Evolution of sexual functioning of men through treated and untreated depression

Depression, selective serotonin reuptake inhibitors, and sexual wellbeing in assigned females: exploring the moderating role of sexual flexibility

BACKGROUND

Depression often causes sexual dysfunction, including reduced desire and pleasure, and selective serotonin reuptake inhibitors (SSRIs), commonly used to treat depression, can worsen these issues, leading to treatment discontinuation.

AIM

To examine sexual wellbeing differences across depression and SSRI groups, how depression, SSRI use, and sexual flexibility predict sexual outcomes, and whether sexual flexibility moderates the relationship between sexual functioning, distress, and pleasure.

METHODS

Participants (N = 357, mean age 26.8 years) assigned female sex at birth were recruited for an online cross-sectional study. Participants were grouped by SSRI use and depression severity: SSRIs-low depression (n = 86), SSRIs-high depression (n = 117), no SSRIs-low depression (n = 81), and no SSRIs-high depression (n = 73).

OUTCOMES

Validated measures of depression, sexual function, sexual distress, sexual flexibility, and sexual pleasure were used.

RESULTS

Analyses of variance (ANOVAs) and multiple regressions examined relationships between depression, SSRI use, and sexual wellbeing. Moderation analyses tested whether sexual flexibility moderated the link between sexual functioning, distress, and pleasure. The SSRIs-high depression group reported the poorest sexual wellbeing, while the No SSRIs-low depression group reported the highest. Depression and SSRI use predicted increased sexual distress and decreased functioning, pleasure, and flexibility, explaining 21%-26% of variance. Sexual flexibility moderated the relationship between functioning and pleasure, with stronger effects at lower flexibility levels.

CLINICAL IMPLICATIONS

Sexual flexibility may improve sexual functioning and pleasure, providing a positive, adaptable framework for therapy; thus, psychosexual and educational interventions focusing on flexibility could enhance sexual pleasure and reduce distress, fostering sexual resilience and improving relationship dynamics.

STRENGTHS AND LIMITATIONS

Strengths include a nuanced analysis of depression severity and SSRI use, offering a comprehensive view of sexual wellbeing. Limitations include reliance on self-reported medication use, inability to assess specific SSRIs, and potential confounding from concurrent antidepressant use.

CONCLUSION

SSRIs and depression each uniquely affect sexual functioning, distress, and pleasure, such that those with moderate to severe depression and SSRI use report significantly poorer sexual outcomes.

Men, masculinities, and mental health: Key issues for nurse practitioners

ABSTRACT

Men's mental health is an important topic for nurse practitioners (NPs) because men and women have different epidemiological profiles and clinical presentations when it comes to behavioral health. As clinicians, we must be aware of these differences to better serve diverse patient populations. In this article, four key issues to men's mental health will be discussed in relationship to masculinities: suicide; depression; stigma; and engagement with mental health services. A case study of a male patient is presented, and the article concludes with clinical implications for NPs.

Inflammatory bowel disease is associated with worse sexual function: a systematic review and meta-analysis

Background

Several studies report that sexuality is often affected by inflammatory bowel diseases (IBD). The aim of this meta-analysis was to investigate the association between IBD and sexual function.

Methods

A literature search was conducted in PubMed, Web of Science, and EMBASE databases (up to September 1, 2020). Scores of sexual functions with a standard deviation and odds ratio (OR) or relative risk (RR) with a 95% CI were used to analysis the association between IBD and sexual function.

Results

Eleven studies with 7,018 male IBD cases and 1,803 female IBD cases were included in the meta-analysis. In male individuals, the pooled results revealed that IBD was significantly associated with impaired erectile function and poor sexual satisfaction (RR for erectile function =1.50, 95% CI: 1.22 to 1.84, P<0.0001; standard mean difference for sexual satisfaction =-0.24, 95% CI: -0.33 to -0.15, P<0.0001). And among female individuals, IBD had impact on most sub-domains of sexual function, except pains.

Conclusions

IBD is associated with worse sexual function. It has significant impact on erectile function and satisfaction for male individuals and has impact on most sub-domains of sexual function for female individuals.

Effectiveness of Vortioxetine in Patients with Major Depressive Disorder in Real-World Clinical Practice: French Cohort Results from the Global RELIEVE Study

AIM

Functional recovery is an important treatment goal in patients with major depressive disorder (MDD). The Real-Life Effectiveness of Vortioxetine in Depression (RELIEVE) study assessed the effectiveness of vortioxetine in patients with MDD receiving treatment in routine clinical care settings in France, Italy, Canada, and the United States. This paper presents the study data for the cohort enrolled in France.

METHODS

RELIEVE was a 6-month, international, observational, prospective cohort study in outpatients initiating vortioxetine treatment for MDD at their physician's discretion (NCT03555136). Patients were assessed at routine clinic visits at study entry (baseline) and after 12 and 24 weeks of vortioxetine treatment. The primary study outcome was patient functioning, assessed by the Sheehan Disability Scale (SDS). Secondary outcomes included depression severity (assessed by the Patient Health Questionnaire [PHQ-9]), cognitive symptoms (assessed by the Perceived Deficits Questionnaire-Depression [PDQ-D-5]), and cognitive performance (Digit Symbol Substitution Test [DSST]). Changes from baseline to week 24 were assessed using mixed models for repeated measures, adjusted for relevant confounders. Adverse events spontaneously reported by the patient or observed by the investigator were recorded.

RESULTS

Data are available for 184 patients in France (mean age, 50.2 years; 65.2% female). Overall, 67.9% of patients had at least one comorbidity and 46.2% reported current anxiety symptoms at baseline. Adjusted least-squares mean (standard error) change in SDS score from baseline to week 24 was -10.9 (0.6) points (P < 0.001). Respective changes for PHQ-9, PDQ-D-5 and DSST scores were -9.3 (0.5), -6.1 (0.4), and +6.9 (1.0) points (all P < 0.0001). Adverse events were reported by 29 patients (15.8%), most commonly nausea (11 patients, 6.0%).

CONCLUSION

Clinically relevant and sustained improvements in overall functioning, depressive symptoms, cognitive symptoms, and cognitive performance were observed in patients with MDD treated with vortioxetine for 6 months in routine clinical practice settings in France.