Psychological Treatment of Major Depression: An Analysis of the Sexual Desire

Objective: Sexual dysfunction is frequently reported as a side effect of many antidepressant medications. As a result, for those depressed patients to whom sexual desire is important, psychological treatment may be a better intervention. Thus, the present study aimed to determine the possible changes in sexual desire following psychological treatments in depression, when focus of therapy is not on sexual function. Methods: This is a quasi-experimental study, which was conducted in Tehran, Iran. A total of ۲۸۱ depressed patients in the remission phase underwent psychological treatments, either cognitive behavioral therapy (CBT, n=۱۳۱) or mindfulness-based cognitive therapy (MBCT, n=۱۵۰). The therapy did not focus on any aspect of sexual function. Using a single item measure before and after treatment, sexual desire of the patients was categorized into intact, mild, moderate, or severe decline. A total of ۲۵۵ participants completed the study questionnaires and were randomly assigned to CBT (۱۲۲) and MBCT groups (۱۳۳). Before therapy, ۱۲۸(۵۰.۲%) participants were categorized in intact sexual desire group, ۷۳(۲۸.۶%) in mild sexual desire dysfunction group, ۴۰(۱۵.۷%) in moderate sexual desire dysfunction group, and ۱۴(۵.۵%) in severe sexual desire dysfunction group. Logistic regression was used for analyzing the data by SPSS-۱۶. Results: Low sexual desire in depression remission was predicted by age (P<۰.۰۰۱, OR=۰.۲۱, CI=۰.۰۱–۰.۰۳), presence of comorbid anxiety disorder (P<۰.۰۴, OR=-۰.۱۳, CI=-۰.۴۶–۰.۰۲), and global assessment of functioning (GAF) (P<۰.۰۰۱, OR=-۰.۲۳, CI=-۰.۰۳–۰.۰۱). Clinical improvement in sexual desire was predicted by the type of intervention (P=۰.۰۲۳, OR=۰.۳۵۱, CI=۰.۱۴۲–۰.۸۶۹) and GAF (P=۰.۰۰۳, OR=۰.۹۲۷, CI=۰.۸۸۱–۰.۹۷۵). Conclusion: CBT might be superior to MBCT in improving sexual desire in patients with depression. Further studies using validated sexual function questionnaires are necessary.

کلیدواژه ها:

Depression ، Sexual desire ، Cognitive behavioral therapy ، Mindfulness-based cognitive therapy