The relation of sexual function to migraine-related disability, depression and anxiety in patients with migraine.

BACKGROUND: Depression and anxiety are two phenomena that affect quality of life as well as sexual function. Depression and anxiety levels are reported to be high in migraine sufferers. We aimed to understand whether sexual function in women with migraine was associated to migraine-related disability and frequency of migraine attacks, and whether this relationship was modulated by depressive and anxiety symptoms. METHODS: As migraine is more commonly seen in females, a total of 50 women with migraine were included. The diagnosis of migraine with or without aura was confirmed by two specialists in Neurology, according to the second edition of International Headache Society (IHS) International Classification of Headache Disorders (ICHD-II) in 2004. Migraine disability assessment scale score, female sexual function index scores, Beck depression inventory score and Beck anxiety inventory scores. RESULTS: Mean MIDAS score was 19.3 ± 12.8, and mean number of migraine attacks per month were 4.3 ± 2.7. Mean Female Sexual Function Index score was 20.9 ± 5.9 and 90% of patients had sexual dysfunction. Sexual dysfunction was not related to MIDAS score or frequency and severity of attacks. No relationship between sexual function and anxiety was found, whereas severity of depressive symptoms was closely related to sexual function. Depressive symptoms affected all dimensions of sexual function, except for pain. CONCLUSION: Sexual dysfunction seemed to be very common in our patients with migraine, while not related to migraine related disability, frequency of attacks and migraine severity or anxiety. The most important factor that predicted sexual function was depression, which was also independent of disease severity and migraine related disability. While future larger scale studies are needed to clarify the exact relationship, depressive and sexual problems should be properly addressed in all patients with migraine, regardless of disease severity or disability.

Association between somatic amplification, anxiety, depression, stress and migraine.

BACKGROUND: The aim of this study is to investigate the associations between migraine related disability and somatosensory amplification, depression, anxiety, and stress. METHOD: Fifty-five migraine patients who applied to the outpatient unit of the Neurology Department of Acibadem University School of Medicine, Maslak Hospital in Istanbul, Turkey, and twenty-eight subjects without migraine were recruited for the study. The participants were asked to complete a sociodemographic form, Migraine Disability Assessment Scale (MIDAS), Depression Anxiety Stress Scale, Somatosensory Amplification Scale (SSAS). RESULTS: Somatosensory amplification scores were significantly higher in the migraineurs than in the control group (29.85+/-6.63 vs 26.07+/-7.1; p=0.027). Somatosensory amplification scores and depression scores were significantly higher in migraineurs with moderate and severe disability than in patients with minimal and mild disability (31.7+/-6.4 vs 27.71+/-5.49; p=0.01, 11.27+/-8.7 vs 7.38+/-8.11; p=0.04, respectively). A significant positive correlation was found between the frequency of migraine attacks for at least three consecutive months (MIDAS A scores) and the SSAS scores (r=0.363, p=0.007) in migraineurs. The MIDAS total scores were also significantly correlated with the DASS depression subcale scores (r=0.267, p=0.04), and the DASS stress subscale scores (r=0.268, p=0.05). CONCLUSION: Psychological factors, and vulnerability to bodily sensations may incease the burden of migraine. We point out that the timely assessing of somatic amplification and the evaluation of mental status would help improve the quality of life of in migraineurs.

The unconsummated marriage: its frequency and clinical characteristics in a sexual dysfunction clinic.

The object of this study was to investigate frequency of the unconsummated marriages and its clinical characteristics among the subjects who referred to a sexual dysfunction clinic in Turkey. Four hundred and forty-nine unconsummated marriage cases were evaluated among 1880 subjects referred to Acibadem Sexual Health Clinic, Istanbul, between December 2000 and December 2004. Unconsummated marriage rose from the female partner in 67% of the cases, 7% males, and 26% both. Vaginismus was the most prominent cause in 81% of the cases, erectile dysfunction in 10.5%, premature ejaculation in 5%. Previous reports from Eastern societies including Turkey indicate higher incidences of premature ejaculation and vaginismus than the Western world which underline a strong cultural influence in the background of these disorders. These also appeared to be the most important precursors of unconsummated marriage in our study.

Sexual dysfunction in patients with schizophrenia on antipsychotic medication.

OBJECTIVE: The objective of this study was to determine the prevalence of sexual dysfunction in patients with schizophrenia under antipsychotic therapy and to investigate the effect of various parameters on sexual dysfunction. METHOD: A total of 827 stabilized outpatients who met DSM-IV criteria for schizophrenia, were recruited in the study. Arizona Sexual Experience Scale (ASEX) and the subscale on sexual function of the UKU Side Effects Rating Scale were applied at a single interview. RESULTS: In total, 52.6% of the patients had sexual dysfunction, 54.2% reported a low sexual desire and 41.7% reported problems in having an orgasm. Erectile dysfunction and ejaculation problems were seen in 48.1% and 64.2% of the men, respectively; amenorrhea was seen in 24.9% of the women. ASEX score and severity of disease were found to be correlated (p=0.02). Higher ASEX scores were observed in patients who smoked (p=0.01). Men receiving atypical monotherapy had lower ASEX scores than those receiving a combination of atypical and conventional antipsychotics (p=0.017). Patients on combination therapy had more ejaculation problems than the atypical group (p=0.001). Low sexual desire was more prevalent among women using conventional drugs than those on atypical drugs (p=0.004). In linear regression analyses, ASEX was affected significantly and independently by the severity of the disease only in men (p=0.005). CONCLUSION: Our results show that sexual dysfunction is widespread among patients with schizophrenia on antipsychotic medications.