{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T01:42:56Z","timestamp":1768873376338,"version":"3.49.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82101681"],"award-info":[{"award-number":["82101681"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Training Program of Anhui Medical University","award":["gxgwfx2020025"],"award-info":[{"award-number":["gxgwfx2020025"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sexual dysfunction (SD) and depression are prevalent issues that significantly affect both physical and mental health.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>This study aimed to explore the association between sexual function (SF) and depression in reproductive-aged population and further examine the mediating role of knowledge regarding the effect of sexual dysfunction on fertility (KSDF).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study enrolled a total of 10\u2009761 participants aged 20-40 from 31 regions, including 5259 males and 5502 females, with a median age of 29.0\u00a0years. Basic demographic data were collected initially, followed by clinical data acquisition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>The International Index of Erectile Function 5 (IIEF5), the Premature Ejaculation Diagnostic Tool (PEDT), the Female Sexual Function Index-19 (FSFI-19), the Patient Health Questionnaire-9, and the Disease Knowledge Questionnaire.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study revealed a significant bidirectional association between SF and depression among the population. Specifically, poorer SF was correlated with higher severity of depressive (IIEF5 [\u03b2\u2009=\u2009\u22120.155, P\u2009&amp;lt;\u2009.001], PEDT [\u03b2\u2009=\u20090.311, P\u2009&amp;lt;\u2009.001], and FSFI-19 [\u03b2\u2009=\u2009\u22120.059, P\u2009&amp;lt;\u2009.001]). Conversely, higher severity of depressive was associated with poorer SF (IIEF5 [\u03b2\u2009=\u2009\u22120.202, P\u2009&amp;lt;\u2009.001], PEDT [\u03b2\u2009=\u20090.249, P\u2009&amp;lt;\u2009.001], and FSFI-19 [\u03b2\u2009=\u2009\u22120.191, P\u2009&amp;lt;\u20090.001]). Furthermore, in males, the KSDF mediated the bidirectional associations between SF and depression. Specifically, the mediating proportions were as follows: KSDF mediated 3.00% of the association between IIEF5 and depression, and 2.20% of the association between PEDT and depression; similarly, for the association between depression and SF, KSDF mediated 2.50% of the association between depression and IIEF5 and 2.20% between depression and PEDT. However, no such mediation was observed in females.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>This provides new insights for the clinical management of these issues in the male reproductive-aged population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>These findings suggest that enhancing this knowledge could interrupt bidirectional association between impaired SF and depression in this demographic, potentially alleviating both conditions without requiring additional interventions. However, cross-sectional study design does not allow us to draw corresponding causal conclusions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The current study further demonstrated a significant bidirectional association between SF and depression among the reproductive-aged population, and importantly, the KSDF was found to mediate this association in males.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdaf070","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T19:56:32Z","timestamp":1746042992000},"page":"1053-1061","source":"Crossref","is-referenced-by-count":2,"title":["The mediating role of sexual dysfunction knowledge in the association between sexual function and depression: a large-scale national cross-sectional study in reproductive-aged 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230000,","place":["China"]},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University , Hefei , 230000,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuying","family":"Sheng","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University , Hefei , 230000,","place":["China"]},{"name":"NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University) , Hefei , 230000,","place":["China"]},{"name":"Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People\u2019s Republic of China , Hefei , 230000,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baoyan","family":"Wu","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University , Hefei , 230000,","place":["China"]},{"name":"NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University) , Hefei , 230000,","place":["China"]},{"name":"Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People\u2019s Republic of China , Hefei , 230000,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Yu","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University) , Hefei , 230000,","place":["China"]},{"name":"Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People\u2019s Republic of China , Hefei , 230000,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenyu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Urology, The Fuyang Affiliated Hospital of Anhui Medical University , Fuyang , 236000,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center , Beijing , 100000,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiansheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Anhui Medical University , Hefei , 230000,","place":["China"]},{"name":"Institute of Urology, The First Affiliated Hospital of Anhui Medical University , Hefei , 230000,","place":["China"]},{"name":"Anhui Province Key Laboratory of 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