OBJECTIVES:
This study assessed sexual dysfunction in men with psychosis, by determining the prevalence, nature & risk factors in drug naïve male patients and the incidence in these patients while on antipsychotic medication.
METHODS:
A cohort of 100 men with ICD-10 diagnosis of acute psychosis or schizophrenia who were either drug naïve or drug free for six months were assessed at baseline (n = 100) and followed up at six weeks (n = 41) and six months (n = 21). Relevant sociodemographic and clinical data were collected; PANSS scores and IIEF scores were used to assess psychopathology and sexual functioning respectively. DSM-IV TR algorithm was used to diagnose sexual dysfunction. Testosterone and sex hormone binding globulin levels were measured at baseline and at six months.
RESULTS:
At baseline the prevalence of sexual dysfunction was 17% [hypoactive sexual desire disorder (14%), premature ejaculation (5%), erectile dysfunction (4%) and orgasmic dysfunction (1%)]. The incidence rates of sexual dysfunction were 15.6% and 47.1% at six weeks and six months respectively. Hypoactive sexual desire disorder was the commonest disorder during all the assessments. Age of the patient and marital status were consistently associated with sexual dysfunction across baseline, six weeks and six months. PANSS scores; antipsychotic medication type, dosage and duration; and testosterone levels were not significantly associated with sexual dysfunction.
CONCLUSION:
This study confirms the high prevalence and incidence of sexual dysfunction in patients with psychotic disorders. The low follow up rate limits the generalization of these findings. Clinicians need to routinely assess for this distressing condition to provide comprehensive care for these patients
