Sexual Function and Depressive Symptoms Among Female North American Medical Students

University of California Davis-Department of Urology, Sacramento, CA 95816, USA.
Journal of Sexual Medicine (Impact Factor: 3.15). 11/2010; 8(2):391-9. DOI: 10.1111/j.1743-6109.2010.02085.x
Source: PubMed


Depression and sexual dysfunction are often comorbid.
We explored the relationship between sexuality, sexual dysfunction, and depressive symptoms in female medical students in North America.
Female North American medical students were invited to participate in an internet survey. The CES-D was utilized to screen for depressive symptoms and an abbreviated Spielberger State-Trait Anxiety Index (STAI) was used to quantify anxiety symptoms.
Subjects completed an ethnodemographic survey, a sexuality survey, and modified instruments for the quantification of sexual function (the Female Sexual Function Index [FSFI] and the Index of Sexual Life [ISL]). Multivariable logistic regression was used to explore the relationship between sexuality and depressive symptoms.
There were 1,241 female subjects with complete data on CES-D and STAI. Mean age was 25.4 years. Depressive symptoms (CES-D>16) were present in 46% of respondents and were more common in subjects with anxiety symptoms. Subjects who were Caucasian, younger than 28, heterosexual, and in a relationship were least likely to report depressive symptoms. High risk of female sexual dysfunction (HRFSD) was significantly associated with greater likelihood of depressive symptoms (odds ratio [OR] 2.25, P<0.001). After adjusting for ethnodemographic and sexual history factors, HRFSD remained significantly positively associated with depressive symptoms (OR 1.85, P<0.001). Analysis of FSFI and ISL domains indicated that depressive symptoms were most directly associated with worse orgasmic function, interference in sex life from stress and lack of partner, and lower general life satisfaction (P<0.05). Interestingly, greater ISL-sexual satisfaction was associated with greater odds of depressive symptoms (OR 1.40, P=0.01).
Depressive symptoms are common in female medical students. HRFSD is associated with depressive symptoms, although the relationship is complex when psychosocial factors are included in the multivariate model. Attention to sexuality factors from student health providers may enhance quality-of-life, academic achievement, and patient care.

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Available from: Benjamin N Breyer, Aug 18, 2015
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    • "Depressive symptoms have been shown to be related to sexual dysfunction in the general population [31] and in large clinical samples [21]. Studies carried out in epileptic patients [32] and patients with obstructive sleep apnea [33] showed that in these medical conditions, depressive symptoms were correlated with sexual dysfunction independent of disease severity. "
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    • "High levels of depressive symptoms were found among all female medical students who participated in our study. The prevalence of depressive symptoms in this study was higher than those reported in previous studies (e.g., 46% of medical students when scores on the CES-D are above 16 in Shindel et al., 2011; 14% of medical students in Bunevicius, Katkute, & Bunevicius, 2008; 25.7% of medical interns in Sen et al., 2010). "
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    • "For example, Shindel et al. report: “Depressive symptoms are common in female medical students.” [16]. There is, however, the possibility that female students were more willing to admit their worries and fears with respect to the questionnaire. "
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