PSSD und Leptin
Pilotstudie zu endokrinologischen und psychiatrischen Auffälligkeiten bei Menschen mit PSSD
PSSD and Leptin
Pilot study on endocrinological and psychiatric abnormalities in people with PSSD
by Franziska Schumacher
Date of Examination:2025-12-15
Date of issue:2025-12-08
Advisor:Prof. Dr. Dirk Wedekind
Referee:Prof. Dr. Dirk Wedekind
Referee:Prof. Dr. Niels Focke
Persistent Address:
http://dx.doi.org/10.53846/goediss-11675
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Abstract
English
This pilot study investigated whether patients with post-SSRI-sexual-dysfunction (PSSD) exhibit abnormal leptin levels and sex hormone parameters. In addition, correlations between PSSD and eating disorders, obsessive-compulsive personality disorder, and hypersexuality were explored. A total of 21 patients who developed sexual dysfunction after taking selective serotonin-reuptake-inhibitors (SSRIs) or selective serotonin-norepinephrine-reuptake-inhibitors (SNRIs) were included in the study. A medical history interview was conducted at the Clinic for Psychiatry and Psychotherapy at Göttingen University Medical Center to diagnose PSSD. All patients underwent a blood count, thyroid-stimulating hormone, albumin, estradiol, luteinizing hormone, follicle-stimulating hormone, sex hormone-binding globulin, testosterone, free testosterone, progesterone, and leptin. Subsequently, the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) for obsessive-compulsive personality disorder was conducted. The participants then independently completed the psychometric tests Beck-Depression-Inventory (BDI)-II, Eating-Disorder-Inventory (EDI)-II, Hypersexual-Behavior-Inventory (HBI), and Compulsive-Sexual-Behavior-Disorder (CSBD)-19-Scale.The results of the groups were evaluated in comparative statistics with regard to various parameters (including age, gender, height, weight, medication, body mass index (BMI), laboratory parameters, psychometric tests) using SPSS software. Parametric tests, such as t-tests for independent samples including Cohen's d and Pearson correlation, and non-parametric methods, such as the chi-square test and Fisher's exact test, were performed. PSSD was diagnosed in 12 of 21 patients (57.14%) and not in nine of 21 patients (42.86%). The participants were divided into two subgroups, PSSD and non-PSSD, and did not differ significantly in terms of gender, age, height, BDI-II, and SSRI/SNRI intake. The parameters weight and BMI were significantly different (weight: t (19) = 2.642; p= .016; BMI: t (19) = 2.869; p= .010). The average leptin level in the PSSD group was below the lower reference value (men: 2.05-5.63 ng/ml; women: 3.63-11.09 ng/ml) and was significantly lower than in the non-PSSD group (t (19) = 3.31; p = .004; d = 1.46). After adjusting the leptin levels for BMI, age, and gender, no significant deviation was found, only a tendency toward lower leptin levels compared to normal values (PSSD: z value: M±SD = -1.01 ± 0.29). The sex hormone levels of the two groups showed no significant differences and were within the normal range, except for an increase in progesterone in 10 subjects. The average total scores of the EDI-II were significantly higher in the non-PSSD group than in the PSSD group (t = .754; Cohen's d = 1.096). The total scores for the SCID-5-PD, HBI, and CSBD were numerically, but not significantly, higher in the PSSD group than in the non-PSSD group. The initial hypothesis of leptin alterations in individuals with PSSD should be further investigated in subsequent studies. Furthermore, a structured collection of testosterone and progesterone data is of interest. Scientific analysis of personality traits and behavioral patterns in individuals with PSSD initially appears less promising. Nevertheless, the differential diagnosis and exclusion of other psychiatric disorders in individuals suspected of having PSSD is of particular importance.
Keywords: PSSD; SSRI; sexual dysfunction; leptin; antidepressants
Schlagwörter: sexuelle Dysfunktion; PSSD; SSRI; sexuelle dysfunction; Leptin; Antidepressiva
