High‐risk sexual behaviours in young people experiencing a first episode of psychosis

Abstract

Aim:The sexual health of adults with schizophrenia is poorer than the general population; however, less is known about young people experiencing a first episode of psychosis (FEP). The aim of this study was to explore the high-risk sexual behaviours and sexual well-being indicators of a cohort of young people with FEP.Methods: Data collected from young people (15-24 years) with FEP attending the EPPIC service in Melbourne and participating in a physical health intervention were analysed. Baseline trial data collected on sexual health and high-risk behaviours, psychiatric symptomology, functioning, and substance use are presented by gender. Associations between symptomology and functioning with sexual behaviour are explored.Results: A total of 69 young people were included in this study; mean age was 19.6 years (SD±2.8), 53.6% were male, 59.6% identified as heterosexual, and 21.7% were currently in a relationship. Within the cohort, 78.3% had ever been sexually active. Of these, 44.2% consistently used a condom at last sex act and 35.7% used barrier contraception consistently, 22.5% had previously been pregnant, and 18.6% had tested positive for an STI. Finally, young people were more likely to have been sexually active if they were currently using substances.Conclusions: These findings suggest that high rates of high-risk sexual behaviour remain an issue for young people experiencing a first episode of psychosis. Promoting sexual well-being and communication skills between sexual partners should be targeted to ensure that high-risk sexual health outcomes are mitigated as early as possible.

Romantic relations, sexuality and intimacy among young adults and adolescents with severe mental illness, intellectual disability and Down syndrome: a review of the literature

“…Numerous research studies have shown that people struggling with severe mental illness and intellectual disability often have unrecognized and unmet needs for intimacy, love and sexuality [10,25,4,18,19,20]. Despite clear evidence indicating that their desires, fantasies and desires for romantic relationships are closely aligned with those of the general population, these needs are often overlooked and remain unaddressed [10,24,15,30].…”

“…As far as serious psychiatric illness is concerned, it is evident that the greatest risk for the onset of risky sexual behaviour occurs for individuals who demonstrate su cient social and personal skills to establish and maintain relationships with others and thus entertain sexual relationships. For this reason, more adolescents and young adults, those subjects, therefore, in whom the psychiatric illness is at its rst onset or, at any rate, not yet chronic [26,25,35,36].…”

Sexual health experiences of women and non-binary people with early psychosis: qualitative study

“…Many themes that emerged around the effects of psychotic symptoms on sexual healthincluding those related to hypersexuality, disinhibition and vulnerability when acutely psychoticare consistent with prior research on sexual health experiences in older individuals with psychosis, 2,4,8 and with prior research in early psychosis. [14][15][16][17][18][19] In particular, our study builds on, in a larger sample, the findings of a British qualitative study (n = 8; three of whom were female) focused specifically on the meaning of relationships for young people with psychosis. 20 They found that relationships were seen as incompatible with psychosis, potentially high risk (e.g.…”

“…However, psychotic disorders typically develop in the late teenage years or early twenties, 13 a key time for exploring sexuality and relationships, and for setting the stage for sexual health across the lifespan. We identified several quantitative studies examining sexual health in early psychosis, with predominantly cisgender male samples; these found elevated rates of higher-risk sexual behaviour such as inconsistent condom use, [14][15][16][17][18] and one found that higher libido was associated with positive symptoms and lower libido was associated with negative symptoms. 19 One qualitative study of young participants (aged 21-31 years) with psychosis was identified, where participants reported significant barriers to romantic relationships.…”

Experiences of Sexual and Reproductive Health Care Access for Women and Nonbinary People With Early Psychosis: Towards an Integrated Perspective of Service Users and Clinicians

“…Youth with psychosis face significant risks during this time including elevated rates of sexually transmitted infections, higher-risk sexual behaviour, and sexual and relationship dysfunction. [12][13][14][15][16][17] However, most research on SRH and psychosis has focused on older populations and most psychosis-specific SRH interventions have not been youth-focused. [18][19][20] Ensuring that young people with psychosis have access to tailored, high-quality SRH care is crucial to improve health trajectories, yet little research has explored SRH care experiences in this population.…”