These findings indicate clinically relevant differences exist in the sexual side effect profiles of these selected antipsychotics. These factors should be considered when selecting the most appropriate treatment for outpatients with schizophrenia.

Although much has been done against the stigmatization and discrimination of the mentally ill, fighting stigma remains an essential task for mental health programs and for society. The descriptions summarized in this volume might serve as an inspiration for anti-stigma work and as an indication of potential collaborators in anti-stigma programs.

The prevalence of sexual dysfunction in schizophrenia patients was investigated as part of this large (n = 7655), prospective, international (27 countries) study. Based on patient reports, sexual dysfunction affected approx. 50% of patients and the prevalence of complaints varied significantly between regions (p < 0.0001). The prevalence of sexual dysfunction, as perceived by psychiatrists, also varied significantly across regions (p < 0.0001). Psychiatrists significantly underestimated the presence of impotence/sexual dysfunction (p < 0.0001) and loss of libido (p < 0.0001), compared to reports from patients. The frequency of sexual dysfunction was significantly higher in patients who had been using prolactin-elevating antipsychotics prior to study entry, compared to those who had been treated with prolactin-sparing antipsychotics (patient reports, p = 0.002; psychiatrist perception, p = 0.0004). This study has shown that the prevalence of sexual dysfunction is high in both male and female patients with schizophrenia and frequently underestimated by psychiatrists. Regional variation is evident in both psychiatrist perceptions and patient reports of sexual dysfunction. Given the importance of sexual function to quality of life and treatment compliance, proactive assessment of sexual function is required to optimize schizophrenia management.

Despite inherent diversity in these patients and the health care systems supporting them, there are striking cross-regional similarities in baseline characteristics for most measures. Not all countries are represented; regional comparisons may not be valid outside of the countries studied.