Background: Sexual dysfunction is sexual complaints or disorders. There are various causes, but the onset leads to deterioration of relationships and quality of life with partners. There is still a deep-rooted awareness that sexuality is a secret in Japan. Aim: This study aims to clarify the relationship between female sexual function and depression or anxiety. Method: Four hundred and fifty-eight Japanese healthy women who worked in four randomly selected medical institutions in Okinawa Prefecture in Japan from March to May 2012 were asked to agree to a consent form of their own free will and participate in self-reported questionnaires. For their evaluation, the Female Sexual Function Index (FSFI; Rosen et al. 2000, which includes the six domains of desire, arousal, lubrication, orgasm, pain, and satisfaction) and the Kessler Psychological Distress Scale (K6; Kessler, 2002, which includes the following six items: felt nervous, hopeless, restless or fidgety, worthless, depressed, and felt that everything was an effort) was used. Moreover, participants’ characteristics showed age, marriage, menopause, annual income, and drinking. In addition, JMP16.2 and R 4.2.0 was used to perform Pearson’s chi-square test, Fisher’s exact test, Mann-Whitney U test, Kruskal-Wallis test, Steel-Dwass test, Spearman’s Rank-Order Correlation, and Cronbach’s alpha. This study was approved by the university and the medical institutional review board (IRB). Results: 178 women were included in the final analysis, and the median (IQR, interquartile range) was 39 (32 - 48) years old, and the mean ± SD (standard deviation) was 40.2 ± 10.4 years old. The median (IQR) and mean ± SD of FSFI Total Score were 22.0 (9.3 - 26.6) and 19.2 ± 9.6. The median (IQR) and the mean ± SD of K6 Total Score were 3 (0 - 7) and 4.2 ± 4.5. 16% of all women with a K6 Total Score of 10 and more, and 5% of all women with a K6 Total Score of 13 and more considered a serious mental illness. There was no clear association between female sexual function and depression or anxiety in all health worker participants between FSFI Total Score and K6 Total Score by Spearman’s Rank-Order Correlation Coefficient (ρ). However, there was a moderate correlation between the K6 Total Score and the FSFI Total Score in health worker participants with a K6 Total Score of 11 or more (n =19, ρ =
References
[1]
Basson, R., Berman, J., Burnett, A., Derogatis, L., Ferguson, D., Fourcroy, J., Goldstein, I., Graziottin, A., Heiman, J., Laan, E., Leiblum, S., Padma-Nathan, H., Rosen, R., Segraves, K., Segraves, R.T., Shabsigh, R., Sipski, M., Wagner, G. and Whipple, B. (2000) Report of the International Consensus Development Conference on Female Sexual Dysfunction: Definitions and Classifications. The Journal of Urology, 163, 888-893. https://doi.org/10.1016/S0022-5347(05)67828-7
[2]
Jha, S. and Thakar, R. (2010) Female Sexual Dysfunction. The European Journal of Obstetrics & Gynecology and Reproductive Biology, 153, 117-123. https://doi.org/10.1016/j.ejogrb.2010.06.010
[3]
UpToDate; Overview of Sexual Dysfunction in Females: Epidemiology, Risk Factors, and Evaluation. https://www.uptodate.com/contents/overview-of-sexual-dysfunction-in-females-epidemiology-risk-factors-and-evaluation
[4]
Shifren, J.L., Monz, B.U., Russo, P.A., Segreti, A. and Johannes, C.B. (2008) Sexual Problems and Distress in United States Women: Prevalence and Correlates. Obstetrics & Gynecology, 112, 970-978. https://doi.org/10.1097/AOG.0b013e3181898cdb
[5]
Laumann, E.O., Paik, A. and Rosen, R.C. (1999) Sexual Dysfunction in the United States: Prevalence and Predictors. JAMA, 281, 537-544. https://doi.org/10.1001/jama.281.6.537
[6]
Fugl-Meyer, K.S., Arrhult, H., Pharmanson, H., Bäckman, A.C., Fugl-Meyer, A.M. and Fugl-Meyer, A.R. (2004) A Swedish Telephone Help-Line for Sexual Problems: a 5-Year Survey. The Journal of Sexual Medicine, 1, 278-283. https://pubmed.ncbi.nlm.nih.gov/16422957 https://doi.org/10.1111/j.1743-6109.04040.x
[7]
Laumann, E.O., Nicolosi, A., Glasser, D.B., Paik, A., Gingell, C., Moreira, E., Wang, T. and GSSAB Investigators’ Group (2005) Sexual Problems among Women and Men Aged 40-80 y: Prevalence and Correlates Identified in the Global Study of Sexual Attitudes and Behaviors. International Journal of Impotence Research, 17, 39-57. https://doi.org/10.1038/sj.ijir.3901250
[8]
Zhang, C., Tong, J., Zhu, L., Zhang, L., Xu, T., Lang, J. and Xie, Y. (2017) A Population-Based Epidemiologic Study of Female Sexual Dysfunction Risk in Mainland China: Prevalence and Predictors. The Journal of Sexual Medicine, 14, 1348-1356. https://doi.org/10.1016/j.jsxm.2017.08.012
[9]
NIMH, National Institute of Mental Health. Mental Health Information, Depression. https://www.nimh.nih.gov/health/topics/depression
[10]
OECD, Organisation for Economic Cooperation and Development. Tackling Coronavirus (COVID-19): Contributing to a Global Effort, Tackling the Mental Health Impact of the COVID-19 Crisis: An Integrated, Whole-of-Society Response. https://www.oecd.org/coronavirus/policy-responses/tackling-the-mental-health-impact-of-the-covid-19-crisis-an-integrated-whole-of-society-response-0ccafa0b
[11]
Hartmann, U. (2007) Depression and Sexual Dysfunction. The Journal of Men’s Health & Gender, 4, 18-25. https://doi.org/10.1016/j.jmhg.2006.12.003
[12]
Sreelakshmy, K., Velayudhan, R., Kuriakose, D. and Nair, R. (2017) Sexual Dysfunction in Females with Depression: A Cross-Sectional Study, Trends Psychiatry Psychother, 39, 106-109. https://doi.org/10.1590/2237-6089-2016-0072
[13]
Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., Ferguson, D. and D’Agostino, R. (2000) Female Sexual Function Index (FSFI). The Female Sexual Function Index (FSFI): A Multidimensional Self-Report Instrument for the Assessment of Female Sexual Function. Journal of Sex & Marital Therapy, 26, 191-208. https://doi.org/10.1080/009262300278597
[14]
Meston, C.M. (2003) Validation of the Female Sexual Function Index (FSFI) in Women with Female Orgasmic Disorder and in Women with Hypoactive Sexual Desire Disorder. Journal of Sex & Marital Therapy, 29, 39-46. https://doi.org/10.1080/713847100
[15]
Kessler, R.C. andrews, G., Colpe, L.J., Hiripi, E., Mroczek, D.K., Normand, S.-L.T., Walters, E.E. and Zaslavsky, A.M. (2002) Short Screening Scales to Monitor Population Prevalences and Trends in Non-Specific Psychological Distress. Psychological Medicine, 32, 959-976. https://doi.org/10.1017/S0033291702006074
[16]
Furukawa, T.A., Kessler, R.C., Slade, T. and Andrews, G. (2003) The Performance of the K6 and K10 Screening Scales for Psychological Distress in the Australian National Survey of Mental Health and Well-Being. Psychological Medicine, 33, 357-362. https://doi.org/10.1017/S0033291702006700
[17]
Furukawa, T.A., Kawakami, N., Saitoh, M., Ono, Y., Nakane, Y., Nakamura, Y., Tachimori, H., Iwata, N., Uda, H., Nakane, H., Watanabe, M., Naganuma, Y., Hata, Y., Kobayashi, M., Miyake, Y., Takeshima, T. and Kikkawa, T. (2008) The Performance of the Japanese Version of the K6 and K10 in the World Mental Health Survey Japan. The International Journal of Methods in Psychiatric Research, 17, 152-158. https://doi.org/10.1002/mpr.257
[18]
Kessler, R.C., Green, J.G., Gruber, M.J., Sampson, N.A., Bromet, E., Cuitan, M., Furukawa, T.A., Gureje, O., Hinkov, H., Hu, C.Y., Lara, C., Lee, S., Mneimneh, Z., Myer, L., Oakley-Browne, M., Posada-Villa, J., Sagar, R., Viana, M.C. and Zaslavsky, A.M. (2010) Screening for Serious Mental Illness in the General Population with the K6 Screening Scale: Results from the WHO World Mental Health (WMH) Survey Initiative. The International Journal of Methods in Psychiatric Research, 19, 4-22. https://doi.org/10.1002/mpr.310
[19]
Wiegel, M., Meston, C. and Rosen, R. (2021) The Female Sexual Function Index (FSFI): Cross-Validation and Development of Clinical Cutoff Scores. Journal of Sex and Marital Therapy, 31, 1-20. https://doi.org/10.1080/00926230590475206
[20]
Okumura, K., Takeda, H., Isobe, Y., Takeuchi, N., Hirabayashi, S. and Otani, T. (2020) Internet Survey on the Sexual Function of Japanese Women Using the Female Sexual Function Index (Japanese Version) in 2012. Japan Journal of Sexology, 38, 43-54. https://ci.nii.ac.jp/naid/40022378706/en
[21]
Okumura, K., Takeda, H. and Otani, T. (2021) Evaluation of Temporal Changes in the Sexual Function among Japanese Women Using the Female Sexual Function Index: An Internet Survey. Women’s Health (London, England), 17, 1-9. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8058786 https://doi.org/10.1177/17455065211009103
[22]
Araki, C. (2020) Sexuality of Middle-Aged and Older Adults: What We Have Learned from Previous Research. Journal of Japanese Society of Geriatric & Gerontological Behavioral Sciences, 25, 2-24. https://www.jstage.jst.go.jp/article/jsbse/25/0/25_2/_article/-char/en
[23]
Oshiio, T. (2014) Mental Health among Middle-aged and Older Adults: Evidence from a Nationwide Panel Survey in Japan. The Economic Review, 65, 332-344.
[24]
Mizuta, A., Furuyama, H., Yamaguchi, H. and Tatsumi, A. (2015) The Relationship between Teachers’ Busyness, Mutual Benefit and Trust between Teachers, and Mental Health. Tokai Journal of Public Health, 3, 67-72. https://www.jstage.jst.go.jp/article/tpha/3/1/3_67/_article/-char/ja/ https://cir.nii.ac.jp/crid/1390564238049280896?lang=en
[25]
National Institute of Health and Nutrition. Health Japan 21 (the Second Term), List of Target, Mental Health, Table 3. https://www.nibiohn.go.jp/eiken/kenkounippon21/en/kenkounippon21/mokuhyou.html#Table03
[26]
National Institute of Health and Nutrition. Health Japan 21 (the Second Term), Annual Changes in Current Data, Mental Health, Table 3. https://www.nibiohn.go.jp/eiken/kenkounippon21/en/kenkounippon21/genjouchi.html#Table03
[27]
NIMH. One Year In: COVID-19 and Mental Health, April 9, 2021. https://www.nimh.nih.gov/about/director/messages/2021/one-year-in-covid-19-and-mental-health
[28]
Awano, N., Oyama, N., Akiyama, K., Inomata, M., Kuse, N., Tone, M., Takada, K., Muto, Y., Fujimoto, K., Akagi, Y., Mawatari, M., Ueda, A., Kawakami, J., Komatsu, J. and Izumo, T. (2020) Anxiety, Depression, and Resilience of Healthcare Workers in Japan during the Coronavirus Disease 2019 Outbreak. Internal Medicine, 59, 2693-2699. https://doi.org/10.2169/internalmedicine.5694-20
[29]
Reddy, R.M., Saravanan, R.A., Praharaj, S.K. and Thirunavukarasu, M. (2020) Sexual Dysfunction in Women with Depression: A Hospital-Based Cross-Sectional Comparative Study. Indian Journal of Psychological Medicine, 42, 46-51. https://doi.org/10.4103/IJPSYM.IJPSYM_321_19
[30]
Schmitz, N., Lesage, A. and Wang, J. (2009) Should Psychological Distress Screening in the Community Account for Self-Perceived Health Status? Canadian Journal of Psychiatry, 54, 526-533. https://doi.org/10.1177/070674370905400805
[31]
Sakurai, K., Nishi, A., Kondo, K., Yanagida, K. and Kawakami, N. (2011) Screening Performance of K6/K10 and Other Screening Instruments for Mood and Anxiety Disorders in Japan. Psychiatry and Clinical Neurosciences, 65, 434-441. https://doi.org/10.1111/j.1440-1819.2011.02236.x
[32]
Kikuchi, H., Takamiya, T., Odagiri, Y., Ohya, Y., Shimomitsu, T. and Inoue, S. (2013) Mental Illness and a High-Risk, Elderly Japanese Population: Characteristic Differences Related to Gender and Residential Location. Psychogeriatrics, 13, 229-236. https://doi.org/10.1111/psyg.12026
[33]
Horikoshi, N., Iwasa, H., Kawakami, N., Suzuki, Y. and Yasumura, S. (2016) Residence-Related Factors and Psychological Distress among Evacuees after the Fukushima Daiichi Nuclear Power Plant Accident: A Cross-Sectional Study. BMC Psychiatry, 16, Article No. 420. https://doi.org/10.1186/s12888-016-1134-9
[34]
Miyaki, K., Song, Y., Htun, N.C., Tsutsumi, A., Hashimoto, H., Kawakami, N., Takahashi, M., Shimazu, A., Inoue, A., Kurioka, S. and Shimbo, T. (2012) Folate Intake and Depressive Symptoms in Japanese Workers Considering SES and Job Stress Factors: J-HOPE Study. BMC Psychiatry, 12, Article No. 33. https://doi.org/10.1186/1471-244X-12-33
[35]
Hajebi, A., Motevalian, A., Amin-Esmaeili, M., Rahimi-Movaghar, A., Sharifi, V., Hoseini, L., Shadloo, B. and Mojtabai, R. (2018) Adaptation and Validation of Short Scales for Assessment of Psychological Distress in Iran: The Persian K10 and K6. The International Journal of Methods in Psychiatric Research, 27, e1726. https://doi.org/10.1002/mpr.1726
[36]
Chowdhary, N. and Patel, V. (2010) Detection of Common Mental Disorder and Alcohol Use Disorders in HIV Infected People: A Validation Study in Goa, India. Asian Journal of Psychiatry, 3, 130-133. https://doi.org/10.1016/j.ajp.2010.08.002
[37]
Fushimi, M., Saito, S., Shimizu, T., Kudo, Y., Seki, M. and Murata, K. (2012) Prevalence of Psychological Distress, as Measured by the Kessler 6 (K6), and Related Factors in Japanese Employees. Community Mental Health Journal, 48, 328-335. https://doi.org/10.1007/s10597-011-9416-7
[38]
Min, J.W. and Lee, S.H. (2015) Validation of the K6/K10 Scales of Psychological Distress and Their Optimal Cutoff Scores for Older Koreans. The International Journal of Aging and Human Development, 80, 264-282. https://doi.org/10.1177/0091415015590316
[39]
Peiper, N., Clayton, R., Wilson, R. and Illback, R. (2015) The Performance of the K6 Scale in a Large School Sample. Psychological Assessment, 27, 228-238. https://doi.org/10.1037/pas0000025
[40]
Prochaska, J.J., Sung, H.Y., Max, W., Shi, Y. and Ong, M. (2012) Validity Study of the K6 Scale as a Measure of Moderate Mental Distress Based on Mental Health Treatment Need and Utilization. The International Journal of Methods in Psychiatric Research, 21, 88-97. https://doi.org/10.1002/mpr.1349
[41]
Shikimoto, R., Sado, M., Ninomiya, A., Yoshimura, K., Ikeda, B., Baba, T. and Mimura, M. (2018) Predictive Factors Associated with Psychological Distress of Caregivers of People with Dementia in Japan: A Cross-Sectional Study. International Psychogeriatrics, 30, 1089-1098. https://doi.org/10.1017/S1041610217002289
[42]
Hamazaki, K., Harauma, A., Otaka, Y., Moriguchi, T. and Inadera, H. (2016) Serum N-3 Polyunsaturated Fatty Acids and Psychological Distress in Early Pregnancy: Adjunct Study of Japan Environment and Children’s Study. Translational Psychiatry, 6, e737. https://doi.org/10.1038/tp.2016.2
[43]
Mujawar, S., Chaudhury, S. and Saldanha, D. (2019) Sexual Dysfunction in Women with Depressive Disorder: A Prospective, Hospital Based Study. Journal of Psychosexual Health, 1, 129-139. https://doi.org/10.1177/2631831819862415
[44]
Kawakami, N., Thi Thu Tran, T., Watanabe, K., Imamura, K., Thanh Nguyen, H., Sasaki, N., Kuribayashi, K., Sakuraya, A., et al. (2020) Internal Consistency Reliability, Construct Validity, and Item Response Characteristics of the Kessler 6 Scale among Hospital Nurses in Vietnam. PLoS ONE, 15, e0233119. https://doi.org/10.1371/journal.pone.0233119
