Main Article Content
Introduction: Spinal cord injury results in loss of functional independence, autonomy and social status. This enormous change contributes to the appearance of depressive symptoms in this population. Objective: To evaluate depressive symptoms and sexual dysfunction in men with traumatic spinal cord injury, and to analyze their association. Methods: Observational study was performed with 44 men with traumatic spinal cord injury, age between 18 and 60 years, injury time over 1 year and active sexual life. The degree of neurological impairment was assessed through the revised 2011 ASIA Impairment Scale, depressive symptoms through the Beck Depression Inventory, and sexual function through the International Erectile Function Index. Descriptive statistics techniques and bivariate analysis were applied to verify association, using a level of significance of 0.05. Results: The volunteers had a mean age of 34.1 years, and an average injury time of 7.7 years. All individuals in the sample had lesion level above the medullary segment L2, with incomplete injury being the most frequent (68.2%). The mean time of the last sexual intercourse was 56.5 days and the weekly frequency of intercourse was the most reported (65.9%). Only 17.6% of the sample presented depressive symptoms, ranging from dysphoria (6.8%) to mild to moderate symptoms (6.8%). No association was found between depressive symptoms and sexual dysfunction, except for the domain of general satisfaction dysfunction (p=0.02). Conclusion: There is no association between depressive symptoms and sexual dysfunction in men with chronic spinal cord injury.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY) that allows others to share and adapt the work with an acknowledgement of the work's authorship and initial publication in this journal.Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
2. Sipski M, Alexander C, Gomez-Marin O. Effects of level and degree of spinal cord injury on male orgasm. Spinal Cord. 2006;44(12):798-804. https://dx.doi.org/10.1038/sj.sc.3101954
3. Dijkers M. Quality of life after spinal cord injury: a meta analysis of the effects of disablement components. Spinal Cord. 1997;35(12):829-40. https://dx.doi.org/10.1038/sj.sc.3100571
4. Hultling C, Giuliano F, Quirk F, Pena B, Mishra A, Smith MD. Quality of life in patients with spinal cord injury receiving Viagra (sildenafil citrate) for the treatment of erectile dysfunction. Spinal Cord. 2000;38(6):363-70. https://dx.doi.org/10.1038/sj.sc.3101011
5. Rosen R. Looking beyond erectile dysfunction: the need for multi-dimensional assessment of sexual dysfunction. Eur Urol. 2003;(Suppl. 2):9-12. https://dx.doi.org/10.1016/j.eursup.2003.11.003
6. Anderson KD. Targeting recovery: priorities of the spinal cord-injured population. J Neurotrauma. 2004;21(10)1371-83. https://dx.doi.org/10.1089/neu.2004.21.1371
7. Al-Owesie RM, Moussa NM, Robert AA. Anxiety and depression among traumatic spinal cord injured patients. Neurosciences (Riyadh). 2012;17(2)145-50.
8. França ISX, Coura AS, França EG, Basilio NNV, Souto RQ. Qualidade de vida de adultos com lesão medular: um estudo com WHOQOL-bref. Rev Esc Enferm USP. 2011;45(6):1364-71. http://dx.doi.org/10.1590/S0080-62342011000600013
9. Dahlberg A, Alaranta H, Kautiainen H, Kotila M. Sexual activity and satisfaction in men with traumatic spinal cord lesion. J Rehabil Med. 2007;39(2):152-5. http://dx.doi.org/10.2340/16501977-0029
10. Dahlberg A, Alaranta H, Sintonen H. Health-related quality of life in persons with traumatic spinal cord lesion in Helsinki. J Rehabil Med. 2005;37:312-6. http://dx.doi.org/10.1080/16501970510034413
11. Barbonetti A, Cavallo F, Felzani G, Francavilla S, Francavilla F. Erectile dysfunction is the main determinant of psychological distress in men with spinal cord injury. J Sex Med. 2012;9(3):830-6. http://dx.doi.org/10.1111/j.1743-6109.2011.02599.x
12. Kennedy P, Rogers BA. Anxiety and depression after spinal cord injury: a longitudinal analysis. Arch Phys Med Rehabil. 2000;81(7):932-7. http://dx.doi.org/10.1053/apmr.2000.5580
13. Conceição MIG, Auad JC, Vasconcelos L, Macêdo A, Bressanelli R. Avaliação da depressão em pacientes com lesão medular. Rev Bras Ter Comport Cogn. 2010;12:(1-2):43-59.
14. Nielsen MS. Post-traumatic stress disorder and emotional distress in persons with spinal cord lesion. Spinal Cord. 2003;41(5):296-302. http://dx.doi.org/10.1038/sj.sc.3101427
15. Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW, et al. Depression following Traumatic Spinal Cord Injury. Neuroepidemiology. 2005;25(2):55-61. http://dx.doi.org/10.1159/000086284
16. Kirshblum SC, Biering-Sorensen F, Betz R, Burns S, Donovan W, Graves D, et al. International Standards for Neurological Classification of Spinal Cord Injury: Cases with classification challenges. J Spinal Cord Med. 2014;37(2):120-7. http://dx.doi.org/10.1179/2045772314Y.0000000196
17. Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Sugestões para o uso do miniexame do estado mental no Brasil. Arq Neuropsiquiatr 2003;61(3B):777-81. http://dx.doi.org/10.1590/S0004-282X2003000500014
18. Kirshblum SC, Burns SP, Biering-Sorensen F, Donovan W, Graves DE, Jha A, et al. International standards for neurological classification of spinal cord injury (revised). J Spinal Cord Med. 2011;34(6):535-46. http://dx.doi.org/10.1179/204577211X13207446293695
19. Cunha JA. Manual da versão em português das Escalas Beck. São Paulo: Casa do Psicólogo, 2001; p.11-13.
20. Gonzáles AI, Sties SW, Wittkopf PG, Mara LSD, Ulbrich AZ, Cardoso FL, et al. Validação do Índice Internacional de Função Erétil (IIFE) para uso no Brasil. Arq Bras Cardiol. 2013;101(2):176-82. http://dx.doi.org/10.5935/abc.20130141
21. Rosen R, Cappelleri J, Gendrano N. The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res. 2002;14(4):226-44. http://dx.doi.org/10.1038/sj.ijir.3900857
22. Castro Filho JE. Epidemiologia da disfunção sexual masculina em pacientes com lesão medular. Tese (Doutorado) - Universidade de São Paulo. São Paulo: 2013.
23. Krueger H, Noonan VK, Williams D, Trenaman LM, Rivers CS. The influence of depression on physical complications in spinal cord injury: behavioral mechanisms and health-care implications. Spinal Cord. 2013;51(4):260-6. http://dx.doi.org/10.1038/sc.2013.3
24. Anderson KD, Borisoff JF, Johnson RD, Stiens SA, Elliott SL. The impact of spinal cord injury on sexual function: concerns of the general population. Spinal Cord. 2007;45(5):328-37. http://dx.doi.org/10.1038/sj.sc.3101977
25. Alexander MS, Biering-Sørensen F, Elliott S, Kreuter M, Sønksen J. International spinal cord injury male sexual function basic data set. Spinal Cord. 2011;49(7):795-8. http://dx.doi.org/10.1038/sc.2010.192
26. Bampi LNS, Guilhem D, Lima DD. Qualidade de vida em pessoas com lesão medular traumática: um estudo com o WHOQOL-bref. Rev Bras Epidemiol. 2008;11(1):67-77. http://dx.doi.org/10.1590/S1415-790X2008000100006
27. Baasch AKM, Cardoso FL. Sexualidade na lesão medular. Dissertação (Mestrado) - Universidade do Estado de Santa Catarina. Florianópolis: 2008.
28. Biering-Sorensen I, Hansen RB, Biering-Sørensen F. Sexual function in a traumatic spinal cord injured population 10-45 years after injury. J Rehabil Med. 2012;44(11):926-31. http://dx.doi.org/10.2340/16501977-1057
29. Smith, AE, Molton, IR, McMullen, K, Jensen, MP. Brief Report: Sexual Function, Satisfaction, and Use of Aids for Sexual Activity in Middle-Aged Adults with Long-Term Physical Disability. Top Spinal Cord Inj Rehabil. 2015;21(3):227-32. https://doi.org/10.1310/sci2103-227
30. Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW, et al. Depression following traumatic spinal cord injury. Neuroepidemiology. 2005;25(2):55-61. http://dx.doi.org/10.1159/000086284
31. Cuenca AIC, Sampietro-Crespo A, Virseda-Chamorro M, Martín-Espinosa N. Psychological impact and sexual dysfunction in men with and without spinal cord injury. J Sex Med. 2015;12(2):436-44. https://doi.org/10.1111/jsm.12741
32. Judd FK, Brown DJ, Burrows GD. Depression, disease and disability: application to patients with traumatic spinal cord injury. Paraplegia. 1991;29(2):91-6. http://dx.doi.org/10.1038/sc.1991.12
33. Tate D, Forchheimer M, Maynard F, Dijkers M. Predicting depression and psychological distress in persons with spinal cord injury based on indicators of handcap. Am J Phys Med Rehabil. 1994;73(3):175-83.
34. Craven C, Hitzig SL, Mittmann N. Impact of impairment and secondary health conditions on health preference among Canadians with chronic spinal cord injury. J Spinal Cord Med. 2012;35(5). http://dx.doi.org/10.1179/2045772312Y.0000000046