الفهرس 
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Abstract
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any factors can affect Female sexual function (FSD) as biological, hormonal, and psychological factors and can have a significant negative effect on female sexual health and quality of life. Female sexual dysfunction takes different forms, including lack of sexual desire, impaired arousal, inability to achieve orgasm, or pain with sexual activity. Sexual dysfunction may be a lifelong problem or acquired later in life after a period of normal sexual functioning.
Obsessive-compulsive disorder (OCD) is a chronic disabling disorder and presenting with obsessions and/or compulsions. OCD is one of the most disorders affecting the patient‘s quality of life. Obsessions include thoughts, feelings, images and urges. They are illogical, unwanted and incongruent. They waste time and interfere with the normal living, occupational functioning, usual social activities or interpersonal relationships. Unlike obsession, compulsion is a behavior. Although compulsion may be associated with obsessions trying to reduce the anxiety, but does not always lead to reducing anxiety. Anxiety may remain unchanged or even increase. It is conscious and recurrent such as counting, checking, or avoiding.
Sexuality and sexual functioning in OCD has largely been overlooked throughout the 20th century because sexual dysfunction, a common problem in patients with OCD, has
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Summary
mainly been accounted for by the effect of pharmacotherapy on sexual functions. There are conflicting reports in the literature regarding the association between sexual dysfunction and OCD. Lower rate of marriage, sexual intercourse difficulties, and reduced sexual experience in OCD patients may be related to sexual dissatisfaction encountered during the disease process. Sexual dysfunction in patients with OCD has been studied independently or in gender specific studies, most of which were uncontrolled and provided relatively limited evidence about sexual dysfunction in OCD.
The current study was conducted at outpatient clinics of the Institute of Psychiatry, Faculty of Medicine, Ain Shams University to determine the relation between OCD and its symptoms` content and sexual dysfunctions by comparing cases and control group. Also, its other aim was to determine the correlation between severity and duration of OCD symptoms and presence of sexual dysfunctions. 70 females diagnosed with OCD using SCID-I (according to DSM-IV diagnostic criteria) were enrolled in the study according to inclusion and exclusion criteria and 70 matching females as a control group.
The mean age of onset of the cases group was 23.13 5.94 while, the mean of duration of the illness was 6.73 3.09. Also, it was found that 42.86 (n=30) of OCD patients had history of one episode of illness, 44.29 (n= 31) of patients had history of 2 episodes and 12.85 (n=9) of patients had history of more than 2 episodes.
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Regarding history of receiving treatment before it was found that 34.3 (n=24) of patients had history of receiving treatment. 41.4 (n=29) of females with OCD had history of genital mutilation and 31.4 (n=22) of females had history of complete sexual abuse.
Females diagnosed with OCD were screened by YBOCS to determine the content of the obsessions and compulsions and then to assess the severity of symptoms. Cases and control group were subjected to FSFI to assess the sexual functions (total and subscales).
81.4 of OCD patients had sexual dysfunctions, while only 25.7 of females of control group had sexual dysfunctions. In comparison between two groups there was a highly significant statistical difference regarding FSFI total and all subscales except FSFI desire scores.
The study found that sexual obsessions and checking compulsions were more common associated with sexual dysfunctions than other content of obsessions and compulsions. Also, history of genital mutilation and complete sexual abuse had no impact on sexual dysfunction in OCD patients.
It was found that there was no statistical difference between OCD patients with sexual dysfunctions and OCD patients without sexual dysfunctions regarding age of onset,
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history of number of episodes of illness or past history of treatment.
The study proved that there was a significant inverse correlation between severity of OCD and FSFI total scores, lubrication, satisfaction, desire and arousal, while there was no significant correlation regarding orgasm and pain scores. There was a significant correlation between duration of OCD and FSFI total scores, desire, orgasm and lubrication, while there was no significant correlation regarding arousal, satisfaction and pain scores.
Lastly, a weak significant inverse correlation between age of onset of OCD and FSFI desire and lubrication scores in patients‘ group were proven, while there was no significant correlation regarding total, arousal, satisfaction, orgasm and pain scores. There was no statistical difference correlation between number of episodes of OCD and FSFI total, desire, arousal, orgasm, satisfaction, pain and lubrication.
Results from this study confirmed previous researches demonstrating a consistent relationship between sexual dysfunctions and OCD with high levels of sexual function problems in OCD (except sexual desire) as Inanir et al. ( ), Kendurkar and Brinder ( ), Vulink et al. ( ) and Aksaray et al. ( ). Despite the agreement with those studies, there was a difference in the sexual desire subscale with other studies. It could be explained by higher sexual desire
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problems in our society due to cultural pressure on females not to be the initiators of sexual pressure and accepting to decreased sexual desire without complaints.
On the other hand, Freund & Steketee ( ) found that obsessive compulsive patients did not appear to differ from normative samples in sexual history or attitudinal variables. Symptomatology interfered with sexual satisfaction, but sexual dysfunction was relatively uncommon. This difference may be related to the small sample size, not using valid instruments as FSFI and the difference in the definition and criteria for diagnosis of sexual dysfunctions.
This study concluded that sexual dysfunctions in females with obsessive compulsive disorder were more common than healthy females especially (arousal, orgasm, satisfaction, pain and lubrication problems) but not regarding FSFI desire