The literature concerning the impact of (a) the schizophrenic illness and (b) the neuroleptic drugs (which are the most commonly employed medications for this disorder) on male sexual behavior is critically reviewed in the light of what is currently known about the interaction of both the schizophrenic illness and the neuroleptic drugs with hormones and neurotransmitters known to play a role in male sexual behavior. The effect of the schizophrenic illness on male sexual behavior is unclear, but there are some indications that chronic, severe schizophrenia may exert detrimental effects on many aspects of male sexual behavior. As for neuroleptic drugs, a wealth of evidence suggests that they have many detrimental effects on male sexual behavior. Nevertheless, since the introduction of these drugs, the reproductive rates of male schizophrenics have increased. The multiplicity of factors involved in the sexual behavior of the schizophrenic patient is emphasized. It is concluded that the sexual behavior of the male schizophrenic provides an important forum for studying the interaction between psychological, sociological and biochemical-pharmacological factors which determine sexual behavior.
In 1972 the World Health Organization organized a cross-cultural five-centre study of depressive disorders. This report is concerned with data collected, after an 11-year follow-up period, in the sample of 110 depressed patients in Montreal, Canada. Eighty-five percent were traced and 59% were interviewed. Of 93 patients, 20 were dead at the follow-up date, 11 by suicide. Fifty-two percent of patients were receiving psychiatric treatment at follow-up, but there was no relation between psychiatric morbidity and treatment-seeking. Moderate or severe impairment of social functioning was present in 32%; in women, a trend linking the presence of social impairment and the time spent in episodes was observed. Of the episodes of psychiatric illness recorded after the index episode, 86% were diagnosed as depressive, 14% as unspecified affective disorder. The mean durations of the index and four subsequent episodes were 10, 11, 7, 11, and 2 months respectively. At least one recurrence after the index episode was reported by 78%, at least four recurrences by 19%. Episodes lasted at least one year in 5%, 4%, 6%, and 6% in the first, second, third and fourth episodes respectively. Sixteen percent were depressed for at least one year and 31% for at least 2 years. There was a marked trend from inpatient to outpatient treatment and from ECT to drug therapy over time. Twenty-two percent reported either moderate or severe problems with alcohol or substance abuse. There was a statistically significant association between the amount of time patients spent in depressive episodes and the number of life events they reported.(ABSTRACT TRUNCATED AT 250 WORDS)
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