Sexual Activity, Sexual Dysfunction, and Sexual Life Quality Among Psychiatric Hospital Inpatients With Schizophrenia

Abstract

Background Sexual dysfunction occurs commonly in patients with psychiatric illness and may be related to the primary mental disorder, comorbidity with sexual disorders or medical illness, or medications used for mental disorders treatment, but the magnitude of this problem is unknown. Aim To estimate the prevalence of current sexual activity, sexual dysfunction, and sexual attitude and influence of factors on patients with schizophrenia. Methods This study used a cross-sectional design with a total of 317 patients diagnosed with schizophrenia. The subjects completed a demographic questionnaire, sexual attitude scale, sexual dysfunction scale, and sexual behavior scale. Descriptive analysis, difference analysis, and logistic regression model were used to identify relevant variables that may affect sexual life quality. Outcomes Age, sexual satisfaction, and patient symptoms may predict sexual life quality on patients with schizophrenia. Results The mean age of patients was 47.71 ± 9.54 years old. About the sexual activities, 53% of subjects had sexual intercourse experience, and 41.3% reported currently having sexual intercourse. The mean ± SD age for first sexual intercourse was 20.83 ± 5.95 years old (median was 20.0 years old). Moreover, women older than 50 years had significantly higher medians for the Brief Psychiatric Rating Scale (BPRS) score, higher proportions of sexual dysfunction, and lower proportions of feeling important to sexual life quality than men. For participants with age ≤50 years old, there was a significant relationship among BPRS group (mean score >2.5 vs ≤2.5), sexual dysfunction (P < .001), sexual life quality (P < .001), and sexual satisfaction (P = .006). Among the predictors of feeling important to sexual life quality, sexual satisfaction (odds ratio = 7.005, 95% CI = 4.126–11.892, P < .001) and BPRS score (odds ratio = 4.501, 95% CI = 2.042–9.923, P < .001) were significant independent factors after adding the interaction of age group and BPRS group. Clinical Translation This study also reveals the close relationship between sexual satisfaction and BPRS score, which may predict sexual life quality of patients with schizophrenia. Limitations include the possibility of underreporting and bias associated with self-report measurement. Conclusion Sexual life quality and sexual dysfunction on patients with schizophrenia are associated with interaction among psychological, sociological, and biochemical-pharmacological factors.

Romantic relationships, sexuality, and psychotic disorders: A systematic review of recent findings.

“…They also tend to experience greater dysfunction in multiple areas of sexual functioning, exhibiting lower sexual self-esteem, motivation, and satisfaction, and higher sexual anxiety, depression, and fear than women without a psychiatric diagnosis (Huguelet et al, 2015). Women with psychotic disorders also tend to report greater sexual dysfunction and lower levels of sexual interest than their male counterparts (Driscoll, 2010; Incedere & Küçük, 2017; Ma et al, 2018), a finding that might in part be explained by women’s increased exposure to emotional and sexual abuse (Huguelet et al, 2015; Matevosyan, 2010).…”

“…The intimate relationship functioning of people with a psychotic disorder was consistently lower than that of healthy controls and individuals with other psychiatric conditions. Although quality of life may be higher among people with psychotic disorders who are married, marriage and cohabitation rates tend to be low in this population, especially for those with an earlier age of onset (Ma, Chao, Hung, Sung, & Chao, 2018;Nyer et al, 2010;Stewart et al, 2013). Stigma, social withdrawal, and limited social worth may all contribute to this phenomenon (Stewart et al, 2013).…”

Sexual Dysfunction in Drug-Naive or Drug-Free Male Patients with Psychosis: Prevalence and Risk Factors

“…[23] The varying prevalence rates can be explained by the differences in sample selection and assessment criteria. [151617] In contrast to this study which used the DSM-IV TR diagnostic criteria, previous studies used questionnaires to assess sexual functioning. The mechanical use of assessment instruments may have resulted in higher rates, as these often do not take into account the distress and broader personal and social context that are necessary for a contextual diagnosis of sexual dysfunction.…”

Sexuality and Quality of Life in Eastern Taiwan People With Schizophrenia

“…Olfson's study showed that schizophrenic patients with current sexual dysfunction showed signi cantly poorer global QoL and less satisfaction enjoyment in their lives when compared to patients without current sexual dysfunction [6]. Ma's study also points out quality of sexual life and sexual dysfunction on PwS are associated with interactions among psychological, sociological, and biochemical-pharmacological factors [7].…”