Association between depressive symptoms and sexual dysfunction in men with traumatic spinal cord injury

Main Article Content

Josepha Karinne de Oliveira Ferro
Caroline Palácio da Silva
Daniella Araújo de Oliveira

Abstract

Introduction: Spinal cord injury results in loss of functional independence, autonomy and social status. This enormous change contributes to the appearance of depressive symptoms in this population. Objective: To evaluate depressive symptoms and sexual dysfunction in men with traumatic spinal cord injury, and to analyze their association. Methods: Observational study was performed with 44 men with traumatic spinal cord injury, age between 18 and 60 years, injury time over 1 year and active sexual life. The degree of neurological impairment was assessed through the revised 2011 ASIA Impairment Scale, depressive symptoms through the Beck Depression Inventory, and sexual function through the International Erectile Function Index. Descriptive statistics techniques and bivariate analysis were applied to verify association, using a level of significance of 0.05. Results: The volunteers had a mean age of 34.1 years, and an average injury time of 7.7 years. All individuals in the sample had lesion level above the medullary segment L2, with incomplete injury being the most frequent (68.2%). The mean time of the last sexual intercourse was 56.5 days and the weekly frequency of intercourse was the most reported (65.9%). Only 17.6% of the sample presented depressive symptoms, ranging from dysphoria (6.8%) to mild to moderate symptoms (6.8%). No association was found between depressive symptoms and sexual dysfunction, except for the domain of general satisfaction dysfunction (p=0.02). Conclusion: There is no association between depressive symptoms and sexual dysfunction in men with chronic spinal cord injury.

Downloads

Download data is not yet available.

Article Details

How to Cite
Ferro, J. K. de O., Silva, C. P. da, & Oliveira, D. A. de. (2019). Association between depressive symptoms and sexual dysfunction in men with traumatic spinal cord injury. ABCS Health Sciences, 44(3). https://doi.org/10.7322/abcshs.v44i3.1147
Section
Original Articles
Author Biography

Josepha Karinne de Oliveira Ferro, Programa de Pós-Graduação em Fisioterapia, Universidade Federal de Pernambuco (UFPE) – Recife (PE)

Doutoranda em Neurociência no Programa de Pós-Graduação em Neuropsiquiatria e ciência do comportamento. Mestre em Fisioterapia pela Universidade Federal de Pernambuco.

References

Benevento BT, Sipski ML. Neurogenic bladder, neurogenic bowel, and sexual dysfunction in people with spinal cord injury. Phys Ther. 2002;82(6):601-12. https://dx.doi.org/10.1093/ptj/82.6.601

Sipski M, Alexander C, Gomez-Marin O. Effects of level and degree of spinal cord injury on male orgasm. Spinal Cord. 2006;44(12):798-804. https://dx.doi.org/10.1038/sj.sc.3101954

Dijkers M. Quality of life after spinal cord injury: a meta analysis of the effects of disablement components. Spinal Cord. 1997;35(12):829-40. https://dx.doi.org/10.1038/sj.sc.3100571

Hultling C, Giuliano F, Quirk F, Pena B, Mishra A, Smith MD. Quality of life in patients with spinal cord injury receiving Viagra (sildenafil citrate) for the treatment of erectile dysfunction. Spinal Cord. 2000;38(6):363-70. https://dx.doi.org/10.1038/sj.sc.3101011

Rosen R. Looking beyond erectile dysfunction: the need for multi-dimensional assessment of sexual dysfunction. Eur Urol. 2003;(Suppl. 2):9-12. https://dx.doi.org/10.1016/j.eursup.2003.11.003

Anderson KD. Targeting recovery: priorities of the spinal cord-injured population. J Neurotrauma. 2004;21(10)1371-83. https://dx.doi.org/10.1089/neu.2004.21.1371

Al-Owesie RM, Moussa NM, Robert AA. Anxiety and depression among traumatic spinal cord injured patients. Neurosciences (Riyadh). 2012;17(2)145-50.

França ISX, Coura AS, França EG, Basilio NNV, Souto RQ. Qualidade de vida de adultos com lesão medular: um estudo com WHOQOL-bref. Rev Esc Enferm USP. 2011;45(6):1364-71. http://dx.doi.org/10.1590/S0080-62342011000600013

Dahlberg A, Alaranta H, Kautiainen H, Kotila M. Sexual activity and satisfaction in men with traumatic spinal cord lesion. J Rehabil Med. 2007;39(2):152-5. http://dx.doi.org/10.2340/16501977-0029

Dahlberg A, Alaranta H, Sintonen H. Health-related quality of life in persons with traumatic spinal cord lesion in Helsinki. J Rehabil Med. 2005;37:312-6. http://dx.doi.org/10.1080/16501970510034413

Barbonetti A, Cavallo F, Felzani G, Francavilla S, Francavilla F. Erectile dysfunction is the main determinant of psychological distress in men with spinal cord injury. J Sex Med. 2012;9(3):830-6. http://dx.doi.org/10.1111/j.1743-6109.2011.02599.x

Kennedy P, Rogers BA. Anxiety and depression after spinal cord injury: a longitudinal analysis. Arch Phys Med Rehabil. 2000;81(7):932-7. http://dx.doi.org/10.1053/apmr.2000.5580

Conceição MIG, Auad JC, Vasconcelos L, Macêdo A, Bressanelli R. Avaliação da depressão em pacientes com lesão medular. Rev Bras Ter Comport Cogn. 2010;12:(1-2):43-59.

Nielsen MS. Post-traumatic stress disorder and emotional distress in persons with spinal cord lesion. Spinal Cord. 2003;41(5):296-302. http://dx.doi.org/10.1038/sj.sc.3101427

Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW, et al. Depression following Traumatic Spinal Cord Injury. Neuroepidemiology. 2005;25(2):55-61. http://dx.doi.org/10.1159/000086284

Kirshblum SC, Biering-Sorensen F, Betz R, Burns S, Donovan W, Graves D, et al. International Standards for Neurological Classification of Spinal Cord Injury: Cases with classification challenges. J Spinal Cord Med. 2014;37(2):120-7. http://dx.doi.org/10.1179/2045772314Y.0000000196

Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Sugestões para o uso do miniexame do estado mental no Brasil. Arq Neuropsiquiatr 2003;61(3B):777-81. http://dx.doi.org/10.1590/S0004-282X2003000500014

Kirshblum SC, Burns SP, Biering-Sorensen F, Donovan W, Graves DE, Jha A, et al. International standards for neurological classification of spinal cord injury (revised). J Spinal Cord Med. 2011;34(6):535-46. http://dx.doi.org/10.1179/204577211X13207446293695

Cunha JA. Manual da versão em português das Escalas Beck. São Paulo: Casa do Psicólogo, 2001; p.11-13.

Gonzáles AI, Sties SW, Wittkopf PG, Mara LSD, Ulbrich AZ, Cardoso FL, et al. Validação do Índice Internacional de Função Erétil (IIFE) para uso no Brasil. Arq Bras Cardiol. 2013;101(2):176-82. http://dx.doi.org/10.5935/abc.20130141

Rosen R, Cappelleri J, Gendrano N. The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res. 2002;14(4):226-44. http://dx.doi.org/10.1038/sj.ijir.3900857

Castro Filho JE. Epidemiologia da disfunção sexual masculina em pacientes com lesão medular. Tese (Doutorado) - Universidade de São Paulo. São Paulo: 2013.

Krueger H, Noonan VK, Williams D, Trenaman LM, Rivers CS. The influence of depression on physical complications in spinal cord injury: behavioral mechanisms and health-care implications. Spinal Cord. 2013;51(4):260-6. http://dx.doi.org/10.1038/sc.2013.3

Anderson KD, Borisoff JF, Johnson RD, Stiens SA, Elliott SL. The impact of spinal cord injury on sexual function: concerns of the general population. Spinal Cord. 2007;45(5):328-37. http://dx.doi.org/10.1038/sj.sc.3101977

Alexander MS, Biering-Sørensen F, Elliott S, Kreuter M, Sønksen J. International spinal cord injury male sexual function basic data set. Spinal Cord. 2011;49(7):795-8. http://dx.doi.org/10.1038/sc.2010.192

Bampi LNS, Guilhem D, Lima DD. Qualidade de vida em pessoas com lesão medular traumática: um estudo com o WHOQOL-bref. Rev Bras Epidemiol. 2008;11(1):67-77. http://dx.doi.org/10.1590/S1415-790X2008000100006

Baasch AKM, Cardoso FL. Sexualidade na lesão medular. Dissertação (Mestrado) - Universidade do Estado de Santa Catarina. Florianópolis: 2008.

Biering-Sorensen I, Hansen RB, Biering-Sørensen F. Sexual function in a traumatic spinal cord injured population 10-45 years after injury. J Rehabil Med. 2012;44(11):926-31. http://dx.doi.org/10.2340/16501977-1057

Smith, AE, Molton, IR, McMullen, K, Jensen, MP. Brief Report: Sexual Function, Satisfaction, and Use of Aids for Sexual Activity in Middle-Aged Adults with Long-Term Physical Disability. Top Spinal Cord Inj Rehabil. 2015;21(3):227-32. https://doi.org/10.1310/sci2103-227

Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW, et al. Depression following traumatic spinal cord injury. Neuroepidemiology. 2005;25(2):55-61. http://dx.doi.org/10.1159/000086284

Cuenca AIC, Sampietro-Crespo A, Virseda-Chamorro M, Martín-Espinosa N. Psychological impact and sexual dysfunction in men with and without spinal cord injury. J Sex Med. 2015;12(2):436-44. https://doi.org/10.1111/jsm.12741

Judd FK, Brown DJ, Burrows GD. Depression, disease and disability: application to patients with traumatic spinal cord injury. Paraplegia. 1991;29(2):91-6. http://dx.doi.org/10.1038/sc.1991.12

Tate D, Forchheimer M, Maynard F, Dijkers M. Predicting depression and psychological distress in persons with spinal cord injury based on indicators of handcap. Am J Phys Med Rehabil. 1994;73(3):175-83.

Craven C, Hitzig SL, Mittmann N. Impact of impairment and secondary health conditions on health preference among Canadians with chronic spinal cord injury. J Spinal Cord Med. 2012;35(5). http://dx.doi.org/10.1179/2045772312Y.0000000046