Sex and relationship dysfunction in neurological disability

OBJECTIVES (1) to ascertain how many people with neurological disability experience sexual or relationship problems; (2) to examine the interplay of neurological disability and sexual function within the context of the dyadic relationship; (3) to consider the implications of the results for service provision. METHODS A survey of outpatients attending Hunters Moor Regional Rehabilitation Centre, Newcastle upon Tyne over a 6 month period. Standardised measures of sexual function and concern, relationship satisfaction, disability, and mental health were used. RESULTS Seventy people were interviewed (18% of the potential study population). Prevalence figures therefore refer to this self selected sample. Fifty one per cent had experienced a change in sexual function and 27% were concerned about this change. Of those in cohabiting relationships 25% were experiencing difficulties. Gender was significantly associated with concern about sexual function, men being more concerned. A high score on the marital adjustment scale indicating relationship dissatisfaction was the best predictor of change in and concern about sexual function. Change in sexual function and duration of illness were the most powerful predictors of relationship dissatisfaction. CONCLUSION If concern is taken as an indication of a desire for help more than one in four of this sample required help for sexual dysfunction. Sexual and relationship functioning were very closely associated and dysfunction in either of these areas was the best predictor of dysfunction in the other area. The dyadic relationship is an important institution in the management of disability. Sexual dysfunction can be predictive of difficulties within a relationship. Any service designed to address sexual health should also address relationship issues.