Male sexual dysfunction and quality of life in schizophrenia.
OBJECTIVE
To describe the prevalence and clinical correlates of sexual dysfunction in a sample of adult male outpatients with schizophrenia treated with olanzapine, risperidone, quetiapine, or haloperidol, focusing on associations between sexual dysfunction and patient-perceived quality of life.


METHODS
Sexual dysfunction was assessed in 139 outpatients with DSM-IV schizophrenia who were receiving olanzapine, risperidone, quetiapine, or haloperidol, but no other medications associated with sexual side effects. Structured assessments were made of psychiatric symptoms, quality of life, and relationships.


RESULTS
Sexual dysfunction occurred in 45.3% of patients. Patients with and without sexual dysfunction did not significantly differ with respect to severity of psychiatric symptoms. However, as compared with patients without sexual dysfunction, patients with sexual dysfunction reported significantly lower ratings on global quality of life (t = 2.4, df = 136, p = .02) and the level of enjoyment in their life (t = 2.5, df = 136, p = .01). Patients with sexual dysfunction were significantly less likely than those without sexual dysfunction to report having a romantic partner (17.5% vs. 43.4%; chi(2) = 10.7, df = 1, p = .001), though they were not significantly less likely to report difficulty making friends (27.0% vs. 32.9%; chi(2) = 0.57, df = 1, p = .45). Among patients with romantic partners, those with sexual dysfunction reported significantly poorer quality of their relationships (t = 2.3, df = 42, p = .02) and were less likely to talk to their partner about their illness (t = 2.0, df = 42, p = .047).


CONCLUSIONS
Sexual dysfunction is common in men with schizophrenia who are treated with olanzapine, risperidone, quetiapine, or haloperidol and is associated with diminished quality of life, decreased occurrence of romantic relationships, and reduced intimacy when relationships are established. High prevalence and substantial interference with quality of life combine to make sexual dysfunction an important area for clinical assessment and appropriate intervention in the community management of schizophrenia.
Olfson
Mark
M
New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, 1051 Riverside Dr., New York, NY 10032, USA. mo49@columbia.edu
Uttaro
Thomas
T
Carson
William H
WH
Tafesse
Eskinder
E
D000328:Adult; D000553:Ambulatory Care; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001294:Attitude to Health; D007172:Erectile Dysfunction / Q000139:chemically induced / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D008149:Love; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life / Q000523:psychology*; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D012737:Sex Factors; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced / Q000175:diagnosis* / Q000523:psychology; D012917:Social Adjustment; D011795:Surveys and Questionnaires
D014150:Antipsychotic Agents