Prevalence of sexual dysfunction in patients with schizophrenia: international variation and underestimation

Dossenbach, M.; Hodge, Andrew; Anders, Martin; Molnár, Béla; Peciukaitiene, Dalia; Krupka-Matuszczyk, I.; Tatu, Mihai; Bondar, V V; Pecenak, Jan; Gorjanc, Tatjana; McBride, Margaret C.

doi:10.1017/s1461145704005012

Cited by 94 publications

(63 citation statements)

References 19 publications

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“…Data on sexual dysfunction associated with antipsychotic medication show variable rates; relatively low rates (16-18%) were identified by some researchers [13,24], whereas others reported high rates (43-80%) [3,22,25]. Similarly, our study pointed to a relatively higher rate of sexual dysfunction.…”

Section: Discussionsupporting

confidence: 40%

Sexual dysfunction related to typical and atypical antipsychotics in drug naive psychotic patients

Saad¹,

Khalifa²,

Elmissiry³

et al. 2015

Middle East Current Psychiatry

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Section: Discussionsupporting

confidence: 40%

Sexual dysfunction related to typical and atypical antipsychotics in drug naive psychotic patients

Saad¹,

Khalifa²,

Elmissiry³

et al. 2015

Middle East Current Psychiatry

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“…[31][32][33] Even those with treatment-resistant schizophrenia may wish to talk about these topics. 34 In contrast, clinicians often do not ask and underestimate the rates of sexual dysfunctions 35 as well as their negative impact on the lives of the patients. Some clinicians may not know enough about the issue 14 or feel ashamed of talking about these sensitive subjects.…”

Section: The Burden Of Sexual Complaints From the Patient's And Doctomentioning

confidence: 99%

“…On the other hand, studies using structured interviews or self report questionnaires tend to report a prevalence of 30-60% for sexual side effects related to treatment with antipsychotics. 5,[36][37][38][39] This emphasizes that direct questioning about sexual functioning including sexual side effects is necessary to avoid underestimating their frequency among patients with schizophrenia and related psychotic disorders.…”

Section: The Burden Of Sexual Complaints From the Patient's And Doctomentioning

confidence: 99%

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

Boer

Castelein

Wiersma

et al. 2015

Schizophrenia Bulletin

138

115

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A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Most patients show an interest in sex that differs little from the general population. By contrast, psychiatric symptoms, institutionalization, and psychotropic medication contribute to frequently occurring impairments in sexual functioning. Women with schizophrenia have a better social outcome, longer lasting (sexual) relationships, and more offspring than men with schizophrenia. Still, in both sexes social and interpersonal impairments limit the development of stable sexual relationships. Although patients consider sexual problems to be highly relevant, patients and clinicians not easily discuss these spontaneously, leading to an underestimation of their prevalence and contributing to decreased adherence to treatment. Studies using structured interviews or questionnaires result in many more patients reporting sexual dysfunctions. Although sexual functioning can be impaired by different factors, the use of antipsychotic medication seems to be an important factor. A comparison of different antipsychotics showed high frequencies of sexual dysfunction for risperidone and classical antipsychotics, and lower frequencies for clozapine, olanzapine, quetiapine, and aripiprazole. Postsynaptic dopamine antagonism, prolactin elevation, and α 1 -receptor blockade may be the most relevant factors in the pathogenesis of antipsychotic-induced sexual dysfunction. Psychosocial strategies to treat antipsychotic-induced sexual dysfunction include psychoeducation and relationship counseling. Pharmacological strategies include lowering the dose or switching to a prolactin sparing antipsychotic. Also, the addition of a dopamine agonist, aripiprazole, or a phosphodiesterase-5 inhibitor has shown some promising results, but evidence is currently scarce.

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“…The exclusion of nonEnglish language journals further risked language bias. The latter may be particularly relevant, as cross-cultural disparities are apparent in AE identification 80 and reporting. [81][82] Demonstrated inadequacies in the ways AE data is indexed in electronic databases 83 means relevant studies may have been missed.…”

Section: Limitationsmentioning

confidence: 99%

Assessing and Reporting the Adverse Effects of Antipsychotic Medication

Longden

Read

2016

Clinical Neuropharmacology

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Objective: Adverse effects (AEs) of antipsychotic medication have important implications for patients and prescribers in terms of wellbeing, treatment adherence and quality of life. This review summarises strategies for collecting and reporting AE data across a representative literature sample to ascertain their rigour and comprehensiveness.Methods: A PsycINFO search, following PRISMA Statement guidelines, was conducted in English-language journals (1980-July 2014) using the following search string: (antipsychotic* OR neuroleptic*) AND (subjective effect OR subjective experience OR subjective response OR subjective mental alterations OR subjective tolerability OR subjective wellbeing OR patient perspective OR self-rated effects OR adverse effects OR side-effects). Of 7,825 articles, 384 were retained that reported quantified results for AEs of typical or atypical antipsychotics amongst transdiagnostic adult, adolescent, and child populations. Information extracted included: types of AEs reported; how AEs were assessed; assessment duration; assessment of the global impact of antipsychotic consumption on wellbeing; and conflict of interest due to industry sponsorship.Results: Neurological, metabolic, and sedation-related cognitive effects were reported most systematically relative to affective, anticholinergic, autonomic, cutaneous, hormonal, miscellaneous, and non-sedative cognitive effects. The impact of AEs on patient wellbeing was poorly assessed. Cross-sectional and prospective research designs yielded more comprehensive data about AE severity and prevalence than clinical or observational retrospective studies. Antipsychotic medication is associated with numerous adverse effects (AEs), ranging from mild and intermittent (e.g., dizziness and nausea) to incapacitating (e.g., extrapyramidal symptoms: EPS), some of which can disrupt an array of physical and psychological systems. [1][2][3] Since the institution of antipsychotics in the 1950s, it has been recognised that patients generate subjective interpretations of the sensations that attend drug consumption. However, the imperative for standardising psychiatric phenomena arguably led "to a gradual disregard of subjective experiences…which were relegated to 'soft' science." 4: p.55 Correspondingly, much research has prioritized efficacy and safety parameters rather than the more subjective construct of tolerability. Interest in the latter was advanced by the work of Hogan et al. psychometrically robust scales that patients can reliably complete has also advanced the research agenda. [13][14][15] This is important progress, given the necessity of auditing the relative prevalence and severity of AEs, and corresponding impact on patient wellbeing. In this respect, the substantial differences in AE profiles for different 5 antipsychotics (compared to robust, yet small, mean differences in efficacy) 16 makes the former an important component of prescribing choices and, in accordance with best-practice guidelines, can empower service-users in making inform...

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Prevalence of sexual dysfunction in patients with schizophrenia: international variation and underestimation

Cited by 94 publications

References 19 publications

Sexual dysfunction related to typical and atypical antipsychotics in drug naive psychotic patients

Sexual dysfunction related to typical and atypical antipsychotics in drug naive psychotic patients

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

Assessing and Reporting the Adverse Effects of Antipsychotic Medication

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