الفهرس 
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Abstract
Depression is a common disorder that can affect overall health and quality of life of those suffering from it, the most common age of onset is 20s and 30s with females affected about twice as often as males, it significantly affects a person’s family and personal relationships, work or school life, sleeping and eating habits, and general health. Sexual dysfunctions are characterized by disturbances in sexual desire and in the psycho physiological changes associated with the sexual response cycle in men and women. Despite increasing demand for clinical services and the potential impact of these disorders on interpersonal relationships and quality of life, epidemiologic data are relatively scarce. Based on the few available community studies, it appears that sexual dysfunctions are highly prevalent in both sexes, ranging from 25% to 63% of women. Lack of sexual knowledge, medical illness, poor physical health, older age, depression and smoking were found to be common significant risk factors for female sexual dysfunction. Some predictors showed variation within the domains. For example, female sexual dysfunction has generally been shown to be age-related. A lot of research studies proposed several theories and mechanisms on how sexual dysfunction and psychiatric disorders are linked. Some researchers suggest that sexual dysfunction can lead to common psychiatric disorders, whereas others have found that psychiatric patients are more prone to sexual dysfunction. The aim of the present study was to evaluate sexual dysfunctions in depressed married premenopausal women and to study mood disorders in married women with primary sexual complain. It is a cross sectional study that was carried out at Tanta University Hospital. Both Neuropsychiatry and Obstetrics and Gynecology departments were the site for the study, during a time interval from April 2019 to the end of March 2021. Participants:- 300 participants were recruited in the study and divided into three groups: group 1: one hundred female patients with major depressive disorders. All patients met DSM 5 diagnostic criteria for Major depressive disorders. group 2: one hundred Female patients with primary sexual complain and/or disorders. All patients of this group were chosen from patients who attended Obstetrics and Gynecology clinic for sexual complaints. group 3: one hundred community female sample Inclusion Criteria: • All patients were married female • Above 18 years • All were premenopausal women Exclusion Criteria: • Postmenopausal women • Pregnant women • Medical diseases that may affect sexual performance e.g. diabetes mellitus, endocrinal disturbances • History of genital tract anomalies or operations • Past history of major psychiatric disorders e. g. Schizophrenia & substance abuse Methods: All subjects of the study were subjected to: • Arabic version of the Female sexual index. • Psychiatric interview by Arabic version of MINI. • Hamilton Depression scale. • Hamilton anxiety scale. • Quality of life assessment. • Modified Fahmy and Sherbiny scale for socioeconomic study. Results Demographic data: The age of participants in this study ranged from 25 to 40 years old in all groups, with no significant difference between these groups (p= 0.168). The duration of marriage ranged from 1 to 22 with no significance difference between groups p= 0.080. There was a significant statistical difference between the studied groups regarding education p= 0.318. Most of participants finished secondary school and university. About occupations, most of participants were housewives and doing manual work or farmers with no significant difference between groups p= 0.698. As regarding number of children it ranged from one to 6 with significant difference between groups p= 0.028. There was no significant difference regarding type of labor in this study p=0.910, there was two types normal delivery and caesarian section, but normal delivery was little more. The same for residence, number of participants who live in rural area more than urban areas, with no significant difference between groups p= 0.685. Quality of life was affected in all domains (physical, psychological, social and environmental domains) in all groups with significant difference between them <0.001.which indicates the great impact of depression and sexual dysfunction on quality of life. Most of patients with major depression did not spontaneously complain from sexual problems and 48% of them reported sexual complaints after direct questions about their sexual life. Among the control group 20% of them reported sexual complaints after asking about detailed sexual history, with significant difference between groups as p = <0.001. Regarding female sexual dysfunction index, Group1 (depressed females) had significantly higher number of patients with low desire (40%), low level of arousal (30%), lubrication (25%), orgasm (36%) and satisfaction (47%) than the other two groups. group 2 had significantly higher number of patients (50%) with pain disorders. According to score of Hamilton depression scale, the mean score of Hamilton depression scale was significantly higher in group 1 than the other two groups (F=18.536, <0.001). But about Hamilton anxiety scale, while patients with major depressive disorder had mild (10%) and moderate (13%) anxiety, women with sexual disorders show mild anxiety in 7 patients and six of the control group show mild anxiety. The difference between the three groups was not significant p= 0.125.