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缓解男性精神分裂症患者的性功能障碍。

Remitted male schizophrenia patients with sexual dysfunction.

机构信息

Department of Psychiatry and Mental HealthDuchess of Kent HospitalSandakanSabahMalaysia.

Department of Psychiatry and Mental HealthTaiping HospitalTaipingPerakMalaysia.

出版信息

J Sex Med. 2014 Apr;11(4):956-965. doi: 10.1111/jsm.12246. Epub 2013 Jul 11.

Abstract

INTRODUCTION

Despite the high prevalence of sexual dysfunction among male schizophrenia patients, there is still a paucity of research on this area.

AIMS

The study aims to determine the prevalence of sexual dysfunction and any association between male patients with schizophrenia in remission and the sociodemographic profile, medication, depression, anxiety, psychopathology of illness, body mass index, and waist circumference.

METHODS

A cross-sectional study with nonprobability sampling method was conducted in a psychiatric outpatient clinic in Taiping Hospital (Perak, Malaysia) over a 7-month period. A total of 111 remitted male schizophrenia patients were recruited. The validated Malay version of the International Index of Erectile Function (Mal-IIEF-15) was administered to the patients and assessed over 4-week duration in the domains of erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Logistic regression analysis was employed.

MAIN OUTCOME MEASURES

Prevalence and associated factors for sexual dysfunction in each domain are the main outcome measures.

RESULTS

All five domains of sexual functioning in patients showed a high prevalence of dysfunction ranging from 78.4% to 97.1% with orgasmic dysfunction being the least impaired and intercourse satisfaction the worst impaired. Among the domains, only orgasmic dysfunction was significantly associated with race, i.e., Chinese at lower risk for impairment than the Malays (OR = 0.23; 95% CI: 0.07, 0.76; P = 0.018); education, i.e., patients with education higher than primary level were at higher risk for dysfunction (OR = 6.49; 95% CI: 1.32, 32.05; P = 0.022); and Positive and Negative Syndrome Scale (PANSS)-positive subscale, i.e., higher PANSS-positive score was a protective factor for orgasmic dysfunction (OR = 0.54; 95% CI: 0.33, 0.89; P = 0.015).

CONCLUSIONS

The prevalence of sexual dysfunction was generally high. Malay patients and those with education higher than primary level were at higher risk for orgasmic dysfunction whereas higher PANSS-positive score was protective against the impairment. The high rate of sexual dysfunction in schizophrenia patients warrants a routine inquiry into patients' sexuality and the appropriate problems being addressed.

摘要

介绍

尽管男性精神分裂症患者性功能障碍的患病率很高,但针对这一领域的研究仍然很少。

目的

本研究旨在确定男性精神分裂症缓解期患者性功能障碍的患病率,并探讨其与社会人口学特征、药物使用、抑郁、焦虑、精神病理、体重指数和腰围之间的关系。

方法

本研究采用非概率抽样方法,在太平医院(马来西亚霹雳州)的精神科门诊进行了一项横断面研究,历时 7 个月。共招募了 111 名缓解期的男性精神分裂症患者。使用经过验证的马来语版国际勃起功能指数(Mal-IIEF-15)评估患者,评估期为 4 周,评估领域包括勃起功能、性高潮功能、性欲、性交满意度和总体满意度。采用逻辑回归分析。

主要观察指标

各领域性功能障碍的患病率及相关因素是主要观察指标。

结果

患者的五个性功能领域均存在较高的性功能障碍患病率,从 78.4%到 97.1%不等,其中性高潮功能障碍的受损程度最低,而性交满意度的受损程度最严重。在这些领域中,只有性高潮功能障碍与种族显著相关,即与马来人相比,中国人的受损风险较低(比值比=0.23;95%可信区间:0.07,0.76;P=0.018);与教育程度显著相关,即受过高于小学水平教育的患者性功能障碍的风险更高(比值比=6.49;95%可信区间:1.32,32.05;P=0.022);与阳性和阴性综合征量表(PANSS)阳性分量表显著相关,即较高的 PANSS 阳性评分是性高潮功能障碍的保护因素(比值比=0.54;95%可信区间:0.33,0.89;P=0.015)。

结论

性功能障碍的总体患病率较高。马来患者和受教育程度高于小学水平的患者性高潮功能障碍的风险较高,而较高的 PANSS 阳性评分则对性功能障碍有保护作用。精神分裂症患者性功能障碍的高发生率需要对患者的性行为进行常规询问,并适当解决相关问题。

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