Sexual dysfunction in drug-naïve or drug-free male patients with psychosis: Prevalence and risk factors

Abstract

Background: There is a growing body of literature on the high prevalence of sexual dysfunction in patients with psychotic disorders. However, most studies have focused on medication-related sexual side effects. Material and Methods: Consecutive males with a diagnosis of acute psychosis or schizophrenia who were either drug-naïve or drug-free for six months were recruited to the study after obtaining informed consent. Sociodemographic and clinical data, psychopathology (using Positive and Negative Syndrome Scale), and sexual functioning (using The International Index of Erectile Functioning and DSM-IV TR criteria) were assessed. Bivariate and multivariate statistics were obtained. Results: One hundred males were recruited. The overall prevalence of sexual dysfunction by DSM IV-TR criteria in this population was 17%. The factors that were associated with sexual dysfunction were older age and later age of onset of illness. The rate was higher on excluding those who said that they were not sexually active (25%). Conclusions: Sexual dysfunction may be found in patients with psychotic disorders even prior to commencing antipsychotic medications. It is possible that this is contributed to by several factors including the disease process. Assessment of sexual function in these patients will help in early identification and appropriate management.

Keywords

• Schizophrenia
• sexual dysfunction—prevalence and nature
• sexual dysfunction—risk factors Key messages: Impaired sexual functioning may be present prior to initiation of treatment in patients with psychotic disorders. Sexual dysfunction in these patients may be contributed to by the disease process and should be differentiated from sexual side effects due to prolactin-increasing properties of the antipsychotic medication. A detailed assessment of sexual functioning at the onset of treatment may be beneficial.