抑郁障碍、抗抑郁药和性功能障碍的关系研究进展

Progress in the relationship among depressive disorders,antidepressant treatment and sexual dysfunction

抑郁障碍和性功能障碍的患病率和共病率较高。在性功能障碍患者中,抑郁障碍的发生率较高;在抑郁障碍患者中,性功能障碍也较常见,其中,最常见的是性欲低下和性兴奋障碍。然而,抑郁障碍和性功能障碍的确切关系仍然不明确,包括是否有确切的因果关系或者是否有共同的发病机制,尤其是抗抑郁药在性功能方面的不良反应进一步使抑郁障碍和性功能障碍的关系复杂化,也使三者形成复杂的关系网。临床实践中,在处理性功能障碍的患者时,应该常规筛查抑郁症状;因为性功能障碍的缓解是抑郁缓解的重要预测因素之一,所以性功能障碍的治疗也应该整合为抑郁障碍治疗的一部分。文中综述了近年来抑郁障碍和性功能障碍关系以及抗抑郁药对性功能影响的研究进展。

A high percentage of men and women suffer from depressive or sexual disorders or both of them.Those who suffer from sexual dysfunction may possibly experience depression and those who suffer from depressive disorder may have sexual dysfunction and low sexual desire and sexual excitement disorder are common.However,the exact relationship between them is still unclear,whether one occurs due to another or they have the same pathogenesis and is further complicated by the sexual side effects of antidepressant treatment,thus constituting a complex network of factors.During clinical practice,sexually dysfunctional patients should be routinely screened for symptoms of depression.Since improvements in sexual functioning consistently belong to the most significant predictors of depression remission,adequate treatment of sexual functioning should be an integral component of therapy for all depressed men and women.Studies about the relationship between depression and sexual disorder and how antidepressants affect sexual function will be briefly reviewed in this review.