title: Sexual function in Italian women with systemic sclerosis is affected by disease-related and psychological concerns.
abstract: OBJECTIVE
  In patients with systemic sclerosis (SSc), sexual function is somewhat impaired. Our aim was to evaluate sexual function in women with SSc in comparison to controls, and to investigate the association with sociodemographic and disease characteristics, and physical and psychological variables.
  
  
  METHODS
  Forty-six women with SSc and 46 healthy women were assessed for sociodemographic characteristics and gynecological development and administered the Female Sexual Function Index (FSFI), Medical Outcomes Study Short Form-36 (SF-36), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale, Coping Orientation to Problems Experienced-New Italian Version, and Functional Assessment of Chronic Illness Therapy-Fatigue Scale. Patients were also assessed for disease duration and subset, Female Sexual Function in SSc, Hand Mobility in Scleroderma test (HAMIS), Cochin Hand Functional Disability Scale, Mouth Handicap in Systemic Sclerosis Scale (MHISS), Disability Sexual and Body Esteem Scale (PDSBE); and fist closure, hand opening, and mouth opening.
  
  
  RESULTS
  In patients with SSc, only FSFI desire subscale score was significantly lower (p = 0.035) versus controls. Total FSFI score, similar to controls, was related with Medical Outcomes Study Short Form-36 mental component, HAQ (p = 0.022), MHISS (p = 0.038), and HAMIS (p = 0.037). In SSc, the main factors independently associated with sexual functioning were vaginal dryness [regression coefficient (B) = -0.72; p < 0.001], PDSBE (B = 0.42; p = 0.001), and HADS depression scale (B = -0.23; p = 0.035). Together, these variables explained 70% of the variance in the FSFI total score.
  
  
  CONCLUSIONS
  In SSc, sexual function, although not different from controls, is influenced by specific disease-related and psychological concerns. Thus it should be included in patient evaluations and assessed in daily clinical practice.
authors.affiliation: From the Department of BioMedicine, Division of Rheumatology, Denothe Centre, Careggi Hospital (AOUC), University of Florence; Unit of Geriatric Rehabilitation, ASL 10, Florence, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Maddali Bongi
authors.forename: Angela
authors.initials: A
authors.lastname: Del Rosso
authors.forename: Svetlana
authors.initials: S
authors.lastname: Mikhaylova
authors.forename: Marco
authors.initials: M
authors.lastname: Baccini
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci Cerinic
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D007558:Italy; D007989:Libido / Q000502:physiology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012595:Scleroderma, Systemic / Q000523:psychology*; D012649:Self Concept; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: FEMALE SEXUAL FUNCTION INDEX; QUALITY OF LIFE; SEXUAL ABILITY; SYSTEMIC SCLEROSIS