Sexual dysfunction in Chinese rural patients with schizophrenia

Abstract

Background Sexual dysfunction is common in patients with schizophrenia, however it is poorly studied in China, especially in primary health care institutions in rural areas. We investigated the prevalence of sexual dysfunction and its correlates including quality of life (QoL), in schizophrenia patients treated in primary care in a rural area in China. Method By using a random numbers table, 21 small town primary care service centers (from 63 totally) were selected in the study. Data of 720 community-dwelling patients with schizophrenia in rural area with diagnoses according to DSM –IV or ICD-10 were collected by interviews. Data on socio-demographic and clinical characteristics including sexual dysfunction and quality of life (QoL) were collected using a standardized protocol and data collection procedure. Data were analyzed using chi-square tests, t-tests, U-tests, ANCOVA and multiple logistic regression as appropriate by SPSS 21.0.The level of significance was set at 0.05 (two-tailed). Results In this sample, sexual dysfunction was found in 71.3% of the whole sample, 82.7% of female patients and 64.5% of male patients. Multiple logistic regression analysis showed that older age (OR = 1.06, P <0.001, 95%CI: 1.04–1.09) and higher Brief Psychotic Rating Scale (negative domain) score (OR = 1.16, P = 0.01, 95%CI: 1.02–1.31) were significantly associated with sexual dysfunction. Contrary to previous findings, sexual dysfunction was not associated with quality of life after controlling for confounding variables. Conclusions More than 2/3 of schizophrenia patients living in a rural area complained of sexual dysfunction, which was associated with older age and more negative psychotic symptoms. Primary care physicians should pay attention to sexual dysfunction during the assessment and treatment of patients with schizophrenia in rural areas in China.

The Relationships Between Hyperprolactinemia, Metabolic Disturbance, and Sexual Dysfunction in Patients With Schizophrenia Under Olanzapine Treatment

“…A difference between the sexes in the prevalence of sexual dysfunction among patients with schizophrenia is inconsistent in previous studies; some authors have reported higher rates of sexual dysfunction in female patients (Bianco et al, 2019;Huang et al, 2019), others have reported the opposite (Cutler, 2003), whereas some have discovered similar rates for both sexes (Fujii et al, 2010). Our study found that female sex was associated with sexual dysfunction in olanzapinetreated patients with schizophrenia.…”

Sexuality and sexual dysfunctions in older people: a forgotten problem

“…Other studies have suggested prevalence of dysfunction between 30 and 60% in drug-free patients with psychosis and prevalence as high as 80% in a more general population of men with schizophrenia (Ravichandran 2019). In a rural Chinese population with schizophrenia 71.3% reported sexual dysfunction and this was associated again with old age and with burden of negative symptoms (Huang 2019). Although there is a paucity of research into this area it has also been suggested that loss of interest in sex in people with schizophrenia is associated with advancing age, female gender, cardiovascular medication, negative symptoms and lower sexual self-efficacy (self-confidence and self-control in sexual experiences) (Bianco 2019).…”

Sexual Dysfunction in Chronically Medicated Male Inpatients With Schizophrenia: Prevalence, Risk Factors, Clinical Manifestations, and Response to Sexual Arousal

“…Sexual dysfunction is a serious side effect that commonly manifests in patients with chronic schizophrenia (1)(2)(3). Previous studies have shown that the prevalence of global sexual dysfunction in schizophrenia patients ranged from approximately 16% to 96% (4)(5)(6). Generally, the illness itself and antipsychotic drugs both can lead to sexual dysfunction in schizophrenia patients (3,5,7).…”

“…Generally, the illness itself and antipsychotic drugs both can lead to sexual dysfunction in schizophrenia patients (3,5,7). Moreover, sexual dysfunction has a negative impact on treatment adherence and intimate relationships, especially in males (3,6,8,9). In addition, due to decreased libido and erectile dysfunction, most males with chronic schizophrenia are accompanied by low self-esteem (10,11) and depression (3,12), which reduce their motivation to seek intimacy and damage their marital relationships (13).…”

“…Some studies have shown that sexual dysfunction is correlated with the severity of clinical symptoms. For example, Huang et al (6) reported that in a sample of 742 schizophrenia patients, sexual dysfunction was related to the Brief Psychotic Rating Scale (negative domain) score. Similarly, the severity of sexual dysfunction was found to be significantly associated with the negative subscale of the Positive and Negative Syndrome Scale (PANSS) (26).…”