精神分裂症男性的性功能障碍与生活质量

Male sexual dysfunction and quality of life in schizophrenia.

作者信息

Olfson Mark, Uttaro Thomas, Carson William H, Tafesse Eskinder

机构信息

New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, 1051 Riverside Dr., New York, NY 10032, USA.

出版信息

J Clin Psychiatry. 2005 Mar;66(3):331-8. doi: 10.4088/jcp.v66n0309.

DOI:10.4088/jcp.v66n0309

PMID:15766299

Abstract

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.

METHOD

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.

摘要

目的

描述接受奥氮平、利培酮、喹硫平或氟哌啶醇治疗的成年男性精神分裂症门诊患者样本中性功能障碍的患病率及其临床相关因素，重点关注性功能障碍与患者感知的生活质量之间的关联。

方法

对139例符合《精神疾病诊断与统计手册》第四版（DSM-IV）精神分裂症诊断标准、正在接受奥氮平、利培酮、喹硫平或氟哌啶醇治疗但未服用其他有性副作用相关药物的门诊患者进行性功能障碍评估。对精神症状、生活质量和人际关系进行结构化评估。

结果

45.3%的患者出现性功能障碍。有和没有性功能障碍的患者在精神症状严重程度方面无显著差异。然而，与没有性功能障碍的患者相比，有性功能障碍的患者在总体生活质量评分（t = 2.4，自由度 = 136，p = 0.02）和生活愉悦程度评分（t = 2.5，自由度 = 136，p = 0.01）上显著更低。有性功能障碍的患者报告有恋爱伴侣的可能性显著低于没有性功能障碍的患者（17.5%对43.4%；卡方 = 10.7，自由度 = 1，p = 0.001），不过他们报告交友困难的可能性与没有性功能障碍的患者相比无显著差异（27.0%对32.9%；卡方 = 0.57，自由度 = 1，p = 0.45）。在有恋爱伴侣的患者中，有性功能障碍的患者报告其恋爱关系质量显著更差（t = 2.3，自由度 = 42，p = 0.02），且与伴侣谈论自己病情的可能性更小（t = 2.0，自由度 = 42，p = 0.047）。