The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19: Reliability, Validity, and Factor Structure of the Persian Version

Abstract

Introduction The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) was designed to assess the perceived influence of multiple sclerosis (MS) symptoms on sexual activity and satisfaction. Aims This study aimed to translate and validate the MSISQ-19 in women with MS in Iran. Methods The translation of the original questionnaire was carried out in accordance with a standard forward–backward procedure. Then, a sample of 226 married women with MS completed the questionnaire. Reliability was estimated using Cronbach's alpha coefficient. Concurrent validity was assessed by comparison with the Female Sexual Function Index (FSFI), the Expanded Disability Status Scale (EDSS), and the Beck Depression Inventory-II (BDI-II). The factor structure of the questionnaire was extracted by performing exploratory factor analyses. All patients underwent a full neurologic examination. Main Outcome Measures MSISQ-19 score was the main outcome measure. Results The mean age of participants was 35.77 years (SD = 8.07), with mean disease duration of 1.84 years (SD = 0.79). Cronbach's alpha coefficient was 0.90 for total MSISQ-19 score, with values of 0.85, 0.90, and 0.78 for the subscales assessing primary, secondary, and tertiary sexual dysfunction, respectively. The principal component analysis indicated a three-factor solution, similar to that found in the original validation study, that explained 63.0% of the total variance for women with MS. Scores on the MSISQ-19 and its subscales correlated with scores on the FSFI, EDSS, and BDI-II (all P < 0.01). Conclusion In general, the findings suggest that the MSISQ-19 is a reliable and valid measure of sexual function among Iranian women with MS. However, further studies are needed to establish psychometric properties for male MS patients in Iran.

Systematic review of the prevalence, symptomatology and management options of sexual dysfunction in women with multiple sclerosis

“…Additionally, a study published in 2019 suggests that SD can trigger depression in PwMS . Depression affects desire, arousal and ability to orgasm, a similar observation as in the general population. Depression and anxiety should, therefore, be screened in women reporting SD .…”

The Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ‐15): Validation of the Dutch version in patients with multiple sclerosis and spinal cord injury

“…It is a valid and reliable short version of the MSISQ-19 and consists of 15 items. The MSISQ-15 is divided in three dimensions to allow focus on the specific domain of sexual concerns; primary SD (items 8, 12, 13, 14, 15), secondary SD (items 1, 2, 3, 4, 5), and tertiary SD (items 6,7,9,10,11). Each item is rated on a five-point Likert scale ranging from 0 (never) to 5 (always).…”

“…Tertiary SD refers to the psychological, emotional, social, and cultural aspects of MS that impact sexual function . The original version of the MSISQ was in English and consisted of 19 items and has been translated and validated in the Persian and Portuguese languages . A re‐evaluation in a larger English cohort resulted in a validated 15 item version …”

Factors associated with intimacy and sexuality among young women with multiple sclerosis

“…Each item is rated on a five-point Likert scale ranging from 1 to 5 (1: never; 2: almost never; 3: occasionally; 4: almost always; and 5: always) [ 7 ]. Psychometric properties of the Iranian version of MSISQ-19 are well documented [ 22 ].…”