Abstract:
Objective: Sexual dysfunction is frequently reported as a side effect of many antidepressant
medications. As a result, for those depressed patients to whom sexual desire is important,
psychological treatment may be a better intervention. Thus, the present study aimed to determine
the possible changes in sexual desire following psychological treatments in depression, when
focus of therapy is not on sexual function.
Methods: This is a quasi-experimental study, which was conducted in Tehran, Iran. A total of 281
depressed patients in the remission phase underwent psychological treatments, either cognitive
behavioral therapy (CBT, n=131) or mindfulness-based cognitive therapy (MBCT, n=150). The
therapy did not focus on any aspect of sexual function. Using a single item measure before
and after treatment, sexual desire of the patients was categorized into intact, mild, moderate, or
severe decline. A total of 255 participants completed the study questionnaires and were randomly
assigned to CBT (122) and MBCT groups (133). Before therapy, 128(50.2%) participants were
categorized in intact sexual desire group, 73(28.6%) in mild sexual desire dysfunction group,
40(15.7%) in moderate sexual desire dysfunction group, and 14(5.5%) in severe sexual desire
dysfunction group. Logistic regression was used for analyzing the data by SPSS-16.
Results: Low sexual desire in depression remission was predicted by age (P<0.001, OR=0.21,
CI=0.01–0.03), presence of comorbid anxiety disorder (P<0.04, OR=-0.13, CI=-0.46–0.02),
and global assessment of functioning (GAF) (P<0.001, OR=-0.23, CI=-0.03–0.01). Clinical
improvement in sexual desire was predicted by the type of intervention (P=0.023, OR=0.351,
CI=0.142–0.869) and GAF (P=0.003, OR=0.927, CI=0.881–0.975).
Conclusion: CBT might be superior to MBCT in improving sexual desire in patients with
depression. Further studies using validated sexual function questionnaires are necessary.
Machine summary:
211 Article info: Received: 18 Mar. 2016 Accepted: 23 Jun. 2016 Keywords: Depression, Sexual desire, Cognitive behavioral therapy, Mindfulness-based cognitive therapy A B S T R A C T Objective: Sexual dysfunction is frequently reported as a side effect of many antidepressant medications.
As a result, for those depressed patients to whom sexual desire is important, psychological treatment may be a better intervention.
Thus, the present study aimed to determine the possible changes in sexual desire following psychological treatments in depression, when focus of therapy is not on sexual function.
Although all types of sexual disorders cause morbidity in depressed patients (Laurent & Simons, 2009), most of these people would like to be sexually active (Traish, Hassani, Guay, Zitzmann, & Hansen, 2011) and a con- siderable proportion face loss of sexual interest as a pre- dominant sexual dysfunction (Fabre & Smith, 2012).
The treatment protocol used in the present study is based on a CBT research protocol for the treatment of patients with depression (Van Straten, Tiemens, Hak- kaart, Nolen, & Donker, 2006).
Mindfulness-Based Cognitive Therapy (MBCT) was the result of concern about and assistance to depressed individuals vulnerable to repeated relapse and recurrence (Teasdale, Segal, & Williams, 1995).
Single item measure of sexual desire has been previously used in the literature (Broeckel, Thors, Jacobsen, Small, & Cox, 2002).
Frequency (%) of sexual desire dysfunction among 255 depressed patients [male (40), female (215)] before and after cognitive behavior therapy.