Sexual Dysfunction in Chronically Medicated Male Inpatients With Schizophrenia: Prevalence, Risk Factors, Clinical Manifestations, and Response to Sexual Arousal.

Dianying Liu,Ning Olivia Zhao,Delong Zhang,Dan Huang,Donghua Huang,Zhongzhen Mao,Hongdong Deng,Meihong Xiu,Lijuan Qiu,Shaohua Liu,Huiyun Guo,Hanjing Emily Wu,Qiumei Miao,Xiangyang Zhang,Wanglin Liu

doi:10.3389/fpsyt.2021.761598

Abstract

BackgroundSexual dysfunction is a common symptom in patients with schizophrenia, especially in chronically medicated patients. However, the relationship between sexual dysfunction and emotional response to sexual arousal in male patients with schizophrenia remains unclear. This study aimed to assess the incidence, risk factors of sexual dysfunction in males, and their clinical correlations to sexual arousal in male patients with schizophrenia in China.MethodsA total of 162 male patients, aged 18–50 years, with schizophrenia were recruited from a psychiatric hospital in Ganzhou. The clinical symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). The Arizona Sexual Experience Scale was utilized to evaluate sexual dysfunction. Erotic images were selected from International Affective Picture System (IAPS). Sixty-eight out of the 162 subjects completed the erotic pictures reactivity task.ResultsOverall, 48 (29.6%) patients were measured as having global sexual dysfunction, 72 (44.4%) patients as having strength of sex drive dysfunction, 51 (31.5%) patients as having sexual arousal dysfunction, 55 (34.0%) patients as having penile erection dysfunction, 60 (37.0%) patients as having reached orgasm dysfunction, and 60 (37.0%) patients as having satisfaction with orgasm dysfunction. The sexual dysfunction patients had significantly higher scores on the negative symptoms of the PANSS. The only important predictor of sexual dysfunction was the severity of PANSS negative factor. The sense of pleasure and arousal post viewing erotic images in the sexual dysfunction group were lower compared to the non-sexual dysfunction group. The sense of pleasure and approach motivation were significantly negatively correlated with the severity of sexual dysfunction.ConclusionsThis study shows that nearly one-third of young and middle-aged chronically medicated male inpatients with schizophrenia suffer from sexual dysfunction. The negative factor of the PANSS can be regarded as the risk factor of sexual dysfunction. Schizophrenia patients with sexual dysfunction experienced lower pleasure and higher avoidance motivation than non-sexual dysfunction patients when exposed to erotic stimuli.

Highlights

Sexual dysfunction is a serious side effect that commonly manifests in patients with chronic schizophrenia [1,2,3]
All subjects met the criteria, as follows: [1] aged 18 years or above, Han Chinese; [2] self-report of heterosexuality; [3] meeting The Diagnostic and Statistical Manual of Mental Disorders IV, Text Revision (DSM-IV-TR) (2000) criteria for schizophrenia, two psychiatrists independently evaluated the mental status of the subjects based on the Structured Clinical Interview for DSM-IV-TR (SCID); [4] adherence to oral second-generation antipsychotics for at least 1 year; [5] be able to understand the requirements and content of the evaluation; [6] no other somatic diseases, such as diseases of the central nervous system, acute, unstable, or life-threatening diseases; [7] normal or corrected-to-normal vision and normal color vision
To the best of our knowledge, this is the first study to investigate the prevalence of sexual dysfunction and its related risk factors among young and middle-aged male Chinese medicated chronic inpatients with schizophrenia, as well as the relationship between sexual dysfunction and the response to erotic pictures

Summary

Introduction

Sexual dysfunction is a serious side effect that commonly manifests in patients with chronic schizophrenia [1,2,3]. Previous studies have shown that the prevalence of global sexual dysfunction in schizophrenia patients ranged from approximately 16% to 96% [4,5,6]. The illness itself and antipsychotic drugs both can lead to sexual dysfunction in schizophrenia patients [3, 5, 7]. The relationship between sexual dysfunction and emotional response to sexual arousal in male patients with schizophrenia remains unclear. This study aimed to assess the incidence, risk factors of sexual dysfunction in males, and their clinical correlations to sexual arousal in male patients with schizophrenia in China

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