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COPENHAGEN -- Half of patients with rheumatoid arthritis (RA) and 30% of those with psoriatic arthritis (PsA) reported substantial problems with sexual function, according to a survey reported here.

Among 27 with RA diagnoses, 13 had scores on the 14-item in the range indicative of sexual dysfunction, said Carlos Valera-Ribera of Hospital Universitario Doctor Peset in Valencia, Spain.

That was also true for 22 of 72 PsA patients, he told attendees at the European Alliance of Associations for Rheumatology (EULAR) annual meeting.

These proportions were markedly higher than those in a control group of 89 healthy people, among whom just five had scores in the CSFQ dysfunction range.

Both types of arthritis patients appear to experience "a deteriorated sexual life," Valera-Ribera said, with all domains affected. He recommended the CSFQ as a clinical tool for managing patients with chronic joint diseases.

The survey asks questions pertaining to five domains: pleasure, desire, arousal, orgasm, and "orgasm completion." Each item is scored from 1-5, with lower numbers reflecting more dysfunction (e.g., 1 for "no enjoyment" and 5 for "great pleasure") for a total range of 14-70. Valera-Ribera didn't indicate exactly what cutoffs he used to define overall dysfunction, but other researchers have set thresholds of 47 for men and 41 for women.

In the current study, conducted among patients at two academic rheumatology clinics in Spain, mean scores were below those levels for men and women with either diagnosis, at about 36 for women and 43 for men. Relative to controls, mean scores for the patients were 8.2 points lower.

Not surprisingly, age was also a factor, though a stronger one in the arthritis patients compared to controls. Among those older than 50, most patients fell into the dysfunction range, although a dot-plot in Valera-Ribera's presentation showed considerable variation.

Other factors associated with increased risk of sexual dysfunction included employment status and lower income, consistent with findings from previous studies of rheumatic disease patients, Valera-Ribera said.

Against expectations, a history of depression did not correlate significantly with likelihood of sexual dysfunction. That could have been a statistical fluke, however, insofar as more than three-quarters of RA and PsA patients were or had been clinically depressed, making it harder to find associations reaching statistical significance.

For the study, Valera-Ribera and colleagues distributed the questionnaire to clinic patients irrespective of sexual preferences, and neither the questions nor responses were necessarily about interactions with partners, but could be taken to refer to masturbation.

About half the respondents were women. Mean participant age was 48 (SD 13), and "more than half" self-rated their overall health as good or very good, Valera-Ribera said. About 80% indicated they were in a relationship.

He acknowledged that using only responses from willing participants was a limitation. Not everyone approached with the CSFQ agreed to fill it out. Valera-Ribera conceded that this could have introduced a bias, such that the results would overstate the prevalence of sexual dysfunction if people with "normal" sex lives disproportionately chose not to participate.

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