The low frequency of reported sexual dysfunction in Asian patients with schizophrenia (2001-2009): low occurrence or ignored side effect?

Xiang, Yu‐Tao; Wang, Chuanyue; Si, Tianmei; H, Lee; He, Yanling; Ungvári, Gábor S.; Chiu, Helen Fung Kum; Yang, Shuyu; Chong, Mian‐Yoon; Tan, C.H.; Kua, Ee Heok; Fujii, Senta; Sim, Kang; Yong, Michael; Jk, Trivedi; Chung, E.K.; Udomratn, Pichet; Chee, Kok Yoon; Sartorius, Norman; Shinfuku, Naotaka

doi:10.1002/hup.1213

Cited by 13 publications

(15 citation statements)

References 29 publications

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“…Cultural/religious differences may influence sexual behavior and therefore the rate of SD in both general populations and SZ (Hocaoglu et al, 2014). The absence of validated questionnaire may explain some results with very low rate (until 3%) of SD in some studies (Xiang et al, 2011).…”

Section: Discussionmentioning

confidence: 98%

Sexual dysfunctions in schizophrenia: Beyond antipsychotics. A systematic review

Dumontaud

Korchia

Khouani

et al. 2020

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Background. Sexual dysfunctions (SD) in schizophrenia are frequent with strong impact on adherence and quality of life. Current recommendations stipulate to switch to prolactin-sparing antipsychotic in case of SD.Objectives. To synthetize in a systematic review data on the SD prevalence and the associated risk factors in schizophrenia (SZ).Methods. Medline, Google Scholar, PsychInfo, and Cochrane were explored, without any year or language restriction. Results. Overall, 89 studies and 25,490 participants were included in the present review. SZ subjects aged 18-70 reported high SD frequency [30%-82%] (men [33%-85%]; women [25%-85%]). For SZ men erectile dysfunction [31%-95%] was the most frequent SD vs. loss of libido for women [31%-100%]. The following risk factors were associated with increased SD: 1. Illness severity (including psychotic symptomatology, early age at SZ onset, negative symptomatology, and continuous illness course), 2. Depressive symptomatology 3. Antipsychotics (especially first generation antipsychotics, risperidone and antipsychotic polytherapy). Switching to prolactinsparing antipsychotics has shown effectiveness in some studies (especially aripiprazole).Antidepressants were not found to be associated with SD in SZ subjects. Conclusion.The prevalence of SD is high in SZ subjects. In addition to the current guidelines, the present review suggests that treating depressive symptoms may be a major intervention to improve SD in SZ subjects. Sociodemographic variables, physical illnesses, metabolic syndrome and peripheral inflammation have been poorly or never explored and should be included in future studies.

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Section: Discussionmentioning

confidence: 98%

Sexual dysfunctions in schizophrenia: Beyond antipsychotics. A systematic review

Dumontaud

Korchia

Khouani

et al. 2020

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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“…In addition, patient reports of sexual dysfunction are significantly influenced by cultural factors and social acceptance in discussing sexual issues. According to a meta analysis, the prevalence of sexual dysfunction reported in Asia countries was lower than western counties [15]. Further, clinicians themselves may be conservative in enquiring about sexual concerns or consider sexual-related complains as insignificant in schizophrenia patients as compared to positive psychotic symptoms [17].…”

Section: Discussionmentioning

confidence: 99%

“…Quality of life is increasingly used to assess treatment outcome for schizophrenia patients [12, 19, 50, 51], and sexual function is an important part of QoL, which could be influenced by social-demographic characteristics [19], psychopathology [12], treatment modalities (eg, antipsychotic drugs) [52–54] and side effects [15, 55]. One study reported that patients with schizophrenia were more dissatisfied with their sex life than any other aspects of life [56].…”

Section: Discussionmentioning

confidence: 99%

“…However, findings reported in western countries could not be generalized to other sociocultural contexts. For instance, schizophrenia patients living in Asia are less likely to report sexual dysfunction compared with their counterparts in western countries because of different attitudes to sexuality [15] and cultural sensitivities [16]. Being a sensitive issue in Asian countries, especially in rural areas, sexual function is given less attention by both patients and clinicians.…”

Section: Introductionmentioning

confidence: 99%

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Sexual dysfunction in Chinese rural patients with schizophrenia

Huang

Hou

et al. 2019

BMC Psychiatry

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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.

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“…Talking about sex can make subjects feel shame, and reporting sexual dysfunction can damage their selfesteem. Therefore, people in Asia, especially in rural areas, are more likely to underestimate their sexual dysfunction (6,44). In addition, age is another important risk factor for sexual dysfunction in the general population (45) and schizophrenia patients (15,38).…”

Section: Discussionmentioning

confidence: 99%

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

Liu

Xiu

et al. 2022

Front. Psychiatry

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BackgroundSexual dysfunction is a common symptom in patients with schizophrenia, especially in chronically medicated patients. However, the relationship between sexual dysfunction and emotional response to sexual arousal in male patients with schizophrenia remains unclear. This study aimed to assess the incidence, risk factors of sexual dysfunction in males, and their clinical correlations to sexual arousal in male patients with schizophrenia in China.MethodsA total of 162 male patients, aged 18–50 years, with schizophrenia were recruited from a psychiatric hospital in Ganzhou. The clinical symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). The Arizona Sexual Experience Scale was utilized to evaluate sexual dysfunction. Erotic images were selected from International Affective Picture System (IAPS). Sixty-eight out of the 162 subjects completed the erotic pictures reactivity task.ResultsOverall, 48 (29.6%) patients were measured as having global sexual dysfunction, 72 (44.4%) patients as having strength of sex drive dysfunction, 51 (31.5%) patients as having sexual arousal dysfunction, 55 (34.0%) patients as having penile erection dysfunction, 60 (37.0%) patients as having reached orgasm dysfunction, and 60 (37.0%) patients as having satisfaction with orgasm dysfunction. The sexual dysfunction patients had significantly higher scores on the negative symptoms of the PANSS. The only important predictor of sexual dysfunction was the severity of PANSS negative factor. The sense of pleasure and arousal post viewing erotic images in the sexual dysfunction group were lower compared to the non-sexual dysfunction group. The sense of pleasure and approach motivation were significantly negatively correlated with the severity of sexual dysfunction.ConclusionsThis study shows that nearly one-third of young and middle-aged chronically medicated male inpatients with schizophrenia suffer from sexual dysfunction. The negative factor of the PANSS can be regarded as the risk factor of sexual dysfunction. Schizophrenia patients with sexual dysfunction experienced lower pleasure and higher avoidance motivation than non-sexual dysfunction patients when exposed to erotic stimuli.

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The low frequency of reported sexual dysfunction in Asian patients with schizophrenia (2001-2009): low occurrence or ignored side effect?

Cited by 13 publications

References 29 publications

Sexual dysfunctions in schizophrenia: Beyond antipsychotics. A systematic review

Sexual dysfunctions in schizophrenia: Beyond antipsychotics. A systematic review

Sexual dysfunction in Chinese rural patients with schizophrenia

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

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