Remitted Male Schizophrenia Patients with Sexual Dysfunction

Abstract

Introduction Despite the high prevalence of sexual dysfunction among male schizophrenia patients, there is still a paucity of research on this area. Aims The study aims to determine the prevalence of sexual dysfunction and any association between male patients with schizophrenia in remission and the sociodemographic profile, medication, depression, anxiety, psychopathology of illness, body mass index, and waist circumference. Methods A cross-sectional study with nonprobability sampling method was conducted in a psychiatric outpatient clinic in Taiping Hospital (Perak, Malaysia) over a 7-month period. A total of 111 remitted male schizophrenia patients were recruited. The validated Malay version of the International Index of Erectile Function (Mal-IIEF-15) was administered to the patients and assessed over 4-week duration in the domains of erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Logistic regression analysis was employed. Main Outcome Measures Prevalence and associated factors for sexual dysfunction in each domain are the main outcome measures. Results All five domains of sexual functioning in patients showed a high prevalence of dysfunction ranging from 78.4% to 97.1% with orgasmic dysfunction being the least impaired and intercourse satisfaction the worst impaired. Among the domains, only orgasmic dysfunction was significantly associated with race, i.e., Chinese at lower risk for impairment than the Malays (OR = 0.23; 95% CI: 0.07, 0.76; P = 0.018); education, i.e., patients with education higher than primary level were at higher risk for dysfunction (OR = 6.49; 95% CI: 1.32, 32.05; P = 0.022); and Positive and Negative Syndrome Scale (PANSS)-positive subscale, i.e., higher PANSS-positive score was a protective factor for orgasmic dysfunction (OR = 0.54; 95% CI: 0.33, 0.89; P = 0.015). Conclusions The prevalence of sexual dysfunction was generally high. Malay patients and those with education higher than primary level were at higher risk for orgasmic dysfunction whereas higher PANSS-positive score was protective against the impairment. The high rate of sexual dysfunction in schizophrenia patients warrants a routine inquiry into patients' sexuality and the appropriate problems being addressed.

Sexual dysfunction in Chinese rural patients with schizophrenia

“…The prevalence of sexual dysfunction was higher in females (82.7%), than in males (64.5%), which is consistent with findings reported in other studies (female 45–80% and male 30–80%) [1, 14, 17, 43]. Compared to our study conducted in the city areas of Guangdong using the same assessment tools which showed a prevalence of sexual dysfunction of 80.6% in females and 60.7% in males [44], the prevalence in the rural areas appear slightly higher than in city areas.…”

“…According to a meta analysis, the prevalence of sexual dysfunction reported in Asia countries was lower than western counties [15]. Further, clinicians themselves may be conservative in enquiring about sexual concerns or consider sexual-related complains as insignificant in schizophrenia patients as compared to positive psychotic symptoms [17].…”

“…Being a sensitive issue in Asian countries, especially in rural areas, sexual function is given less attention by both patients and clinicians. Due to cultural barriers, schizophrenia patients may feel uncomfortable in raising their sexual issues and clinicians may be unwilling to discuss sexual problems, fearing that it may interfere with the doctor-patient relationship [12, 17].…”

Sexual dysfunctions in schizophrenia: Beyond antipsychotics. A systematic review

“…When it was possible, the authors were contacted by email in case of missing data. Four teams were contacted (Byerly et al, 2006;Konarzewska et al, 2009;Mahmoud et al, 2012aMahmoud et al, , 2011aOng et al, 2014a). but none of them answered.…”

Sexuality and sexual dysfunctions in older people: a forgotten problem

“…Although there is a paucity of research into this area it has also been suggested that loss of interest in sex in people with schizophrenia is associated with advancing age, female gender, cardiovascular medication, negative symptoms and lower sexual self-efficacy (self-confidence and self-control in sexual experiences) (Bianco 2019). It is not clear whether treatment of the psychotic disorder confers an improvement in dysfunctions: a study of men with schizophrenia in remission still showed high levels of dysfunction (between 78.4 and 97.1%) across five domains of sexual functioning (Kheng Yee 2014). Another aspect of sexuality studied in schizophrenia is risky sexual behaviour, which refers to unprotected sex with risk of unwanted/unintended pregnancy and transmission of sexual diseases.…”