What Effects Can Expressive Writing Have on Sexual Dysfunction in Women with Multiple Sclerosis? A Randomized Controlled Trial

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2023-02-09 DOI:10.1155/2023/6754178

B. Afshar, L. Amini, S. Nabavi, M. Hasani, M. Mohammadnoori, S. Jahanfar, A. Sahebkar

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Abstract

Background. Sexual dysfunction is a common complication in women with multiple sclerosis due to limitation in physical and mental functioning. Expressive writing as a psychological intervention can significantly improve sexual dysfunction in women with other diseases. Aim. The aim of the current study was to determine the effect of expressive writing on sexual dysfunction in Iranian women with multiple sclerosis. Methods. A randomized controlled trial with a Solomon four-group design was conducted on 116 Iranian women with MS in February 2021. Participants were randomly assigned into two control subgroups of A1 (without pretest) and A2 (with pretest) and two intervention subgroups of B1 (without pretest) and B2 (with pretest). Expressive writing was conducted for six weeks at home including morning pages (writing three pages about everything that comes to mind everyday), date with inner child (once a week), and performing weekly creative assignments. Sexual dysfunction was assessed using MSISQ-19 before the intervention in two groups of A2 and B2 and follows in immediately, four weeks and eight weeks after the intervention in all subgroups. The control group was provided with routine care of treatment. Data were analyzed using the intention to treat method. P < 0.05 was considered significant. Results. Twenty-nine women were analyzed in each subgroup. Although expressive writing had a positive and significant effect on primary, tertiary, and overall sexual dysfunction in B2 intervention subgroup compared with A2 control subgroup ( P ≤ 0.001 ), it could not improve secondary sexual dysfunction. Since tertiary sexual dysfunction was related to psychological aspects and the present intervention was also a subset of psychotherapy, most of the changes were observed at this level, which included a decrease of 7-8 points. Comparison between the two groups of with and without pretest in each of the control and intervention groups revealed that completing the pretest questionnaire did not have a significant impact on sexual dysfunction score. Conclusion. As a cost-effective and noninvasive intervention, expressive writing can be used along with the main treatment for women suffering from multiple sclerosis to improve sexual dysfunction.

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表达性写作对多发性硬化症女性性功能障碍有何影响?随机对照试验

背景。由于身体和精神功能的限制，性功能障碍是多发性硬化症女性常见的并发症。表达性写作作为一种心理干预手段可以显著改善患有其他疾病的女性性功能障碍。的目标。当前研究的目的是确定表达性写作对伊朗多发性硬化症女性性功能障碍的影响。方法。2021年2月，对116名患有多发性硬化症的伊朗妇女进行了所罗门四组设计的随机对照试验。参与者被随机分为A1(未预试)和A2(有预试)两个对照亚组和B1(未预试)和B2(有预试)两个干预亚组。为期六周的表达写作是在家里进行的，包括早晨的页面(每天写三页关于想到的所有事情)，与内心的孩子约会(每周一次)，以及每周完成创造性作业。在干预前用MSISQ-19对A2组和B2组的性功能障碍进行评估，并在干预后立即、4周和8周对所有亚组进行随访。对照组给予常规护理治疗。采用意向治疗法对数据进行分析。P < 0.05被认为是显著的。结果。每个亚组分析29名妇女。与A2对照亚组相比，B2干预亚组表达性书写对原发性、三级和整体性功能障碍均有显著正向影响(P≤0.001)，但对继发性性功能障碍无显著改善作用。由于第三性功能障碍与心理方面有关，目前的干预也是心理治疗的一个子集，因此大多数变化都是在这一水平上观察到的，其中包括7-8分的下降。对照组和干预组有预测和没有预测的两组比较发现，完成预测问卷对性功能障碍评分没有显著影响。结论。作为一种成本效益高且无创的干预手段，表达性写作可以与多发性硬化症女性的主要治疗方法一起使用，以改善性功能障碍。

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来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.