Pos0043-hpr do coping strategies, illness perceptions and relationship dynamics contribute to sexual dysfunction for women with sjögren’s syndrome?

Background Women with Sjögren’s syndrome (SS) are more likely to experience vaginal dryness, dyspareunia and reduced sexual function than healthy controls 1 . There is limited data investigating relationships with psychosocial influences, such as coping mechanisms, illness perceptions, partners behaviours and relationship satisfaction. Objectives To investigate associations between sexual function and psychosocial parameters in women with SS. Methods Cisgender women aged 18+, diagnosed with SS, were invited to participate in a cross-sectional online survey. Ethical approval and informed consent were obtained. Participants completed the Female Sexual Function Index (FSFI), EULAR Sjӧgren’s Syndrome Patient Reported Index (ESSPRI), NRS scale for vaginal dryness (0-10), Profile of Fatigue and Discomfort (ProFaD), Cognitive Emotion Regulation Questionnaire (CERQ), Brief Illness Perceptions Questionnaire (BIPQ), West-Haven Yale Multidimensional Pain Inventory (WHYMPI – Part II) and Maudsley Marital Questionnaire (MMQ – Marital subscale). Associations between the FSFI and the outcome measures were assessed using Spearman’s correlations. Variables that significantly correlated with FSFI total score were entered into a backward stepwise multiple regression. Results The survey was completed by 98 women (M = 48.13, SD = 13.26), 70.4% were diagnosed as having primary SS (disease duration range = 3 – 348 months); 43.8% were premenopausal and 48% were postmenopausal. Vaginal dryness was reported by 92.9% of participants, and sexual dysfunction was identified in 85.2% (n = 69/81) of cases (<26.55). Participants who were not sexually active in the previous three-month period (n = 17) were excluded from analyses as inactivity may cause a low FSFI score which may be incorrectly construed as sexual dysfunction. Reduced sexual function was significantly associated with increases in age, vaginal dryness, mental fatigue (ProFaD), self-blame, rumination and catastrophising (CERQ), consequences and identity (BIPQ), negative partner responses (WHYMPI) and relationship dissatisfaction (MMQ). Reduced sexual function was also significantly associated with decreases in positive reappraisal and perspective (CERQ), personal control (BIPQ), solicitous responses and distracting responses (WHYMPI) (Table 1). No significant associations were found for disease duration, relationship duration or ESSPRI total. Results from regression analyses indicated that vaginal dryness (β = -.278, p = .004), CERQ positive reappraisal (β = .322, p = .003) and CERQ catastrophising (β = -.277, p = .009) were significantly related to sexual function and explained 42.0% of the variance in total FSFI scores (F(3,72) = 17.394, p < .001). Table 1. Associations between sexual function and psychosocial parameters FSFI total r s p 95% CI (LB, UB) Age (years) -.270 .015 -.467 -.049 Disease duration (months) -.030 .793 -.253 .196 Relationship duration (months) -.180 .119 -.396 .054 VAS Vaginal dryness -.350 .001 -.533 -.136 ESSPRI total -.165 .141 -.376 .062 ProFaD Mental Fatigue -.294 .008 -.486 -.074 CERQ Self-Blame -.264 .017 -.461 -.042 CERQ Rumination -.296 .007 -.488 -.077 CERQ Positive Reappraisal .469 .000 .273 .628 CERQ Perspective .341 .002 .126 .525 CERQ Catastrophising -.499 .000 -.651 -.310 BIPQ Consequences -.237 .033 -.438 -.013 BIPQ Personal Control -.288 .009 -.481 -.068 BIPQ Identity -.294 .008 -.487 -.075 MMQ -.282 .013 -.483 -.054 WHYMPI Negative Responses -.252 .028 -.457 -.021 WHYMPI Solicitous Responses .267 .020 .037 .470 WHYMPI Distracting Responses .311 .006 .085 .506 Note. N = 81. Associations that were not significant are not shown. Conclusion Women with SS using positive coping strategies have better sexual function than those with negative coping strategies. Learning positive coping strategies may be an important line of approach for managing sexual dysfunction in SS. References [1]Priori R, et al. Quality of sexual life in women with primary Sjögren syndrome. J Rheumatol . 2015;42(8): 1427-31. Disclosure of Interests None declared