Sexual Dysfunction Prevalence Remains High in Schizophrenia Patients

A prevalence of sexual dysfunction remains high in individuals with schizophrenia with no clear improvement over time or better tolerance of second-generation anti-psychotics, according to study published recently in JAMA Psychiatry. However, treating depression could help to reduce sexual dysfunction in patients with schizophrenia.

The findings were based on a systematic review and meta-analysis of 72 studies that included 21,076 participants with schizophrenia, among whom prevalence and heterogeneity of global sexual dysfunction were high.

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Factors associated with the diversity of the studies reviewed included study design, time and location, and sociodemographic data, as well as alcohol use disorder diagnosis, psychiatric diagnosis, illness severity, and the use of antidepressants and anxiolytics. 

Among all participants in the studies reviewed, the global prevalence of sexual dysfunction was 56.4%, with a prevalence of 55.7% for men and 60.0% for women. The most frequent sexual dysfunctions observed were the following:

• Erectile dysfunction in men (44%); 
• Loss of libido in men (41%);
• Ejaculation dysfunction in men (39%);
• Orgasm dysfunction in women (28%); and 
• Amenorrhea in women (25%). 

Sexual dysfunctions were found to be more frequent in patients with schizophrenia compared to patients diagnosed with non-schizophrenia mood disorders. Erectile disorders were less frequent in individuals with longer illness duration.

Prescriptions for antidepressant and mood stabilizer medications were associated with lower rates of erectile dysfunction and ejaculation disorders, but no clear improvements in the rates of sexual dysfunction at other times were found and results regarding antipsychotic medication classes produced conflicting results.

“The association between lower rates of dysfunction and antidepressant use suggests that treating comorbid depression could be an effective strategy to improve sexual health,” the researchers wrote.

Reference
Korchia T, Achour V, Faugere M, et al. Sexual dysfunction in schizophrenia. JAMA Psychiatry. Published online 2023. doi:10.1001/jamapsychiatry.2023.2696