Frequency of self-reported persistent post-treatment genital hypoesthesia among past antidepressant users: a cross-sectional survey of sexual and gender minority youth in Canada and the US.

IF 3.6 2区医学 Q1 PSYCHIATRY Social Psychiatry and Psychiatric Epidemiology Pub Date : 2024-09-20 DOI:10.1007/s00127-024-02769-0

Yassie Pirani, J Andrés Delgado-Ron, Pedro Marinho, Amit Gupta, Emily Grey, Sarah Watt, Kinnon R MacKinnon, Travis Salway

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Abstract

Purpose: Persistent post-treatment genital hypoesthesia (PPTGH) is a primary symptom of post-SSRI sexual dysfunction (PSSD), an iatrogenic syndrome characterized by enduring sexual dysfunction following the discontinuation of some antidepressants. We aimed to estimate the frequency of PPTGH among past users of psychiatric treatments, particularly antidepressants.

Methods: We used a subsample of UnACoRN, a US/Canada survey of sexual and gender minority youth aged 15 to 29. We included participants with a history of psychiatric drug use. We excluded individuals with genital surgeries or without sexual experience. The analysis involved chi-square tests for initial group comparisons, post hoc tests for multiple comparisons, and logistic regression among those who had stopped taking medication. We exponentiated the regression to estimate the odds of PPTGH by drug type, adjusting for age, sex-assigned-at-birth, hormone treatment, and depression severity in three nested models.

Results: 574 of 2179 survey participants reported genital hypoesthesia. They were older and more likely to report male sex assignment at birth, hormonal therapy history, and psychiatric drug history. The frequency of PPTGH among antidepressant users was 13.2% (93/707) compared to 0.9% (1/102) among users of other medications; adjusted odds ratio: 14.2 (95% CI: 2.92 to 257).

Conclusion: Antidepressant discontinuation is strongly associated with PPTGH in the US and Canada where SSRI/SNRI medications account for 80% of antidepressant prescriptions. We call for standardized international warnings and transparent, informed consent. Future research should expand upon our efforts to estimate the risk of PSSD by including all the proposed diagnostic criteria, including documentation of temporal changes in PSSD-related symptoms before and after treatment (≥3 months).

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曾经使用过抗抑郁药的人自述治疗后持续性生殖器麻木的频率：一项针对加拿大和美国性少数群体和性别少数群体青年的横断面调查。

目的：治疗后持续性生殖器感觉减退（PPTGH）是SSRI后性功能障碍（PSSD）的主要症状，PSSD是一种先天性综合征，其特点是停用某些抗抑郁药后出现持久性功能障碍。我们的目的是估算精神病治疗（尤其是抗抑郁药）既往使用者出现 PPTGH 的频率：我们使用了 UnACoRN 的子样本，这是一项针对美国/加拿大 15 至 29 岁的性少数群体和性别少数群体青年的调查。我们纳入了有精神科药物使用史的参与者。我们排除了进行过生殖器手术或没有性经验的人。分析方法包括对初始分组比较进行卡方检验，对多重比较进行事后检验，以及对停药者进行逻辑回归。我们在三个嵌套模型中对年龄、出生时性别、激素治疗和抑郁严重程度进行了调整，并对回归结果进行了指数化处理，以估算不同药物类型导致 PPTGH 的几率：2179名调查参与者中有574人报告了生殖器感觉减退。结果发现：2179 名调查对象中有 574 人报告了生殖器感觉减退，他们的年龄较大，更有可能报告出生时性别为男性、激素治疗史和精神病药物史。使用抗抑郁药的患者发生 PPTGH 的频率为 13.2%（93/707），而使用其他药物的患者发生 PPTGH 的频率为 0.9%（1/102）；调整后的几率比：14.2（95% CI：2.92 至 257）：结论：在美国和加拿大，SSRI/SNRI药物占抗抑郁药物处方的80%，因此抗抑郁药物的停用与PPTGH密切相关。我们呼吁制定标准化的国际警告和透明的知情同意书。未来的研究应通过纳入所有建议的诊断标准，包括记录治疗前后（≥3 个月）PSSD 相关症状的时间变化，来扩大我们估算 PSSD 风险的工作。

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来源期刊

Social Psychiatry and Psychiatric Epidemiology 医学-精神病学

CiteScore

8.50

自引率

2.30%

发文量

184

审稿时长

3-6 weeks

期刊介绍： Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic. In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation. Both original work and review articles may be submitted.