EMDR v. other psychological therapies for PTSD: a systematic review and individual participant data meta-analysis.

BACKGROUND: This systematic review and individual participant data meta-analysis (IPDMA) examined the overall effectiveness of eye movement desensitization and reprocessing (EMDR) in reducing posttraumatic stress disorder (PTSD) symptoms, achieving response and remission, and reducing treatment dropout among adults with PTSD compared to other psychological treatments. Additionally, we examined available participant-level moderators of the efficacy of EMDR. METHODS: This study included randomized controlled trials. Eligible studies were identified by a systematic search in PubMed, Embase, PsyclNFO, PTSDpubs, and CENTRAL. The target population was adults with above-threshold baseline PTSD symptoms. Trials were eligible if at least 70% of study participants had been diagnosed with PTSD using a structured clinical interview. Primary outcomes included PTSD symptom severity, treatment response, and PTSD remission. Treatment dropout was a secondary outcome. The systematic search retrieved 15 eligible randomized controlled trials (RCTs); 8 of these 15 were able to be included in this IPDMA (346 patients). Comparator treatments included relaxation therapy, emotional freedom technique, trauma-focused cognitive behavioral psychotherapies, and REM-desensitization. RESULTS: One-stage IPDMA found no significant difference between EMDR and other psychological treatments in reducing PTSD symptom severity (ß = -0.24), achieving response (ß = 0.86), attaining remission (ß = 1.05), or reducing treatment dropout rates (ß = -0.25). Moderator analyses found unemployed participants receiving EMDR had higher PTSD symptom severity at the post-test, and males were more likely to drop out of EMDR treatment than females. CONCLUSION: The current study found no significant difference between EMDR and other psychological treatments. We found some indication of the moderating effects of gender and employment status.

Indicators of Sensory and Intellectual Thinking Based on Clinical Psychology and Islamic Perspective and their Role in Psychotherapy and Spiritual Health: Introducing a New Model of Thinking.

Today, the field of health is not limited to physical and mental health, but is related to all aspects of life, including spirituality. Spiritual health is so important that it is suggested as the fourth dimension of health, and in the near future, it will form part of the definition of health by the WHO. According to research in clinical psychology, in addition to spiritual health, another important issue in most psychotherapy theories is the issue of thinking. Given the importance of health and thinking, so far, no model has been presented in the field of the relationship between "thinking and health". So, the purpose of the present study is introducing a new model of healthy thinking based on human soul faculties. In this study, qualitative content analysis method has been used. Indicators of sensory and intellectual thinking have been noted within research results, which are the main components of the new model of thinking. In this type of thinking model, it is argued that all human beings have powers within them that can grow, which are referred to as the faculties of the soul. The level of thinking of individuals is determined by the level of each person's soul faculties. The lowest level is sensory perception and the highest level is intellectual perception. The more a person grows from the level of sensory thinking to the level of intellectual thinking, the sources of thought error decrease and the better the health of the thinking. Also, those who have a level of intellectual thinking have a higher level of spiritual health and the lifestyle of these people is health-oriented. This is a philosophical-psychological model in which indicators of sensory thinking and intellectual deviation have been extracted from theories and texts of psychology and philosophy. The results of this study can be used in psychotherapy because research has shown that thinking, especially healthy thinking, has a very effective role in mental health and a healthy lifestyle as well as treatment of disorders.

Global Study of Social Odor Awareness.

Olfaction plays an important role in human social communication, including multiple domains in which people often rely on their sense of smell in the social context. The importance of the sense of smell and its role can however vary inter-individually and culturally. Despite the growing body of literature on differences in olfactory performance or hedonic preferences across the globe, the aspects of a given culture as well as culturally universal individual differences affecting odor awareness in human social life remain unknown. Here, we conducted a large-scale analysis of data collected from 10 794 participants from 52 study sites from 44 countries all over the world. The aim of our research was to explore the potential individual and country-level correlates of odor awareness in the social context. The results show that the individual characteristics were more strongly related than country-level factors to self-reported odor awareness in different social contexts. A model including individual-level predictors (gender, age, material situation, education, and preferred social distance) provided a relatively good fit to the data, but adding country-level predictors (Human Development Index, population density, and average temperature) did not improve model parameters. Although there were some cross-cultural differences in social odor awareness, the main differentiating role was played by the individual differences. This suggests that people living in different cultures and different climate conditions may still share some similar patterns of odor awareness if they share other individual-level characteristics.

Efficacy of metacognitive therapy for hypoactive sexual desire disorder among Iranian couples.

OBJECTIVE: The aim of present study was to compare the efficacy of metacognitive therapy (MCT) against Masters-Johnson sex therapy (MJST) for hypoactive sexual desire disorder (HSDD) in Iranian couples. METHODS: A randomized treatment trial was conducted. Participants were recruited from the family counseling clinics in Tehran and Isfahan. All were suffering from HSDD as defined by DSM-IV-R criteria. They were assigned randomly to two groups that received 10 sessions of either MCT or MJST. A sexual desire questionnaire was completed by participants before and after therapy and at 6-month follow-up. RESULTS: Sexual desire increased significantly in the MCT group with respect to the MJST group which failed to show any significant improvement from baseline. Both groups showed a reduction in scores at 6-month follow-up. The difference recorded between the two groups after therapy was no longer significant at 6-month follow-up. CONCLUSION: MCT affected sexual desire more than MJST as evaluated after therapy but the gain was not maintained at follow-up. Future research needs to investigate whether a greater focus on metacognitive beliefs about sexual behavior can improve the stability of treatment effects.

REM desensitization as a new therapeutic method for post-traumatic stress disorder: a randomized controlled trial.

AIM: to evaluate potential efficacy of a new therapeutic approach in posttraumatic stress disorder in comparison with eye movement desensitization and reprocessing (EMDR), a standard treatment approach and controls. METHODS: the study was designed using a randomized controlled trial methodology. Participants were recruited from military servicemen aged between 25 to 50 years who were admitting hospitals of Bushehr, Iran, with the final diagnosis of PTSD. Finally 33 male patients were devided into three subgroups: G1: EMDR; G2: REM Desensitization; and group 3: controls who received no therapy. Mississippi Scale for Posttraumatic Stress Disorder, Pittsburgh Sleep Quality Index (PSQI) and a 37 item death anxiety questionnaire were used for measures. RESULTS: multiple comparisons showed that intrusive thoughts were significantly more likely to improve with REM Desensitization versus EMDR (P=0.03), while depression was more responsive to EMDR (p=0.03). Among the Pittsburgh scale for the quality of sleep items, sleep quality (p=0.02), sleep duration (p=0.001), and total sleep quality score (p=0.002) were significantly more likely to improve in the REM Desensitization group. Change in the absolute death anxiety scores was not different between subgroups excepting EMDR versus control group (p=0.05). CONCLUSION: REM, desensitization, the new therapeutic approach to PTSD is a highly effective strategy, even more than EMDR, the standard treatment, in most of the evaluated subjects, with special emphasis on sleep symptoms, and also in the management of intrusive thoughts. Depression is the only factor in which, REM Desensitization was significantly less likely to represent a superior therapeutic effect than EMDR.

Malingering and PTSD: detecting malingering and war related PTSD by Miller Forensic Assessment of Symptoms Test (M-FAST).

BACKGROUND: Malingering is prevalent in PTSD, especially in delayed-onset PTSD. Despite the attempts to detect it, indicators, tools and methods to accurately detect malingering need extensive scientific and clinical research. Therefore, this study was designed to validate a tool that can detect malingering of war-related PTSD by Miller Forensic Assessment of Symptoms Test (M-FAST). METHODS: In this blind clinical diagnosis study, one hundred and twenty veterans referred to War Related PTSD Diagnosis Committee in Iran in 2011 were enrolled. In the first step, the clients received Psychiatry diagnosis and were divided into two groups based on the DSM-IV-TR, and in the second step, the participants completed M-FAST. RESULTS: The t-test score within two groups by M-FAST Scale showed a significant difference (t = 14.058, P < 0.0001), and 92% of malingering war-related PTSD participants scored more than 6 and %87 of PTSD group scored less than 6 in M-FAST Scale. CONCLUSIONS: M-FAST showed a significant difference between war-related PTSD and malingering participants. The ≥6 score cutoff was suggested by M-FAST to detect malingering of war-related PTSD.

Indicators of Intellectual Thinking as Healthy Thinking and Its Relation with Health-Promoting Lifestyle: A New Perspective in Clinical Psychology and Public Health.

Background: Quality of life is determined by the lifestyle of individuals. If people have a healthy lifestyle, then they have a higher quality of life. What makes a person's lifestyle is the way he thinks. Therefore, if the thinking is healthy, the person's lifestyle will be healthy, and if the thinking is unhealthy, the person's lifestyle will also be damaged, which will reduce the quality of life. Methods: The research method was mixed method in two quantitative and qualitative phases. The research method in the qualitative phase was customary qualitative content analysis, in which the data analysis process was based on the approach of Granheim and Ladman. In the quantitative phase, the psychometric properties of the research scale were measured. This research was conducted from 2016 to 2021 in Iran. The statistical population in the qualitative section was all scientific texts in the form of articles, books and dissertations that were extracted from scientific databases such as ScienceDirect, PubMed, Elsevier, Ebsco, Sid, Magiran. Results: Indicators of intellectual thinking have been mentioned as research results, which are the main components of the new model of thinking. Moreover, the level of thinking was mentioned and Cognitive distortions, cognitive bias, and perceptual errors were mentioned as sources of harm and error. Conclusion: Intellectual thinking has been mentioned as healthy thinking, which is the main factor of a health promotion lifestyle because healthy lifestyle improves the quality of life of people, which is one of the indicators of public health. Therefore, a higher quality of life can be achieved from the model of healthy thinking, which is a new perspective on promoting public health.

Factors Associated With Highest Symptoms of Anxiety During COVID-19: Cross-Cultural Study of 23 Countries.

The COVID-19 restrictions have impacted people's lifestyles in all spheres (social, psychological, political, economic, and others). This study explored which factors affected the level of anxiety during the time of the first wave of COVID-19 and subsequent quarantine in a substantial proportion of 23 countries, included in this study. The data was collected from May to August 2020 (5 June 2020). The sample included 15,375 participants from 23 countries: (seven from Europe: Belarus, Bulgaria, Croatia, Hungary, Italy, Romania, Russia; 11 from West, South and Southeast Asia: Armenia, India, Indonesia, Iran, Iraq, Jordan, Malaysia, Pakistan, Saudi Arabia, Thailand, Turkey; two African: Nigeria and Tanzania; and three from North, South, and Central America: Brazil, Canada, United States). Level of anxiety was measured by means of the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the 20-item first part of The State-Trait Anxiety Inventory (STAI)-State Anxiety Inventory (SAI). Respondents were also asked about their personal experiences with COVID-19, attitudes toward measures introduced by governments, changes in attitudes toward migrants during a pandemic, family income, isolation conditions, etc. The factor analysis revealed that four factors explained 45.08% of variance in increase of anxiety, and these components were interpreted as follows: (1) personal awareness of the threat of COVID-19, (2) personal reaction toward officially undertaken measures and attitudes to foreigners, (3) personal trust in official sources, (4) personal experience with COVID-19. Three out of four factors demonstrated strong associations with both scales of anxiety: high level of anxiety was significantly correlated with high level of personal awareness of the threat of COVID-19, low level of personal reaction toward officially undertaken measures and attitudes to foreigners, and high level of presence of personal experience with COVID-19. Our study revealed significant main effects of sex, country, and all four factors on the level of anxiety. It was demonstrated that countries with higher levels of anxiety assessed the real danger of a pandemic as higher, and had more personal experience with COVID-19. Respondents who trusted the government demonstrated lower levels of anxiety. Finally, foreigners were perceived as the cause of epidemic spread.

Effect of Radiance-Dimmer Devices Simulating Natural Sunlight Rhythm on the Plasma Melatonin Levels and Anxiety and Depression Scores of the Submarine Personnel.

Objective: Not perceiving circadian shifts of sunlight due to living in enclosed environments may have deleterious effects on mental health and plasma parameters. This study aimed to determine the effect of dim regulation on the submarine personnel of Iranian Navy forces by radiating devices according to natural circadian sunlight shifts. Also, this study aimed to investigate the impact of mimicking sunlight circadian by artificial radiance luminating devices on the serological and psychological measures of submarine personnel. Method : Participants were randomly assigned to experimental and control groups in this non-randomized controlled trial. There were 26 participants in each group, and they were all male aged 21-29 years. Both groups were living in the submarine underground hall, with 120 meters 2 area with constant radiance with the same intensity. The experimental group had been given extra lighting devices with changing radiance intensity according to the natural sunlight circadian cycles. Plasma melatonin levels and depression and anxiety scores were determined before and after the experiment for both groups. Minnesota Multiphasic Personality Inventory (MMPI) and Cattell's Anxiety Scale Questionnaire (IPAT) were used to measure depression and anxiety, respectively. Results: Findings indicate that the plasma melatonin levels (-16.2±13.6 vs 8.0±9.3 mg/dL, respectively; p<0.001), depression scores (-6±6 vs 3.9±5.4, respectively; p<0.001), and anxiety scores (-1±1.2 vs 0.73±1.04, respectively; p<0.001) significantly reduced in the experimental group compared to the control group. Conclusion: Using radiance dimmers, with a radiance intensity regularity according to the sunlight, is effective in improving psychiatric and plasma parameters and can be used in closed occupational environments such as underground environments and submarine halls.

Sexual dysfunction and marital satisfaction among the chemically injured veterans.

INTRODUCTION: Researches show that chronic illnesses may affect marital adjustment and sexual function. Therefore, the purpose of this research was to recognize marital satisfaction, sexual dysfunction and demographic factors among Chemically Injured Veterans (CIV). MATERIALS AND METHODS: In this descriptive research, we selected and studied 185 cases of CIVs referred to Tehran's hospitals. Data gathering tools were Enrich Marital Satisfaction Scale and structured interview. The items of interview included 28 questions about sexual dysfunction according to DSM-IV-r. The statistical methods were T-test, ANOVA and Correlation. RESULTS: The results show that 45.5%, i.e. nearly half of the CIV subjects were dissatisfied with their marriage and marital relationship and the dissatisfaction level in 11% was very high. Other results show that 65/4% of veterans with chemical injuries suffered from a kind of sexual dysfunction. The most common dysfunctions were: erectile problem and libido reduction by 49.2% and 48.6% respectively. Also, results show that there was a relation between demographic factors and sexual dysfunction in CIVs. DISCUSSION: As far as the results show, sexual libido reduction rate in CIVs is like that in chronic obstructive pulmonary disease patients. Therefore, sex therapy, psychotherapy and couple therapy must be a component of the treatment of CIVs.

Extent of Coronary Stenosis and Anxiety Symptoms among Patients Undergoing Coronary Angiography.

Background: The association between coronary angiographic findings and the level of anxiety symptoms among patients who undergo coronary angiography is not known. The aim of this study was to investigate the association between the extent of coronary stenosis and anxiety symptoms in patients who undergo coronary angiography. Methods: In a cross-sectional study, 106 patients who underwent coronary angiography and had varying degrees of coronary artery disease were enrolled. Demographic characteristics (i.e., age and gender), socioeconomic status (i.e., educational attainment, income, and marital status), and traditional risk factors (i.e., hypertension, diabetes mellitus, hyperlipidemia, and smoking) were measured. The independent variable was the extent of coronary stenosis shown by coronary angiography, coded as single-vessel disease (n = 19), 2-vessel disease (n = 28), or 3-vessel disease (n = 59). The main outcome was symptoms of anxiety measured using the Hospital Anxiety Depression Scale (HADS). The Kruskal-Wallis test was used for bivariate analysis, and linear regression was applied for multivariable analysis. Results: Participants were mostly men (n = 78, 73%), at a mean age of 50.14 ± 10.60 years. We found an inverse association between the extent of coronary stenosis and anxiety symptoms in our samples. Anxiety symptoms were lowest in the patients with 3-vessel disease and highest in those with single-vessel disease. The above association remained significant in a linear regression model, controlled for the demographic, socioeconomic, and traditional risk factors. Conclusion: An inverse association may exist between the extent of coronary stenosis and the severity of anxiety symptoms in patients who undergo coronary angiography. Patients who undergo angiography and have fewer angiographic findings require screening for anxiety symptoms.

Triangular relationship among risky sexual behavior, addiction, and aggression: A systematic review.

BACKGROUND: Risky sexual behavior (RSB), addiction, and aggression are three important personal and social factors which influence each other. OBJECTIVE: To overview the potential relationship among RSB, addiction, and aggression to conduct an interactive model for the pathology and management of human behavior. METHODS: This review article was carried out by searching studies in PubMed, Medline, Web of Science, Ebsco, IEEE, Scopus, Springer, MagIran, and IranMedex databases from the year 1993 to 2013. The search terms were violence, aggression, drug abuse, substance abuse, illicit drug, psychoactive drug, intravenous drug users, addiction and high-risk sexual relationships, unprotected sex, high risk sexual behavior, and sexual risk-taking. In this study, forty-nine studies were accepted for further screening, and met all our inclusion criteria (in English or Persian, full text, and included the search terms). RESULTS: Forty-nine articles were included; 17 out of 26 studies showed a significant correlation between addiction and risky sexual behavior, 15 out of 19 articles indicated a statistically significant correlation between aggression and addiction, and 9 out of 10 articles reported significant correlation between aggression and risky sexual behavior. CONCLUSION: According to the results, the triangle hypothesis of sex, addiction, and aggression led to the definition of the relationship among the variables of the hypothetical triangle based on the reviewed studies; and the proposed dual and triple relationship based on the conducted literature review was confirmed. This is not a meta-analysis, and there is no analysis of publication bias.

Corrigendum: Marital Satisfaction, Sex, Age, Marriage Duration, Religion, Number of Children, Economic Status, Education, and Collectivistic Values: Data from 33 Countries.

[This corrects the article on p. 1199 in vol. 8, PMID: 28785230.].

Leisure Activity Patterns and Marital Conflict in Iran.

BACKGROUND: Over the past few decades, the association between leisure activity patterns and marital conflict or satisfaction has been studied extensively. However, most studies to date have been limited to middle-class families of developed societies, and an investigation of the issue, from a developing country perspective like Iran, is non-existent. OBJECTIVES: In an observational, analytical, cross-sectional study we aimed to investigate the relationship between leisure activity patterns and marital conflict in a nationally representative sample of Iranian married males. PATIENTS AND METHODS: Using the cluster sampling method, a representative sample of 400 Iranian married individuals from seven provinces of Iran was surveyed. Self-administered surveys included a checklist collecting demographic and socioeconomic characteristics of the enrolled participants, leisure time questionnaire, and marital conflict questionnaire. The main patterns of leisure activity were derived from principal component analysis. For each pattern, factor scores were calculated. The relationship between factor scores and marital conflict were assessed using multivariate linear regression models accounting for the potential confounding effects of age, education, socioeconomic status, job status, number of children, duration of marriage, and time spent for leisure. RESULTS: Two hundred and ninety-nine respondents completed the leisure time and marital conflict questionnaires. Five major leisure patterns were identified accounting for 60.3% of the variance in data. The most dominant pattern was family-oriented activities (e.g. spending time with family outdoors and spending time with family indoors) and was negatively linked to marital conflict (standardized beta= -0.154, P = 0.013). Of the four remaining patterns, three only included individual activities and one was a family-individual composite. Individual patterns exhibited discrepant behavior; while the pattern involving activities like 'watching TV', 'non-purposive time spending', and 'napping' was positively associated with conflict (standardized beta = 0.165, P = 0.009) and the other two were not. The mixed family-individual pattern was also positively associated with marital conflict (standardized beta = 0.240, P < 0.001). CONCLUSIONS: Among Iranian married men, family-based leisure activities are linked to a lower level of marital conflict. The associations for individual patterns are less congruent.

INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW.

BACKGROUND: Sexual behavior is a complex activity affecting all aspects of human's life. Risky sexual behaviors impose negative outcomes on family, relationships and health. Unsafe sex is the second most leading cause of disability adjusted life years worldwide. Valid and reliable tools for assessment of risky sexual behaviors are necessary for implementing preventive measures. METHODS: we searched Medline and the Cochrane Library of Systematic Reviews, with the keywords of "risky sexual behavior assessment", "sexual risk assessment", "high risk sexual behavior", "sexual risk taking". By reviewing references of the articles, some complementary studies were added. RESULTS: Assessment can be performed by questionnaire or non-questionnaire instruments. Questionnaires vary depending on their target population, evaluation of risky sexual behavior as a whole or focusing on an associated risk factor. In order to avoid usual biases in self reports, objective biomarker assessment of unprotected sex are employed. These markers include prostate specific antigen, chromosome Y DNA and Seminogelin. CONCLUSION: Risky sexual behavior can be assessed by various subjective and objective methods. While self-reports are more feasible, objective methods offer a higher degree of reliability. Further studies for finding more feasible methods of using biomarkers are recommended.

Corrigendum: The Associations of Dyadic Coping and Relationship Satisfaction Vary between and within Nations: A 35-Nation Study.

[This corrects the article on p. 1106 in vol. 7, PMID: 27551269.].

The Associations of Dyadic Coping and Relationship Satisfaction Vary between and within Nations: A 35-Nation Study.

OBJECTIVE: Theories about how couples help each other to cope with stress, such as the systemic transactional model of dyadic coping, suggest that the cultural context in which couples live influences how their coping behavior affects their relationship satisfaction. In contrast to the theoretical assumptions, a recent meta-analysis provides evidence that neither culture, nor gender, influences the association between dyadic coping and relationship satisfaction, at least based on their samples of couples living in North America and West Europe. Thus, it is an open questions whether the theoretical assumptions of cultural influences are false or whether cultural influences on couple behavior just occur in cultures outside of the Western world. METHOD: In order to examine the cultural influence, using a sample of married individuals (N = 7973) from 35 nations, we used multilevel modeling to test whether the positive association between dyadic coping and relationship satisfaction varies across nations and whether gender might moderate the association. RESULTS: RESULTS reveal that the association between dyadic coping and relationship satisfaction varies between nations. In addition, results show that in some nations the association is higher for men and in other nations it is higher for women. CONCLUSIONS: Cultural and gender differences across the globe influence how couples' coping behavior affects relationship outcomes. This crucial finding indicates that couple relationship education programs and interventions need to be culturally adapted, as skill trainings such as dyadic coping lead to differential effects on relationship satisfaction based on the culture in which couples live.

Marital Quality Trajectory among Iranian Married Individuals: A Collectivist Perspective.

BACKGROUND: The trajectory of marital quality over the life course assumes a curvilinear pattern and declines over time. However, most studies to date have been conducted in developed societies, leaving the generalizability of their findings open to skepticism. In this study, we aimed to delineate the trajectory of marital satisfaction in Iran. METHODS: Using cluster-sampling method, representative sample of 800 Iranian married individuals from urban areas of seven provinces of Iran, between February and May 2011 was surveyed. Each cluster included 50 households. Sealed packages containing survey material were delivered to households. Self-administered surveys included a checklist collecting demographic and socioeconomic data, and the Comprehensive Marital Satisfaction Scale. Generalized additive models (GAM) were used to explicate the trajectory of marital satisfaction over marital duration. RESULTS: A total of 644 complete questionnaires were returned (response rate: 80.5%). Average age of the participants was 40yr and average duration of marriage 17yr. The fitted GAM showed that marital satisfaction is highest at the beginning but drastically declines over the first 10yr. After arriving a nadir, the downward progression is reversed in the next 10-15yr, reaching a level comparable to the beginning. At 23-25yr, a second declining wave initiates and marital satisfaction steadily declines thereafter. The overall shape remains the same after adjustment for number of children, economic status, and retirement. CONCLUSION: Marital trajectory assumes a curvilinear pattern and has three periods of decline, stagnation, and decline. The shape of trajectory bears similarities to the observed patterns in the US but is distinct, nevertheless.

Sexual Self-Concept and General Health in Rheumatoid Arthritis Patients.

BACKGROUND: There are several studies regarding sexual dysfunction in chronic diseases such as diabetes and renal failure; however, no significant study has been done on Iranian rheumatoid arthritis (RA) patients. OBJECTIVES: In this study, we aimed to identify and compare sexual dysfunction between RA patients and the normal population. PATIENTS AND METHODS: In this case-control study, two groups of females (87 RA patients and 89 controls) were randomly selected from the rheumatology clinic of Baqiyatallah Hospital, Tehran, Iran. General health questionnaire (GHQ-28) and multidimensional sexual self-concept questionnaire (MSSCQ) were used to evaluate RA patients. We used SPSS for statistical analysis mainly by the t-test and chi-square test. P values less than 0.05 were considered significant. RESULTS: In the GHQ-28 evaluation, RA patients had lower social function; however somatization rated higher in normal patients (P < 0.05). Sexual health was lower in the RA population (P < 0.05). No significant difference was found in sexual desire. Except sexual pain, other sexual health parameters were lower in RA patients. The scores were as follow: sensation 13.6 ± 4.4 vs. 12.2 ± 4.5, P = 0.024; lubrication 6.9 ± 2.1 vs. 6.2 ± 2.1, P = 0.017; orgasm 10.4 ± 2.8 vs. 9.5 ± 3.2, P = 0.37; pain 10.1 ± 2.2 vs. 10.8 ± 1.9, P = 0.013; enjoyment 23.8 ± 5.8 vs. 21.3 ± 7.5, P = 0.009 and partner related 8.5 ± 1.7 vs. 7.6 ± 2.4, P = 0.005. Furthermore, the concern of losing their sexual partner was higher in the normal population. CONCLUSIONS: Our study demonstrated that almost all GHQ and MSSCQ parameters were lower in RA patients, which indicates lower quality sexual life in RA patients. We recommend further consideration for the treatment and care of these patients.