Male Sexual Dysfunction and Quality of Life in Schizophrenia

Olfson, Mark; Uttaro, Thomas; Carson, William H.; Tafesse, Eskinder

doi:10.4088/jcp.v66n0309

Cited by 133 publications

(109 citation statements)

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“…Unlike the more traditional and lengthy scales for assessing sexual dysfunctions, the ASEX can be completed in approximately 5 minutes 27 , it is a brief 5-item questionnaire designed to measure sexual functioning in the following domains: sexual drive, arousal, penile erection/vaginal lubrification, ability to reach orgasm, and satisfaction with orgasm over the past week 25 . The frequency of sexual dysfunctions was very high, a finding consistent with previous studies conducted in different countries 6,11,15,[32][33][34][35] . Females had a much higher rate (79.2%) than males (33.3%).…”

Section: Discussionsupporting

confidence: 80%

“…Although new second-generation antipsychotics were expected to be associated with a lower incidence of sexual dysfunction as compared with first-generation antipsychotic medications [37][38][39][40][41][42][43][44] , other studies have not confirmed these findings 6,15,22,30 . Increased prolactin levels are believed to play a major role in sexually induced side effects, but the underlying mechanism of antipsychotic agent-induced sexual dysfunction remains poorly understood 45 .…”

Section: Discussionmentioning

confidence: 54%

“…Antipsychotics can cause sexual dysfunction through multiple mechanisms, including sedation, hyperprolactinaemia (wich can cause sexual dysfunction directly and indirectly by causing secondary hypogonadism) and antagonism of a-adrenergic, dopaminergic, histaminic and muscarinic receptors 2 . Moreover, there are many other factors that may cause sexual problems for patients with schizophrenia, including concomitant medications, the effect of the disease itself, comorbidity with other psychiatric disorders and various endocrine, vascular or genitourinary diseases 6 . Negative symptoms of the disorder, such as anhedonia, avolition and blunted affect related to hypodopaminergic activity in the frontal cortex, severely harm the ability to enjoy sexual life.…”

Section: Introductionmentioning

confidence: 99%

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A acurácia da Escala de Experiência Sexual do Arizona (ASEX) para identificar disfunção sexual em pacientes do espectro da esquizofrenia

Nunes¹,

Dieckmann²,

Lacaz³

et al. 2009

Rev. psiquiatr. clín.

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Background: Sexual dysfunction is frequent in patients with schizophrenia, it is reported as one of the most distressing antipsychotic's adverse effects and it is directly related to treatment compliance. Objectives: a) to evaluate the accuracy of the Arizona Sexual Experience Scale (ASEX) to identify sexual dysfunction; b) to assess the frequency of sexual dysfunction in a sample of outpatients with schizophrenia and schizoaffective disorder under antipsychotic therapy; and c) to investigate the effect of different antipsychotics on sexual function. Method: Outpatients with schizophrenia or schizoaffective disorder were asked to fulfill both the ASEX and the Dickson Glazer Scale for the Assessment of Sexual Functioning Inventory (DGSFi) at a single interview. Results: 137 patients were interwied. The sensitivity and specificity of the ASEX in relation to DGSFi were: 80.8%, (95% CI = 70.0%-88.5%) and 88.1% (95% CI = 76.5%-94.7%), and the misclassification rate was 9.5%. The ROC curve comparing the ASEX and the DGSFi scores revealed a value of 0.93 (CI = 0.879-0.970), with the optimum cut-off point of ASEX being 14/15. Sexual dysfunction measured was higher in females (79.2%) than in males (33.3%) (χ 2 = 27.41, d.f. = 1, p < 0.001). Discussion: Patients under antipsychotic treatment showed a high level of sexual complaints, and the ASEX proved to be an accurate instrument to identify sexual dysfunction in an outpatient sample of patients with schizophrenia spectrum. Females showed a higher frequency of sexual dysfunctions and sexual drive and ability to reach orgasm were the most affected areas. The use of antipsychotics, especially the combinations, was more likely to impair sexual functioning.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

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A acurácia da Escala de Experiência Sexual do Arizona (ASEX) para identificar disfunção sexual em pacientes do espectro da esquizofrenia

Nunes¹,

Dieckmann²,

Lacaz³

et al. 2009

Rev. psiquiatr. clín.

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“…The most frequent complaints in clinical practice include orgasmic and erectile difficulties in the short term and decreased desire in the longer term. The most frequent pattern in male patients is the combination of lowered libido with erectile dysfunction, which is usually unacceptable 16,17 .…”

Section: Influence Of Treatment Of Psychosis On Sexualitymentioning

confidence: 99%

The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management

2018

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Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment-related sexual adverse events tend to persist over time, and are unfortunately under-recognized by clinicians and scarcely investigated in clinical trials. Treatment-emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action. Antidepressants with a predominantly serotonergic activity, antipsychotics likely to induce hyperprolactinaemia, and mood stabilizers with hormonal effects are often linked to moderate or severe sexual dysfunction, including decreased libido, delayed orgasm, anorgasmia, and sexual arousal difficulties. Severe mental disorders can interfere with sexual function and satisfaction, while patients wish to preserve a previously satisfactory sexual activity. In many patients, a lack of intimate relationships and chronic deterioration in mental and physical health can be accompanied by either a poor sexual life or a more frequent risky sexual behaviour than in the general population. Here we describe the influence of psychosis and antipsychotic medications, of depression and antidepressant drugs, and of bipolar disorder and mood stabilizers on sexual health, and the optimal management of patients with severe psychiatric illness and sexual dysfunction.

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“…However, there is no difference between women suffering from schizophrenia and healthy women in successfully reproducing over all ages. The lower rates may also be influenced by other variables not readily considered such as lower rates of sexual activity, difficulties maintaining stable romantic relationships [27], medication induced abnormalities in prolactin levels and menstruation (which can vary depending on which medication is taken) [28] and medication induced sexual dysfunction (30-80% in women) [29][30][31]. It has been shown that more than half of the women with psychosis in the sample for the McGarth group (1999) were mothers and had higher levels of fertility was associated with a later age at first diagnosis [32].…”

Section: Motherhood and Schizophreniamentioning

confidence: 99%

Estrogen and schizophrenia in women: animal models lend a hand in understanding cognition

Belgrave¹,

Pato²,

Pato³

2017

IJCNMH

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Women experience a differential onset of schizophrenia symptoms and a bi-modal peak of onset in the early years of adulthood and in the post-menopausal period. Cognitive deficits that accompany schizophrenia are some of the more severe symptoms associated with the disease. The understanding of the mechanisms underlying cognitive dysfunction is still very limited and its understanding can bring important contributions to the adequate clinical management of the disease. Using rodent research to explore cognition, and how female hormones may affect cognitive decline with age in the context of schizophrenia can expand our understanding and perhaps offer more treatment options.

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Male Sexual Dysfunction and Quality of Life in Schizophrenia

Cited by 133 publications

References 0 publications

A acurácia da Escala de Experiência Sexual do Arizona (ASEX) para identificar disfunção sexual em pacientes do espectro da esquizofrenia

A acurácia da Escala de Experiência Sexual do Arizona (ASEX) para identificar disfunção sexual em pacientes do espectro da esquizofrenia

The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management

Estrogen and schizophrenia in women: animal models lend a hand in understanding cognition

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