title: [Sexual dysfunction and depression: Validity of a French version of the ASEX scale].
abstract: BACKGROUND
  Since the Beck study (1967), it is well known that sexual dysfunction is particularly prevalent in depressive patients compared to the general population, at 70% and 30% respectively. Depression, psychotropics and antidepressants are responsible for altering sexuality, and patients are considerably affected by these symptoms that dramatically decrease their quality of life. Screening for sexual dysfunctions seems essential, and a scale such as the Arizona Sexual Experience Scale (ASEX) may help practitioners. The English version of this scale was validated in 2000 (McGahuey et al. [9]), and is widely used in scientific research. The aim of this study was to assess the validity of the French version of the ASEX scale.
  
  
  METHODS
  Following authorization from the University of Arizona, the ASEX scale was translated into French by our team at the University hospital of Besançon (France), by the back translation technique, and then checked by a professional translator. ASEX, Mini International Neuropsychiatric Interview (MINI), Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS) were filled out by 37 depressed inpatients, and ASEX and PHQ-9 by 64 controls (hospital employees, residents and students at the University of Besançon), and again one to two weeks later. Bivariate correlations were performed using total ASEX scores to determine the test-retest reliability. Internal consistency of the ASEX scale was assessed using Cronbach's alpha analysis. Analyses of variance (Anova) were performed to determine the validity of the ASEX scale to compare patients to controls for total ASEX score and for individual ASEX item scores. In order to determine whether the ASEX criteria accurately reflect sexual dysfunction (determined by the HDRS rating or self-report), positive and negative predictive value and sensitivity and specificity were measured. To determine how well the total ASEX score differentiates between individuals with sexual dysfunction and those without, a Receiver Operating Characteristic (ROC) analysis was performed. We expected similar results between the French version of the ASEX scale and the original one (McGahuey and al., 2000).
  
  
  RESULTS
  Patients and controls were similar in terms of sex and age. The test-retest reliability was good, and the internal consistency was excellent using Cronbach's alpha analysis (alpha=0.9451). Analyses of variance (Anova) showed strong differences between the two groups, confirming the validity of the ASEX scale to compare patients to controls for total ASEX score and individual ASEX item scores. Positive and negative predictive values were respectively 89.66% (PPV) and 85.33% (NPV). Specificity and sensitivity were respectively 95.31% (Sp) and 70.27% (Se). The ROC analysis showed the area under the curve (AUC=0.8457) and the best ASEX criteria to demonstrate that sexual dysfunction had been correctly identified (total ASEX score ≥ 18).
  
  
  CONCLUSIONS
  This study assessed the validity and reliability of the French version of the ASEX scale. These findings demonstrate the highly acceptable psychometric properties of ASEX in patients with depression.
authors.affiliation: Service de psychiatrie et d'addictologie, CHU de Dijon, 2, rue du Faubourg-Raines, 21000 Dijon, France. Electronic address: malick.briki@chu-dijon.fr.
authors.forename: M
authors.initials: M
authors.lastname: Briki
authors.affiliation: Département de psychiatrie clinique, CHU de Besançon, 25030 Besançon cedex, France; EA 481, laboratoire de neurosciences, université de Franche-Comté, 1, place du Maréchal-Leclerc, 25030 Besançon cedex, France; Inserm centre d'investigation clinique et d'innovation technologique (Inserm CIC-IT808), CHU de Besançon, 25030 Besançon cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Haffen
authors.affiliation: Département de psychiatrie clinique, CHU de Besançon, 25030 Besançon cedex, France; Inserm centre d'investigation clinique et d'innovation technologique (Inserm CIC-IT808), CHU de Besançon, 25030 Besançon cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Monnin
authors.affiliation: Département de psychiatrie clinique, CHU de Besançon, 25030 Besançon cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Tio
authors.affiliation: Département de psychiatrie clinique, CHU de Besançon, 25030 Besançon cedex, France; Inserm centre d'investigation clinique et d'innovation technologique (Inserm CIC-IT808), CHU de Besançon, 25030 Besançon cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Nicolier
authors.affiliation: Département de psychiatrie clinique, CHU de Besançon, 25030 Besançon cedex, France; EA 481, laboratoire de neurosciences, université de Franche-Comté, 1, place du Maréchal-Leclerc, 25030 Besançon cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Sechter
authors.affiliation: Département de psychiatrie clinique, CHU de Besançon, 25030 Besançon cedex, France; EA 481, laboratoire de neurosciences, université de Franche-Comté, 1, place du Maréchal-Leclerc, 25030 Besançon cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Vandel
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D012016:Reference Values; D015203:Reproducibility of Results; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D014175:Translating
chemical_list: D000928:Antidepressive Agents
keywords: ASEX; Depression; Dépression; French validation; Measurement; Psychométrie; Sexual dysfunction; Troubles sexuels; Validation française