polish version of MSISQ-15 exhibited excellent measurement properties. It is a suitable and reliable instrument to assess sexual dysfunction in MS and SCI individuals. The Polish MSISQ-15 will enhance routine clinical practice and assist research for neurogenic patients in Poland. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02132-9.
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Affiliation(s)
- Mikolaj Przydacz
- Department of Urology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688, Krakow, Poland.
| | - Tomasz Golabek
- Department of Urology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688, Krakow, Poland
| | - Przemyslaw Dudek
- Department of Urology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688, Krakow, Poland
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688, Krakow, Poland
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Validation of the Italian version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19. Neurol Sci 2020; 42:2903-2910. [PMID: 33222102 DOI: 10.1007/s10072-020-04873-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/29/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND People with multiple sclerosis (MS) may experience sexual dysfunction throughout the disease course. Validated scales to assess sexual dysfunction in MS for Italian patients are lacking. Hence, we aimed at validating Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-19) for Italian MS patients. METHODS We included both male and female MS patients. Each patient completed the Italian translation of the MSISQ-19. Construct validity was explored by the exploratory factor analysis and the Cronbach's alpha coefficient. Test-retest stability and concurrent internal and external validity were examined by Pearson' correlation coefficients. RESULTS We enrolled 369 MS patients (323 female and 46 male). Italian MSISQ-19 showed a Cronbach's alpha of 0.92. MSISQ-19 test and retest total scores correlated between each other (r = 0.48, p = 0.01). MSISQ-19 total score also correlated with primary, secondary and tertiary subscales (p < 0.001). CONCLUSION The Italian Version of the MSISQ-19 showed satisfactory internal consistency and reliability with moderately adequate test-retest reproducibility, suggesting that it may be used as a valuable measure of sexual dysfunction in the Italian population.
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Gaviria Carrillo M, Ortiz Salas PA, Rueda Vergara KP, Cortes Bernal GA, Nava Mesa M, Moreno Medina K. Tools for comprehensive evaluation of sexual function in patients with multiple sclerosis. Neurologia 2020; 38:S0213-4853(20)30220-6. [PMID: 32917438 DOI: 10.1016/j.nrl.2020.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/28/2020] [Accepted: 04/15/2020] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) that affects young adults, causing a variety of symptoms (motor alterations, visual alterations, loss of sphincter control, gait alterations) that impair the patient's functional status. However, other symptoms, such as sexual dysfunction, can also have an effect on quality of life. DEVELOPMENT Sexual dysfunction can occur at any time during the course of the disease; its prevalence varies between 50% and 90%, and it can be secondary to demyelinating lesions in the spinal cord and/or brain or caused by symptoms that do not directly involve the nervous system (fatigue; psychological, social, and cultural factors; etc.). Although its prevalence and impact on quality of life are well known, sexual dysfunction is still frequently underestimated. Therefore, in this article we review the different scales for assessing presence or severity of sexual dysfunction, in order to offer early multidisciplinary management. CONCLUSION We evaluated 5 questionnaires that could identify the presence of sexual dysfunction in patients with MS and determine its aetiology, assisting in treatment decision making. MS must be understood as a complex disease that encompasses and compromises different aspects of patients' health, and goes beyond simply measuring disability.
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Affiliation(s)
- M Gaviria Carrillo
- Neurología, Fundación Cardio Infantil Instituto de Cardiología, Universidad del Rosario, Bogotá, Colombia.
| | - P A Ortiz Salas
- Neurología y Epidemiología, Fundación Cardio Infantil Instituto de Cardiología, Bogotá, Colombia
| | | | | | - M Nava Mesa
- Grupo de investigación en Neurociencias (NEUROS), Universidad del Rosario, Bogotá, Colombia
| | - K Moreno Medina
- Epidemiología, Fundación Cardio Infantil Instituto de Cardiología, Bogotá, Colombia
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Mohammadi K, Rahnama P, Rafei Z, Ebrahimi-Aveh SM, Montazeri A. Factors associated with intimacy and sexuality among young women with multiple sclerosis. Reprod Health 2020; 17:110. [PMID: 32650800 PMCID: PMC7350564 DOI: 10.1186/s12978-020-00960-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with multiple sclerosis (MS) especially those with younger age experience an alteration in physiological and emotional lifestyle that can affect intimacy and sexuality. The aim of this study was to determine demographic and disease related determinants of intimacy and sexuality in young women with MS. METHODS This was a cross sectional study carried out in Tehran, Iran. A convenience sample of young women aged ≤35 years old with MS attending to outpatient clinics in a teaching hospital affiliated to Tehran University of Medical Sciences was entered into the study. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) was used to evaluate how the disease influences sexual function and satisfaction in these patients. Multivariable analysis using hierarchical method was performed to identify variables that are associated with intimacy and sexuality. RESULTS In total 117 young women with confirmed diagnosis of MS were included in the study. Participants mean was 25.7 (SD = 8.07) years. A multivariable hierarchical regression analysis was performed using demographic variables entered in step one, relevant neurological variables in step two, and psychological variables in step three. Furthermore, we loaded antidepressant use in the last step. Overall, the seven variables accounted for 39% of total variance observed for the MSISQ score (P < 0.001). At step one the demographic variables accounted for 13% of the variance in the MSISQ score (P < 0.001). At step two the inclusion of relevant neurological variables increased the R2 significantly and explained 27% of variance for the MSISQ (P < 0.001). However in the third step the inclusion of psychological factors increased R2 significantly (adjusted R2 increased to 0.39, P < 0.001). CONCLUSIONS The findings indicated that psychological, disease-related and demographic factors (education and employment status) contributed to intimacy and sexuality in young women with multiple sclerosis. Appropriate interventions, especially psychological interventions, appear to be essential immediately following a definite MS diagnosis in young women.
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Affiliation(s)
- Khadijeh Mohammadi
- Department of Midwifery, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran
| | - Parvin Rahnama
- Department of Midwifery, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran
| | | | | | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Science &Culture, ACECR, Tehran, Iran
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The Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-15): validation of the Italian version for individuals with spinal cord injury. Spinal Cord 2020; 58:1128-1133. [PMID: 32332876 DOI: 10.1038/s41393-020-0469-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Psychometric study. OBJECTIVE The aim of the study was to translate and culturally adapt the MSISQ-15 into Italian and to administer it to individuals with a spinal cord injury (SCI). SETTING Rome's Wheelchair Rugby Team and three spinal units in Italy. METHODS Translation and validation of the MSISQ-15 were performed based on international guidelines. The questionnaire, which was in a paper and online format, was administered with the Short Form-12 Health Survey (SF-12) and the Spinal Cord Independence Measure Self-Report. RESULTS Sixty-five participants were recruited. Internal consistency coefficient of MSISQ-15 scale, assessed by Cronbach's alpha, was 0.75. Test-retest reliability interclass correlations was, for example, 0.86. The construct validity was calculated and showed statistically significant results in relation to the mental health status investigated with the SF-12. CONCLUSIONS The MSISQ-15 is a valid, reliable, and useful questionnaire for investigating how often the symptoms of an SCI interfere with a person's satisfaction or sexual activity.
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Prevalence, dimensions, and predictor factors of sexual dysfunction in women of Iran Multiple Sclerosis Society: a cross-sectional study. Neurol Sci 2020; 41:1105-1113. [PMID: 31897948 DOI: 10.1007/s10072-019-04222-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Sexual dysfunction (SD) is a stressful and common symptom in women with multiple sclerosis (MS) and affects different aspects of their life, seriously. The purpose of this study was to determine the prevalence, dimensions, and predictor factors of SD in Iranian women with MS. METHODS This cross-sectional study was conducted in Iran MS Society. Participants were 260 married women who had definite MS. Data were collected using self-report questionnaires, including Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19); Fatigue Severity Scale (FSS); Depression, Anxiety, and Stress Scale-21 (DASS-21); Questionnaire for Urinary Incontinence Diagnosis (QUID); ENRICH Marital Satisfaction Scale (EMS); Sexual Self-Efficacy Questionnaire; and socio-demographic and disease information questionnaire. Pearson correlation coefficients, independent sample t-test, one-way analysis of variance (ANOVA), and multiple linear regression model were used for data analysis. RESULTS Majority (76.2%) of the participants had SD, and according to the dimensions of SD in MS, primary SD was found in 176 (67.7%), secondary SD in 158 (60.7%), and tertiary SD in 126 (48.5%) of the participants. The most important and common problem was delayed orgasm (60%). According to the results of multiple linear regression model, the predictor factors of SD were sexual self-efficacy (B = -0.721, P < 0.001), disability status (B = 2.714, P < 0.001), urge incontinence (B = 0.367, P = 0.029), depression (B = 0.446, P = 0.007), anxiety (B = 0.332, P = 0.037), fatigue (B = 0.177, P = 0.002), duration of disease (B = -0.463, P = 0.014), and duration of DMT use (B = 0.662, P = 0.002). CONCLUSION According to the results of this cross-sectional study, SD was a very common and complex problem in women of Iran MS Society, and a number of physical, neurological, and psychological factors, such as sexual self-efficacy, disability status, urge incontinence, depression, anxiety, fatigue, duration of DMT use, and duration of disease, play a role in SD of these patients. So, in the treatment procedure of SD in MS women, adopting a multidisciplinary approach, as well as considering all contributory factors and their impact on sexual function, is recommended.
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Polat Dunya C, Tulek Z, Uchiyama T, Haslam C, Panicker JN. Systematic review of the prevalence, symptomatology and management options of sexual dysfunction in women with multiple sclerosis. Neurourol Urodyn 2019; 39:83-95. [PMID: 31765492 DOI: 10.1002/nau.24232] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 11/03/2019] [Indexed: 12/28/2022]
Abstract
AIMS Sexual dysfunction (SD) is highly prevalent in women with multiple sclerosis (MS), however little is known about treatment options. The aim of this paper is to review the prevalence, symptomatology, and management options of sexual dysfunction in women with MS. METHODS The Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, PEDro, Database of International Rehabilitation Research, Occupational Therapy Systematic Evaluation of Evidence, ClinicalTrials.gov, and Current Controlled Trials databases were searched. No limitations were placed on the date. A critical appraisal of the literature on SD in women with MS was performed according to the PRISMA statement. Two reviewers screened and extracted data. Study quality was evaluated using a standardized tool. RESULTS A search of 12 databases identified 61 relevant studies (33 observational, 14 case-control, 4 follow up, 10 interventional). Significant variability in the prevalence of SD and questionnaires used to evaluate SD were observed. The most commonly reported sexual difficulties were problems with desire, arousal, and orgasm. Different demographics and MS-related characteristics were found to contribute to SD. Few studies have evaluated interventions for treating SD, and bias was high because of the weak quality of trial designs. CONCLUSIONS SD in women with MS is multidimensional, comparable in prevalence with other neurological disorders and increases with advancing disease. Studies evaluating practical strategies and pharmacological interventions are few, and properly designed trials using MS-specific validated outcome measures of SD are required to inform evidence-based treatment options for this high impact MS-related dysfunction.
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Affiliation(s)
- Cansu Polat Dunya
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Queen Square Institute of Neurology, London, United Kingdom.,Department of Medical Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Zeliha Tulek
- Department of Medical Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tomoyuki Uchiyama
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Queen Square Institute of Neurology, London, United Kingdom.,Department of Neurology, International University of Health and Welfare and International University of Health and Welfare Ichikawa Hospital, Chiba, Japan
| | - Collette Haslam
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Jalesh N Panicker
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Queen Square Institute of Neurology, London, United Kingdom
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Noordhoff TC, Scheepe JR, 't Hoen LA, Sluis TAR, Blok BFM. The Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-15): Validation of the Dutch version in patients with multiple sclerosis and spinal cord injury. Neurourol Urodyn 2018; 37:2867-2874. [DOI: 10.1002/nau.23804] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/29/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Toscane C. Noordhoff
- Department of Urology; Erasmus University Medical Center; Rotterdam The Netherlands
| | - Jeroen R. Scheepe
- Department of Urology; Erasmus University Medical Center; Rotterdam The Netherlands
| | - Lisette A. 't Hoen
- Department of Urology; Erasmus University Medical Center; Rotterdam The Netherlands
| | - Tebbe A. R. Sluis
- Department of Rehabilitation; Rijndam Rehabilitation; Rotterdam The Netherlands
| | - Bertil F. M. Blok
- Department of Urology; Erasmus University Medical Center; Rotterdam The Netherlands
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18
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't Hoen LA, Groen J, Scheepe JR, Reuvers S, Diaz DC, Fernández BP, Del Popolo G, Musco S, Hamid R, Ecclestone H, Karsenty G, Phé V, Boissier R, Kessler TM, Gross T, Schneider MP, Pannek J, Blok BFM. A Quality Assessment of Patient-Reported Outcome Measures for Sexual Function in Neurologic Patients Using the Consensus-based Standards for the Selection of Health Measurement Instruments Checklist: A Systematic Review. Eur Urol Focus 2017; 3:444-456. [PMID: 28753768 DOI: 10.1016/j.euf.2016.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/31/2016] [Accepted: 06/13/2016] [Indexed: 01/15/2023]
Abstract
CONTEXT Impaired sexual function has a significant effect on quality of life. Various patient-reported outcome measures (PROMs) are available to evaluate sexual function. The quality of the PROMs to be used for neurologic patients remains unknown. OBJECTIVE To systematically review which validated PROMs are available to evaluate sexual function in neurologic patients and to critically assess the quality of the validation studies and measurement properties for each identified PROM. EVIDENCE ACQUISITION A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. The included publications were assessed according to the Consensus-Based Standards for the Selection of Health Measurement Instruments checklist. EVIDENCE SYNTHESIS Twenty-one studies for PROMs regarding sexual function were identified for the following patient groups: spinal cord injury (11 studies), multiple sclerosis (MS; 6 studies), Parkinson's disease (2 studies), traumatic brain injury (1 study), and epilepsy (1 study). The evidence for the quality of PROMs was found to be variable, and overall evaluation of measurement properties was lacking in 71% of the studies. The measurement error and responsiveness were not studied in any of the publications. CONCLUSIONS Several PROMs have been identified to evaluate sexual function in neurologic patients. Strong evidence was found only for the Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 and Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 for patients with MS, although evidence was lacking for certain measurement properties as well. Future research should focus on identifying relevant PROMs and establishing adequate quality for all measurement properties in studies with high methodological quality. PATIENT SUMMARY A quality assessment of patient-reported outcome measures (PROMs) for sexual function in neurologic patients was made. The evidence found for good PROMs was limited. Studies with high methodological quality are needed to improve the quality of PROMs to evaluate sexual function in neurologic patients.
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Affiliation(s)
- Lisette A 't Hoen
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - Jan Groen
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jeroen R Scheepe
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Sarah Reuvers
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - David Castro Diaz
- Department of Urology, University Hospital of the Canary Islands, Tenerife, Spain
| | | | - Giulio Del Popolo
- Department of Neuro-Urology, Careggi University Hospital, Florence, Italy
| | - Stefania Musco
- Department of Neuro-Urology, Careggi University Hospital, Florence, Italy
| | - Rizwan Hamid
- Department of Neuro-Urology, London Spinal Injuries Centre, Stanmore, England
| | - Hazel Ecclestone
- Department of Neuro-Urology, London Spinal Injuries Centre, Stanmore, England
| | - Gilles Karsenty
- Department of Urology, Aix Marseille University, Marseille, France
| | - Veronique Phé
- Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, London, England
| | - Romain Boissier
- Department of Urology, Aix Marseille University, Marseille, France
| | - Thomas M Kessler
- Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland
| | - Tobias Gross
- Department of Urology, University of Bern, , Bern, Switzerland
| | - Marc P Schneider
- Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland
| | - Jürgen Pannek
- Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland
| | - Bertil F M Blok
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
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Sexual dysfunction in women with migraine and tension-type headaches. Int J Impot Res 2016; 28:201-204. [PMID: 27654031 DOI: 10.1038/ijir.2016.22] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 03/21/2016] [Accepted: 04/24/2016] [Indexed: 11/08/2022]
Abstract
Primary headaches (PHAs) prominently affect the performance and life quality of people. Sexual dysfunction (SD) is an important health problem caused by several factors. This study aimed to compare the sexual function of women who have PHAs. Forty-one female patients who were diagnosed with migraine, 39 female patients who were diagnosed with tension-type headache (TTHA) and 41 healthy subjects were included in study. Sexual function of the cases were evaluated by using the 'Female Sexual Function Index (FSFI)'. Beck Depression Scale was applied to subjects and those who were diagnosed with depression were excluded from the study. SD was detected in both the migraine and TTHA groups. FSFI subgroup scores were statistically significantly lower in the migraine and TTHA groups compared with the control group. No significant differences were detected between the migraine and TTHA groups in terms of FSFI and its components. In addition, no significant differences were detected between the blood prolactin levels or SD and headache. It was concluded that primary headaches (which are chronic diseases) itself may cause SD in female patients with migraine and TTHA independently of factors that may cause development of SD such as comorbid condition, depression, drug use and age.
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