PSSD studies and depression/anxiety among the exclusion criteria

General discussions. Feel free to use this like a support group also.
User avatar
anacleta
Posts: 695
Joined: Fri Jan 23, 2015 5:47 am
Contact:

PSSD studies and depression/anxiety among the exclusion criteria

Unread post by anacleta »

Some authors who have conducted and are conducting survey studies on PSSD to determine its existence and prevalence put depression/anxiety among the exclusion criteria.

If you are depressed/anxious, this may be causing the symptoms you complain about, so you are out of the "valid" sample of PSSD patients.

On the one hand this is understandable because from an external and scientific point of view it is well known that depression/anxiety often causes sexual problems such as low libido and erectile dysfunction, and the intent of such studies anyway is to say: Do you see? PSSD exists independently from depression/anxiety!

On the other hand, skeptical doctors and psychiatrists in bad faith take the opportunity to say: Do you see? Out of 100 patients who complain of PSSD almost all do not really suffer from it! So it is very unlikely that YOU are suffering from it, it is much more likely that you are depressed or influenced.

This also leads to a drastic reduction in the prevalence of PSSD in the initial patient sample.

It is absurd and paradoxical to exclude from the sample all the people who are depressed after a serotonergic! Rather, a high probability of being depressed in conjunction with PSSD should be assumed without this interfering with the possibility of PSSD, both because many people have received an SRI antidepressant specifically for depressive/mental problems, which in many cases are chronic, and because PSSD ruins your life, the last straw would be not to get depressed or worry.

Unfortunately, currently not having measurable biological evidence leads to these criteria being unfavorable to the recognition of many (perhaps the majority) cases.

But it is too complicated to give more value to the answer to the question: "Did you suffer from these sexual symptoms before the treatment?" and investigate which symptomatology for each case, before excluding categories of patients from the considered sample?

Don't they trust you if you say you didn't suffer from it before the drug or if you say you lost sensation in your genitals? If you say you are depressed, however, they immediately trust you!


Study examples that applied these exclusion criteria (there may have been others both among those concluded and among those in progress):

- Post-SSRI Sexual Dysfunction: Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Response Relationship (2015)
- Estimating the risk of irreversible post-SSRI sexual dysfunction (PSSD) due to serotonergic antidepressants (2023)
Numby
Posts: 152
Joined: Tue Sep 19, 2017 11:55 am
Location: Germany
Contact:

Re: PSSD studies and depression/anxiety among the exclusion criteria

Unread post by Numby »

In the 2015 study, the authors didn’t exclude people suffering from anxiety or depression. They defined individuals suffering from anxiety or depression as a „possible case“, not a non-case. That’s a major difference.
TABLE 1. Criteria for Case Probability Categories
Noncase
One or more of the criteria for a possible case are not met (see below)
Possible case
All of the following:
(1) Treatment-emergent sexual dysfunction while taking one antidepressant of the SSRI or SNRI class
(2) As the above treatment-emergent sexual dysfunction appeared, the patient was not taking any additional medications
(3) The patient reported no pretreatment sexual dysfunction
(4) The antidepressant was discontinued at least 1 month before
the survey
(5) Sexual dysfunction persisted despite drug discontinuation, as
indicated by subject's ASEX scores High-probability case
All the above criteria for possible case plus all the following:
(6) Subject is younger than 50 years old
(7) Current medical conditions reported by the subject did not
include conditions associated with sexual dysfunction
(8) Current medications reported by the subject did not include medications associated with sexual dysfunction
(9) The subject did not report use of addictive substances that may cause sexual dysfunction
(10) Subject's HADS-Depression score is within normal range (0–7)
(11) Subjects' HADS-Anxiety score is within normal range (0-7)
What is more important is the following finding:
It is important to note, however, that genital anesthesia did not correlate with either depression (when controlled for ASEX score) or anxiety severity in any of the samples in our study (totaling in 532 subjects), raising doubt about a psychogenic etiology.
vk13
Posts: 26
Joined: Thu Jul 07, 2022 11:19 am
Contact:

Re: PSSD studies and depression/anxiety among the exclusion criteria

Unread post by vk13 »

Sexual dysfunction its complicated and can happen due to many reasons. There are many people who suffer from some sexual dysfunction who never touched any drug or medication. As for pssd and every disease there must be some exclusion criteria, its making sense then.. Imagine saying for example that someone eat spaghetti with ginger and his gut microbiata got destroyed ...can this happen?? Maybe but we have to exclude many many other etiologies first. Same for pssd we have to make some exclusions and not put as pssd case some who experience only low libido or ed for example... But on the other hand genital anesthesia and pleasureless orgasms cant be related to other etiologies easy... these are core symptoms of pssd...Thats why the genital numbness and gen. anesthesia are the no1 diagnostic symptom for pssd. Having this and some other symptoms it is making sense to be an obvious pssd case.
BlackCat
Posts: 59
Joined: Thu Jan 02, 2020 11:34 am
Location: https://poslovice.org/
Contact:

Re: PSSD studies and depression/anxiety among the exclusion criteria

Unread post by BlackCat »

I have personally known depressed people who masturbate 5 times a day. It is totally possible and quite common that people are both horny and depressed. PSSD is something else entirely.
User avatar
anacleta
Posts: 695
Joined: Fri Jan 23, 2015 5:47 am
Contact:

Re: PSSD studies and depression/anxiety among the exclusion criteria

Unread post by anacleta »

Depressed people who have "sexual dysfunction" are used to say, I don't give a damn about sex. Low libido.
Anxious people may recognize that they have erectile dysfunction due to performance anxiety; they usually function quietly in solitary.
The obsessed and autosuggested that they cannot function often express doubt themselves about the causes.
If someone says flat out that with even his worst depression it worked perfectly, he had sexuality that had grown with him/her, the arousal response was like an unconditioned reflex that occurred spontaneously at the first visual stimulus or touch, and then it was all natural escalation of arousal and pleasure with stimulation to orgasm, and all of this horribly failed coincidentally with the drug/withdrawal, at which point the specialist who still has doubts is either in bad faith or unwilling to get busy.

I haven't read the whole thing, but the last study on the prevalence of PSSD being retrospective could not give room for people's direct word so every possible correlation was used as an exclusion criterion.
https://annals-general-psychiatry.biome ... 23-00447-0
While this confirms that there is a risk of PSSD, it underestimates it.
In questionnaire survey studies on pssd, on the other hand, delegitimizing "cases" because they report depression etc. instead of delving deeper to discern the what/when is just missing the mark.

The questionnaire from the University of Rome Tor Vergata, someone told me, includes many questions about depression etc. but there are not the more specific questions to discern pssd, primarily: What symptoms? Were you suffering from such symptoms before the drug/withdrawal? This does not bode too well.
https://www.reddit.com/r/PSSD/comments/ ... _research/

On the other hand, since many cases of post ssri syndrome also present with new emotional dysfunction, as well as depressive and anxious growth consequent to the iatrogenic problem, maybe they think: okay it was the drug that caused it, messed up your chemistry, but you are now depressed in a new way, and the sexual dysfunction is nothing more than a symptom of this new condition you are in. So, psychoactive treatments might benefit you. Maybe that makes sense for some cases? Not for those like mine, with only sexual/genital dysfunction and no anhedonia or emotional blunting.
Post Reply

Who is online

Users browsing this forum: No registered users and 8 guests