People with Multiple sclerosis (MS) may experience sexual dysfunction throughout the disease course. Prevalence for sexual dysfunction in MS ranges from 70 to 90 %, higher than in healthy controls (about 50%). Clinicians do not always ask for sexual dysfunction both for the limited timeframe for clinical assessment and the intimate nature of the subject. Hence, the use of self-reported questionnaires would be useful in clinical practice. However, validated scales to assess sexual dysfunction in MS for Italian patients are lacking.
We aimed at validating Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-19) for Italian MS patients.
We included both male and female MS patients. Each patient completed the Italian translation of the MSISQ-19, the Beck Depression Inventory (BDI-II), the Modified Fatigue Impact Scale (MFIS), the State-Trait Anxiety Inventory (STAI-Y) questionnaire, the International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life Module (ICIQ-LUTSqol), the Female Sexual Function Index (FSFI, for female) and the International Index of Erectile Function (IIEF for male). Construct validity for the Italian version of the MSISQ-19 was explored by the exploratory factor analysis and the Cronbach’s alpha coefficient. Test-retest stability and concurrent internal and external validity was examined by Pearson’ correlation coefficients.
We enrolled 369 MS patients (323 female). Mean MSISQ-19 total score was 37.2 ± 15.2 (range 18 - 89) with a sexual dysfunction prevalence of 59% in male MS patients and 41% in female MS patients. Cronbach’s alpha was 0.92 for the MSISQ-19. MSISQ-19 test and retest total scores correlated between each other (r=0.48, p=0.01). MSISQ-19 total score also correlated with primary, secondary and tertiary subscales (p<0.001), with the EDSS (r=0.19, p<0.001) and all other neuropsychological scales.
The Italian Version of the MSISQ-19 showed satisfactory internal consistency and reliability with moderately adequate test-retest reproducibility, suggesting that the Italian MSISQ-19 questionnaire provides a valuable measure of sexual dysfunction in the Italian population.