Frequency of sexual dysfunction in patients with a psychotic disorder receiving antipsychotics.
BACKGROUND
Although it is a troublesome side effect, information on antipsychotic-induced sexual dysfunction is limited.


OBJECTIVE
To evaluate the frequency of sexual dysfunction and its impact on treatment adherence in patients with a psychotic disorder treated with various antipsychotics under routine clinical conditions.


METHODS
Subjects included were sexually active male and female patients 18 years of age or older with a diagnosis of schizophrenia, schizophreniform disorder, schizoaffective disorder, or other psychotic disorder. This was a multicenter, cross-sectional, and naturalistic study conducted by 18 investigators. In addition to sexual functioning, we recorded demographic data, psychiatric diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), and medication history.


METHODS
Pyschotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SalSex).


RESULTS
All the analyses were performed in the 243 evaluable patients. Most patients were males (71%), and the most common diagnosis was schizophrenia (71%). Overall, 46% of the patients exhibited sexual dysfunction according to the assessment with the SalSex (50% of the males and 37% of the females). Only 37% of the patients with sexual dysfuntion spontaneously reported it. Among the patients exhibiting sexual dysfunction, 32% reported to have poor tolerance to the disturbance. With the exception of conventionals depot, which had a very important and greater effect on females' sexual funtioning, the severity and tolerance of sexual dysfunction were worse in males than in females regardless of the antipsychotic studied. In the univariate logistic regression analysis, using olanzapine as a reference category, risperidone (odds ratio [OR] 7.45, 95% confidence interval [CI] 3.73-14.89) and conventionals, depot (OR 4.57, 95% CI 1.72-12.13) and nondepot (OR 4.92, 95% CI 1.43-16.93), showed a significant increased risk of sexual dysfunction.


CONCLUSIONS
Our results show that sexual dysfunction is very common in patients receiving long-term treatment with antipsychotics, and it is associated with a great impact in a substantial proportion of patients.
Montejo
Angel L
AL
Psychiatry Department, Hospital Universitario de Salamanca, Spain. amontejo@usal.es
Majadas
Susana
S
Rico-Villademoros
Fernando
F
Llorca
Ginés
G
De La Gándara
Jesús
J
Franco
Manuel
M
Martín-Carrasco
Manuel
M
Aguera
Luis
L
Prieto
Nieves
N
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D000077152:Olanzapine; D011618:Psychotic Disorders / Q000188:drug therapy*; D012307:Risk Factors; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy; D012720:Severity of Illness Index; D012737:Sex Factors; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced*
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine