Conviviendo con esclerosis múltiple: relación entre disfunción sexual, calidad de vida y salud mental

Introduction

Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease of the central nervous system that primarily affects young individuals and is the leading cause of disability in this group. Sexual dysfunction (SD) in patients with MS is more common than previously recognized. The present study aimed to determine the prevalence of sexual dysfunction, depression, and negative health perception, as well as their relationships with the Expanded Disability Status Scale (EDSS).

Materials and Methods

We conducted an observational, descriptive, cross-sectional study in our MS population. Data were obtained using the Beck Depression Inventory (BDI-2), Short-form 12 (SF-12), and Multiple Sclerosis Intimacy and Sexuality Questionnaire 19 (MSISQ-19). Parametric and non-parametric data were analyzed using EPI Info 7.

Results

A total of 53 patients were included over a period of 15 months. The median EDSS score was 1.5. Of the patients, 50,9% presented some form of sexual dysfunction, 37,7% had some degree of depression, and 26,4% had a negative self-perception of health. Non-parametric analysis showed that patients with sexual dysfunction had a median EDSS score of 2, while those without dysfunction had a median score of 1.5 (p = 0.03). Patients with severe depression had an EDSS score of 3.25, compared to 1.5 for those without depression (p = 0.04), and those with a negative perception of health had an EDSS score of 2,75, while those with a positive perception had a score of 1.5 (p = 0.0003). Parametric evaluation found that patients with EDSS < 2 had a 34.6% prevalence of sexual dysfunction and a 31.6% prevalence of depression, whereas those with EDSS >2 had an 66.7% prevalence of sexual dysfunction (p = 0.001) and a 53.3% prevalence of depression (p = 0.08). Patients with EDSS < 4 presented sexual dysfunction in 44.4% and with EDSS >4 in 87.5% (p = 0.01). Patients with EDSS < 4 presented depression in 30.4% and patients with EDSS >4 85.7% (p = 0.004). Patients with EDSS < 4 were perceived positively by 91.7% and patients with EDSS >4 by 85.7% negatively (p = 0.0001).

Conclusion

There is a high prevalence of sexual dysfunction and depression in patients with MS, which correlates with increased disability, even from EDSS values of 2 or higher. This suggests poor quality of life and the need for comprehensive treatment addressing both physical and emotional aspects of MS from the early stages.