Sexual Dysfunction in Men With Inflammatory Bowel Disease: A New IBD-Specific Scale.

Background Men with inflammatory bowel disease (IBD) may have increased sexual dysfunction. To measure the prevalence of sexual dysfunction in our male patients, we aimed to develop a new IBD-specific Male Sexual Dysfunction Scale (the IBD-MSDS). Methods We used a cross-sectional survey and enrolled male patients (N = 175) ≥18 years old who attended IBD clinics at 2 Boston hospitals. We collected information on sexual functioning via a 15-item scale. General male sexual functioning was measured using the International Index of Erectile Dysfunction (IIEF); the Patient Health Questionnaire (PHQ-9) measured depressive symptoms. Medical history and sociodemographic information were extracted from medical record review. Exploratory factor analyses (EFA) assessed unidimensionality, factor structure, reliability, and criterion and construct validity of the 15-item scale. We used regression models to identify clinical factors associated with sexual dysfunction. Results EFA suggested retaining 10-items generating a unidimensional scale with strong internal consistency reliability, α = 0.90. Criterion validity assessed using Spearman's coefficient showing that the IBD-MSDS was significantly correlated with all the subscales of the IIEF. The IBD-MSDS was significantly correlated (construct validity) with the PHQ-9 (P < 0.001) and the composite score for active IBD cases (P < 0.05). Male sexual dysfunction in IBD was significantly associated with the presence of an ileoanal pouch anastomosis (P = 0.047), depression (P < 0.001), and increased disease activity (P = 0.021). Conclusions We have developed and validated an IBD-specific scale to assess the psychosexual impact of IBD. This new survey tool may help physicians screen for and identify factors contributing to impaired sexual functioning in their male patients.

[1]  K. Katsanos,et al.  Inflammatory Bowel Disease and Sexual Function in Male and Female Patients: An Update on Evidence in the Past Ten Years. , 2015, Journal of Crohn's & colitis.

[2]  Linda G. Marc,et al.  Reliability and Validity of the Haitian Creole PHQ-9 , 2014, Journal of General Internal Medicine.

[3]  J. E. Domínguez-Muñoz,et al.  Psychological Factors Are Associated with Changes in the Health-related Quality of Life in Inflammatory Bowel Disease , 2013, Inflammatory bowel diseases.

[4]  H. Raspe,et al.  Clinical status, psychosocial impairments, medical treatment and health care costs for patients with inflammatory bowel disease (IBD) in Germany: an online IBD registry. , 2013, Journal of Crohn's & colitis.

[5]  Peter Szolovits,et al.  Similar Risk of Depression and Anxiety Following Surgery or Hospitalization for Crohn's Disease and Ulcerative Colitis , 2013, The American Journal of Gastroenterology.

[6]  Linda G. Marc,et al.  Psychometric evaluation of the HIV symptom distress scale , 2012, AIDS care.

[7]  Myung-Gyu Choi,et al.  Anxiety, depression and quality of life in patients with irritable bowel syndrome. , 2011, Gut and liver.

[8]  L. E. Gibbons,et al.  Measuring depression levels in HIV-infected patients as part of routine clinical care using the nine-item Patient Health Questionnaire (PHQ-9) , 2010, AIDS care.

[9]  B. Thombs,et al.  PHQ-9 and PHQ-2 in Western Kenya , 2009, Journal of General Internal Medicine.

[10]  K. Kroenke,et al.  Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya , 2009, Journal of General Internal Medicine.

[11]  T. Sheldon,et al.  Screening and case-finding instruments for depression: a meta-analysis , 2008, Canadian Medical Association Journal.

[12]  G. Rogler,et al.  Determinants of male sexual function in inflammatory bowel disease: A survey‐based cross‐sectional analysis in 280 men , 2007, Inflammatory bowel diseases.

[13]  C. Hewitt,et al.  Screening for Depression in Medical Settings with the Patient Health Questionnaire (PHQ): A Diagnostic Meta-Analysis , 2007, Journal of General Internal Medicine.

[14]  G. Rogler,et al.  Sexual function in persons with inflammatory bowel disease: a survey with matched controls. , 2007, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[15]  L. Lix,et al.  The relationship of inflammatory bowel disease type and activity to psychological functioning and quality of life. , 2006, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[16]  O. O. Afolabi,et al.  Validity of the patient health questionnaire (PHQ-9) as a screening tool for depression amongst Nigerian university students. , 2006, Journal of affective disorders.

[17]  B. Yueh,et al.  Swahili Translation and Validation of the Patient Health Questionnaire-9 Depression Scale in the Kenyan Head and Neck Cancer Patient Population , 2006, International journal of psychiatry in medicine.

[18]  R. Spitzer,et al.  Using the patient health questionnaire-9 to measure depression among racially and ethnically diverse primary care patients , 2006, Journal of General Internal Medicine.

[19]  Simon Gilbody,et al.  Should we screen for depression? , 2006, BMJ : British Medical Journal.

[20]  Winfried Rief,et al.  Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population. , 2006, General hospital psychiatry.

[21]  A. Leplège,et al.  Methodological issues in determining the dimensionality of composite health measures using principal component analysis: Case illustration and suggestions for practice , 2005, Quality of Life Research.

[22]  G. Okulate,et al.  Somatic symptoms in depression: Evaluation of their diagnostic weight in an African setting , 2004, British Journal of Psychiatry.

[23]  J. Becker,et al.  Psychiatric and neurocognitive disorders among HIV-positive and negative veterans in care: Veterans Aging Cohort Five-Site Study , 2004, AIDS.

[24]  L. Wulsin,et al.  The Feasibility of Using the Spanish PHQ-9 to Screen for Depression in Primary Care in Honduras. , 2002, Primary care companion to the Journal of clinical psychiatry.

[25]  S. Becker,et al.  Screening for Somatization and Depression in Saudi Arabia: A Validation Study of the Phq in Primary Care , 2002, International journal of psychiatry in medicine.

[26]  J. Cappelleri,et al.  The International Index of Erectile Function (IIEF): a state-of-the-science review , 2002, International Journal of Impotence Research.

[27]  G. Ramirez,et al.  Identifying depression in primary care: a literature synthesis of case-finding instruments. , 2002, General hospital psychiatry.

[28]  Kathleen N Lohr,et al.  Screening for Depression in Adults: A Summary of the Evidence for the U.S. Preventive Services Task Force , 2002, Annals of Internal Medicine.

[29]  R. Spitzer,et al.  The PHQ-9: validity of a brief depression severity measure. , 2001, Journal of general internal medicine.

[30]  G. A. Marcoulides,et al.  A First Course in Structural Equation Modeling , 2000 .

[31]  R. Pounder,et al.  A simple clinical colitis activity index , 1998, Gut.

[32]  I. Osterloh,et al.  The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. , 1997, Urology.

[33]  L. Giese,et al.  Sexual health issues in inflammatory bowel disease. , 1996, Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates.

[34]  M. Testa,et al.  Methods for quality-of-life studies. , 1994, Annual review of public health.

[35]  J. Mayberry,et al.  Perceived sexual dysfunction amongst patients with inflammatory bowel disease. , 1993, Digestion.

[36]  Michael King,et al.  Health measurement scales. A practical guide to their development and use: David L Streiner and Geoffrey R Norman. Oxford: Oxford University Press, (HB) 1989, (PB) 1990. Price £15.00 (PB) 175 pp , 1992 .

[37]  Robert F. DeVellis,et al.  Scale Development: Theory and Applications. , 1992 .

[38]  D. Drossman,et al.  The rating form of IBD patient concerns: a new measure of health status. , 1991, Psychosomatic medicine.

[39]  L. Kupper,et al.  Development of a Crohn's index for survey research. , 1988, Journal of clinical epidemiology.

[40]  R. F. Harvey,et al.  A SIMPLE INDEX OF CROHN'S-DISEASE ACTIVITY , 1980, The Lancet.

[41]  R. Sitgreaves Psychometric theory (2nd ed.). , 1979 .

[42]  F Kern,et al.  Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. , 1976, Gastroenterology.