Psychometric properties of the Spanish version of the Changes in Sexual Functioning Questionnaire Short-Form (CSFQ-14) in patients with severe mental disorders

Maria Paz Garcia-Portilla, Pilar Alejandra Saiz, Eduardo Fonseca, Susana Al-Halabi, Maria Teresa Bobes-Bascaran, Manuel Arrojo, Antonio Benabarre, Jose Manuel Goikolea, Emilio Sanchez, Fernando Sarramea, Julio Bobes
Journal of Sexual Medicine 2011, 8 (5): 1371-82

INTRODUCTION: Sexual dysfunction in patients with severe mental disorders is often underestimated or overlooked by psychiatrists. A brief and valid self-report instrument for assessing sexual functioning may well contribute to changing this situation.

AIMS: To validate the Short Form of the Changes in Sexual Functioning Questionnaire (CSFQ-14) in Spanish patients with severe mental disorders.

METHODS: Naturalistic, cross-sectional, multicenter, validation study. Eighty-nine patients with schizophrenia and 82 with bipolar disorder were evaluated using the CSFQ-14, the Visual Analogue Scale for Sexual Functioning Satisfaction (VAS-SFS), and the Clinical Global Impression-Severity scales for mental disorders (CGI-S) and for Sexual Dysfunction (CGI-SSD).

MAIN OUTCOME MEASURES: The 14-item Changes in Sexual Functioning Questionnaire.

RESULTS: Internal reliability (Cronbach's alpha) = 0.90. Construct validity = 3 principal components, of which the first, arousal-orgasm, explained 46.4% of the total variance. Convergent validity: Pearson correlation coefficients between CSFQ-14 and VAS-SFS = 0.33 (P < 0.01) and between CSFQ-14 and CGI-SDS = -0.71 (P < 0.01). Discriminant validity: The CSFQ-14 was able to discriminate among patients with no, mild, moderate, and severe sexual dysfunction according to CGI-SDS scores, both in males (P < 0.001) and females (P < 0.001). In males, the area under the curve (AUC) was 0.833 and a cutoff point of 49 provided a sensitivity of 92.9% and a specificity of 59.5%. In females, the AUC was 0.834 and a cutoff point of 43 provided a sensitivity of 91.9% and a specificity of 62.5%.

CONCLUSION: The Spanish version of the CSFQ-14 is a reliable and valid instrument for assessing sexual functioning in patients with severe mental disorders. As a brief, self-rated instrument, the CSFQ-14 scale seems to be appropriate for use in everyday clinical practice as a means of identifying and monitoring changes in sexual functioning.

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