Impact of Sjögren's Disease on Quality of Sexual Life Using the Qualisex Score
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Objective: This study aimed to assess the impact of Sjögren disease (SjD) on the quality of sexual life and its determinants using the Qualisex questionnaire.
Methods: The Qualisex questionnaire was administered to participants within the ASSESS cohort, a French national multicentric prospective cohort of individuals with SjD. Patients' characteristics and psychometric evaluations were also collected.
Results: Among the 395 patients of the cohort, 92 (23%) completed the questionnaire, with a median age of 56 (44-59) years and a female ratio of 92% (85/92). The median Qualisex score was 3.4 (1.1-5.9).Comparing the first and last quartiles of the Qualisex score, a worst sexual satisfaction was associated with older age (median (IQR) 58 (52-65) vs 52 (41-56) years, p=0.005), higher EULAR Sjögren's disease Patient Reported Index (ESSPRI) (6.8 (5.7-7.7) vs 4.3 (2.8-5.3), p<0.0001) lower SF-36 mental and physical scores (respectively, 43 (38-46) vs 49 (47-53), p=0.0035 and 31 (29-35) vs 35 (30-37), p=0.035), higher Depression and Anxiety scores (HADS) (respectively, 9 (7-11) vs 2 (1-4), p<0.0001 and 11 (8-14) vs 7 (4-10), p=0.006). Interestingly, EULAR Sjögren's disease Disease Activity Index (ESSDAI) score did not differ significantly (4 (1-10) vs 2.5 (1.8-4), p=0.35). In a multivariable analysis, the Qualisex score remained strongly associated with a higher HADS depression score and, to a lesser extent, with a higher ESSPRI. The inability to obtain a score was associated with older age.
Conclusion: In SjD patients, sexual satisfaction assessed with the Qualisex score, was strongly associated with depression and, to lesser extent, with ESSPRI, but not with systemic activity.