(P28) unveiling sexual complaints in married couples seeking relationship therapy: an analysis of alternative presenting symptoms

Abstract Background Many Arab couples seek therapy for relationship challenges while concealing underlying sexual issues, leading to a gap in effective intervention. This study aims to identify patterns in these presentations, distinguishing between couples with sexual complaints and those masking these issues as relationship problems. Methods Married couples seeking psychosexual and relationship therapy with at least one partner of Arab descent between June 2022 and June 2024 were included. The assessment tools included a thorough history evaluation, the Gottman Institute questionnaire for couples, the Sexual Health Inventory for Men (SHIM), the Female Sexual Function Index (FSFI), the Sexual Desire Inventory, and the Sexual Interest Questionnaire. Results The study included 40 couples, 32 (80%) presenting with sexual problems and 8 (20%) presenting with relationship challenges. The average duration of marriage was 4.2 ± 4.5 years. The average age was 36.8 ± 6.3 years for men and 33.3 ± 4.9 years for women. All were college graduates. Nineteen couples (47.5%) initially presented together, 8 (20%) husbands alone, and 13 (32.5%) the wives alone. Six couples (15%) had experienced a previous marriage, and 15 couples (37.5%) had previous couple therapy. This study showed a significant difference in the presentation between couples with relationship challenges and those with sexual problems. Couples with relationship challenges were on the brink of divorce (50% vs. 12.5%, p = 0.037), had an ongoing affair (50% vs. 0%, p = 0.001), greater inability to repair after fights (100% vs. 46.9%, p = 0.006) and reported less sexual problems (0% vs. 62.5%, p = 0.002), respectively. However, the most significant underlying issue not initially presented was sexual dissatisfaction (50% vs. 9.4%, p = 0.02). Conclusion Many couples seeking relationship therapy conceal underlying sexual problems, highlighting the need for therapists to identify these hidden issues.