性功能障礙的相關風險因子於憂鬱症患者的研究：應用亞利桑那性經驗量表中文版 (ASEX-CV) 在台灣一項橫切面觀察式多中心之調查

Risk Factors of Sexual Dysfunction in Depressive Patients：A Cross-sectional Observational Multi-center Survey Using ASEX-CV in Taiwan

目的：應用亞利桑那性經驗量表中文版(ASEX-CV)來評估台灣憂鬱症病人性功能障礙的盛行率與相關風險因子。方法：本研究從西元2004年六月至2005年十月，由四家不同醫院招募到604位憂鬱症病人。統計上本研究使用迴歸分析方法來探討性功能與人口學資料，生理疾病，憂鬱症嚴重程度和抗憂鬱藥物的使用之間的關聯性。結果：研究發現性功能障礙盛行率在憂鬱病人者高達65.2%。性功能障礙的相關風險因子包括女性(p<0.001)、年齡增加(p<0.05)、離婚或寡居(p<0.01)、嚴重的憂鬱症狀(p<0.001)、前列腺疾病(p<0.01)和月經相關障礙(p<0.01)。抗憂鬱藥物的使用沒有和性功能障礙盛行率的提升有相關性，而性功能障礙的盛行率在使用NaSSA的病人顯著較低(p<0.05)。結論：本研究點出性功能障礙盛行率在憂鬱病人相當的高，建議臨床醫師在照顧憂鬱症病人時須特別注意性功能障礙的影響，尤其是針對風險群須更注意。

Objective: In this study, we intended to assess the prevalence and the potential risk factors of sexual dysfunction in depressive patients with Arizona Sexual Experiences Scale-Chinese Version (ASEX-CV). Methods: In this study, we recruited 604 participants from psychiatric outpatient clinics in four different hospitals from June 2004 to October 2005. All participants completed copies of ASEXCV and Taiwanese Depression Questionnaire. We did correlation study between sexual function and antidepressant use, demographics, physical illnesses or severity of depressive symptoms. Results: The overall prevalence of sexual dysfunction was 65.2%. Factors associated with signifi cantly increased risk of sexual dysfunction included female gender (p < 0.001), older age (p < 0.05), divorced or widowed marital status (p < 0.01), more severe depressive symptoms (p < 0.001), prostate diseases (p < 0.01) and menstruation-related illness (p < 0.01). Antidepressant use was not associated with increased risk of sexual dysfunction and lower risk was found in patients using norepinephrine and specifi c serotonin antidepressant (NaSSA) (p < 0.05). Conclusion: Our study showed that the overall prevalence of sexual dysfunction was high. We suggest that clinicians should ask patients specifi cally about their sexual side effects of antidepressants, especially in those with high risk factors.