Sexual and Relationship Satisfaction among Persons with Young-Onset Parkinson's Disease
Contributed by Wielinski CL, Varpness SC, Erickson-Davis C, Paraschos AJ, and Parashos SA
Journal of Sexual Medicine 2010;7: 1438-1444
Reviewed October 2011
ABSTRACT
Introduction: Parkinson's disease (PD) presents unique personal and social challenges, particularly for those with onset before the age of 50 years.
Aim: The aim of this article is to evaluate sexual and non-sexual aspects of relationship satisfaction among persons with young-onset PD and their partners.
Main Outcome Measures: The main outcome measures were Index of Sexual Satisfaction (ISS) and Golombok-Rust Inventory of Marital State (GRIMS).
Methods: Persons with PD (PWP) and partners who attended the 2005 National Parkinson Foundation Young Onset Network Conference were asked to complete a survey. Each survey included demographics, a clinical history questionnaire, the Beck Depression Inventory (BDI), ISS, and GRIMS.
Results: Sixty PWP (63% men, 85% in a relationship) responded to the survey. Median age was 50 years (range 29-62), with a median age at symptom onset of 43 years (range 17-55). ISS scores indicated clinically significant sexual dissatisfaction in 37%. Relationship dissatisfaction measured by the GRIMS was scored as "poor" or worse in 57%. Depressive symptomatology was severe in 19% and mild in 33%. Sexual dissatisfaction (ISS) correlated with relationship dissatisfaction (GRIMS) (correlation coefficient [CC] = 0.58, P < 0.001). Relationship dissatisfaction (GRIMS) correlated with depressive symptomatology (BDI) (CC = 0.38, P = 0.007). No correlations were found with any demographic or disease characteristics. Thirty-two couples (both the PWP and their partner) completed the surveys. Sexual and relationship dissatisfaction among PWP paralleled that of their partner (ISS: CC = 0.48, P = 0.005; GRIMS: CC = 0.61, P < 0.001). Depressive symptomatology of the PWP correlated with their partners' relationship dissatisfaction (CC = 0.46, P = 0.010).
Conclusions: In this study, sexual and relationship dissatisfaction were prevalent among young-onset PD patients. PD patients were similar to their partners in their level of sexual and relationship dissatisfaction. The degree of dissatisfaction did not correlate with demographics or self-reported disease characteristics. Self-reported depressive symptomatology among PD patients was adversely associated with both their and their partner's relationship satisfaction.
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Review contributed by Gila Bronner, MPH, MSW, CST
Sexual dysfunction (SD) is one of the non-motor manifestations of Parkinson's Disease (PD), often compounded by physical disability, psychological factors and medication effects [1] and contributes to poor quality of life of patients and partners. Wielinski et al. provide information on the effect of PD on sexuality and relationship satisfaction of young-onset persons with PD (PWP).
At the 2005 National Parkinson Foundation's Young Onset Network Conference (Phoenix, Arizona), Wielinski et al. asked PWP and their partners to complete a survey. Because sexual function typically declines with advancing age, they decided to focus on younger patients to provide a clearer insight into the PD-specific aspects of the problem. Previous studies show that when compared to older PD patients, young-onset patients have been found to have worse scores in marital satisfaction scales [2].
The authors found that both sexual and relationship satisfaction were affected among partners of PWP as much as among the PWP themselves. There was also correlation between sexual dissatisfaction and relationship dissatisfaction. In addition, they found that the severity of the depressive symptomatology among PWP had a negative association not only on their own, but also on their partner's relationship satisfaction. Sexual dysfunction was quite prevalent, including difficulty in reaching orgasm, erectile dysfunction, premature ejaculation and vaginal tightness.
We should take into consideration that this study represents a group of less severely affected young-onset PD population, those who could participate in a conference. Given the high prevalence of such problems found in this study, it would be advisable that health care providers take the initiative and proactively inquire about issues of sexual and nonsexual relationship satisfaction. Practical strategies for discussing sexual issues with PWP and their partners have been published [3,4].
References
Bronner G, Royter V, Korczyn AD, Giladi N. Sexual dysfunction in Parkinson's disease. J Sex Marital Ther. 2004; 30(2):95-105
Schrag A, Hovris A, Morley D, Quinn N, Jahanshahi M. Young versus older-onset Parkinson's disease: Impact of disease and psychosocial consequences. Mov Disord 2003;18:1250-6.
Bronner G. Sexual problems in Parkinson's disease: The multidimensional nature of the problem and of the intervention. J Neurol Sci. 2011 Jun 30. [E-pub ahead of print]
Bronner G. Practical strategies for the management of sexual problems in Parkinson's disease. Parkinsonism Relat Disord. 2009;15 Suppl 3:S96-100.
About Gila Bronner, MPH MSW, CST
Gila Bronner, Sex Therapist and Sex Therapy Supervisor, MPH MSW, CST is a certified sex therapist and the director of the Sex Therapy Service (Sexual Medicine Center, Sheba Medical Center, Israel). Since 1984 Gila has trained professionals (physicians, nurses, social workers and health educators) to cope with issues of sexual health promotion, sexual rehabilitation and sex education. She was the sex therapist in the neurologic, psychiatric and cardiologic departments of the Tel-Aviv Medical Center (1997-2003), contributing to a multidisciplinary approach in the promotion of sexual health and treatment of sexual problems. In neurology, she studied the sexual aspects of PD and helped the multidisciplinary staff develop coping skills.
She has served on the Board of Directors, Israeli Family Planning Association (1985-2000) and as President and board member of the Israeli Association of Sex Therapists (2002-2010). She chaired the scientific committee of the European Congress of Sexology (2002), and served on the scientific committee of the World Congress of Sexology (2005, 2007, 2010).
She has also served as co-chair of the MDS Health Professionals (Non-Physicians) webpage.