Managing antipsychotic-related sexual dysfunction in patients with schizophrenia

Silva, Carlos; Rebelo, Marta; Chendo, Inês

doi:10.1080/14737175.2023.2281399

Cited by 2 publications

(1 citation statement)

References 97 publications

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“… 47 Additionally, nonpharmacologic interventions, such as targeted psychotherapy and cognitive therapy, can be incorporated into treatment regimens to mitigate the adverse effects of antipsychotic-induced sexual dysfunction. 47 , 48 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of sexual dysfunction in Chinese patients with schizophrenia: a systematic review and meta-analysis

Zhang,

Chen,

Sun

et al. 2024

Sexual Medicine

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Background There may be a higher risk of sexual dysfunction in the schizophrenia population. China has made significant contributions to the global community of patients with schizophrenia. Currently, there is no estimation of the prevalence of sexual dysfunction in Chinese patients with schizophrenia. Aim We conducted a meta-analysis to pool the evaluated prevalence of sexual dysfunction in Chinese patients with schizophrenia. Methods We systematically searched PubMed, Web of Science, Embase, PsycINFO, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Medical Network, and Huayi Academic Literature Database from inception to September 2023. Meta-analysis was conducted with R version 4.3.1. Outcomes To examine the pooled prevalence of sexual dysfunctions among Chinese patients with schizophrenia. Results In our meta-analysis, we included 16 studies with 5417 participants, among whom 1727 experienced sexual dysfunction. The results of the meta-analysis reveal that the prevalence of sexual dysfunction in Chinese patients with schizophrenia is 50.43% (95% CI, 37.86%-62.95%). Subgroup analysis results indicate that various factors—including the specific type of dysfunction, duration of illness, assessment tools, mean ages, study region, gender, research setting, marital status, publication years, and type of antipsychotics—all have a particular impact on the occurrence rate of sexual dysfunction in Chinese patients with schizophrenia. Female patients had a slightly higher prevalence of sexual dysfunction than male patients (65.22% vs 54.84%). Clinical Implications The findings of this study can be used in high-quality nursing care for the schizophrenia population, particularly for the care of specific sexual dysfunction nursing. Strengths and Limitations This meta-analysis is the first to evaluate the prevalence of sexual dysfunction in China among patients with schizophrenia. The limited number of studies is the most important limitation. Conclusions The pooled prevalence of sexual dysfunction in Chinese patients with schizophrenia is relatively high, and the prevention and intervention of individual sexual dysfunctions in schizophrenia are advised.

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Section: Discussionmentioning

confidence: 99%

Prevalence of sexual dysfunction in Chinese patients with schizophrenia: a systematic review and meta-analysis

Zhang,

Chen,

Sun

et al. 2024

Sexual Medicine

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Antipsychotic Use and Risk of Breast Cancer in Women With Severe Mental Illness: Replication of a Nationwide Nested Case–Control Database Study

Solmi,

Lähteenvuo,

Tanskanen

et al. 2024

Schizophrenia Bulletin

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Background and hypothesis Breast cancer is more prevalent in women with severe mental illness than in the general population, and use of prolactin-increasing antipsychotics may be a contributing factor. Study design A nested case–control study was conducted using the Swedish nationwide registers (inpatient/outpatient care, sickness absence, disability pension, prescribed drugs, cancers). All women aged 18–85 years with schizophrenia/schizoaffective/other nonaffective psychotic disorder/bipolar disorder and breast cancer (cases) were matched for age, primary psychiatric diagnosis, and disease duration with five women without cancer (controls). The association between cumulative exposure to prolactin-increasing/prolactin-sparing antipsychotics and breast cancer was analyzed using conditional logistic regression, adjusted for comorbidities and co-medications. Study results Among 132 061 women, 1642 (1.24%) developed breast cancer between 2010 and 2021, at a mean age of 63.3 ± 11.8 years. Compared with 8173 matched controls, the odds of breast cancer increased in women with prior exposure to prolactin-increasing antipsychotics for 1–4 years (adjusted odds ratio [aOR] = 1.20, 95% confidence interval [CI] = 1.03–1.41), and for ≥ 5 years (aOR = 1.47, 95%CI = 1.26–1.71). There were no increased or decreased odds of breast cancer with exposure to prolactin-sparing antipsychotics of either 1–4 years (aOR = 1.17, 95%CI = 0.98–1.40) or ≥5 years (aOR = 0.99, 95%CI = 0.78–1.26). The results were consistent across all sensitivity analyses (ie, according to different age groups, cancer types, and primary psychiatric diagnosis). Conclusions Although causality remains uncertain, exposure to prolactin-elevating antipsychotics for ≥ 1 year was associated with increased odds of breast cancer in women with severe mental illness. When prescribing antipsychotics, a shared decision-making process should consider individual risk factors for breast cancer.

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Managing antipsychotic-related sexual dysfunction in patients with schizophrenia

Cited by 2 publications

References 97 publications

Prevalence of sexual dysfunction in Chinese patients with schizophrenia: a systematic review and meta-analysis

Prevalence of sexual dysfunction in Chinese patients with schizophrenia: a systematic review and meta-analysis

Antipsychotic Use and Risk of Breast Cancer in Women With Severe Mental Illness: Replication of a Nationwide Nested Case–Control Database Study

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