Evolution of sexual functioning of men through treated and untreated depression

Objectives.- Depression as well as a treatment by antidepressant are factors that may interfere with sexu-ality. Due to this complex relationship between depression, antidepressant and sexuality, it is difficult to incontestably establish the exclusive accountability of a treatment or of a psychiatric disorder on sexual dysfunctions. The main purpose of the SADD (for Sexuality, Anti-Depressant and Depression) study is to evaluate sexual dysfunctions in depressed men treated with antidepressant or not. Methods. - Participants of this transversal, observational study were men aged over 18 years old, suffering from unipolar major depressive disorder and treated by a psychiatrist, with or without antidepres-sant. Assessment of sexual functioning through three times: euthymia (before depression), untreated depression and treated depression if applicable was performed based on the ASEX scale. Results. -Seventy patients were included. Eight percent of euthymic patients presented a sexual dysfunc-tion (average score on the ASEX = 12.4) whereas 56% of untreated patients presented a sexual dysfunction (average total score on the ASEX = 17.7) and 62% (34/55) of patients treated with antidepressant (average total score on ASEX = 18.5) (P < 0.001). Sexual functioning of men receiving treatment is not significantly different to that among men not receiving any antidepressant, even if patients treated with antidepressant reported that they had a better mood than those untreated. Conclusions. - Our results reveal a high prevalence of sexual dysfunction within the framework of major depressive disorder and its treatment and underlines the complex relationship between major depressive disorder, antidepressant and sexuality. (c) 2021 L'Encephale, Paris.