Martín Joaquín C, Acuña María J, Labrador José, Blanco Matilde, Casas Cristina
Unidad de Gestión Clínica de Salud Mental. Hospital Universitario de Valme. Sevilla. España.
Actas Esp Psiquiatr. 2018 Nov;46(6):217-25. Epub 2018 Nov 1.
Despite the high prevalence of sexual dysfunction in patients with schizophrenia, its origins are still unclear.
to determine the prevalence and causal factors of sexual dysfunction in a group of outpatients with schizophrenia.
The study was designed to be cross-sectional and naturalistic, including outpatients with schizophrenia undergoing second generation antipsychotic monotherapy. Patients receiving antidepressants and/or mood stabilisers were excluded. The following data were recorded: sexual functionality, sociodemographic information, sexual history, psychotic and depressive psychopathology, metabolic syndrome and BMI. Psychotropic-Related Sexual Dysfunction Questionnaire (PR SexDQ-Salsex); Positive and Negative Syndrome Scale; Hamilton Depression Rating Scale; Plasma concentrations of prolactin, testosterone, estradiol, progesterone and the International Diabetes Federation diagnostic criteria for metabolic syndrome, were used to complete the study.
Of the 57 patients included in the study, 80% exhibited sexual dysfunction, one-third of which suffered severe levels of dysfunction. However, only 30% of patients spontaneously reported this problem. Although there were significant differences in the prevalence of hyperprolactinemia and metabolic syndrome according to the antipsychotic received, multivariant regression analysis did not show a correlation between sexual dysfunction and prolactin, sexual hormones, type of antipsychotic received, psychotic psychopathology or metabolic syndrome. Sexual dysfunction was only associated with age, civil status and depressive psychopathology.
There is a high prevalence of sexual dysfunction in the patients with schizophrenia who participated in the study, but it was only associated with higher age, being single or divorced or having depressive psychopathology; this suggests a multifactorial etiology for sexual dysfunction in schizophrenia.
尽管精神分裂症患者性功能障碍的患病率很高，但其病因仍不清楚。
确定一组精神分裂症门诊患者性功能障碍的患病率及病因。
本研究设计为横断面自然观察性研究，纳入接受第二代抗精神病药物单药治疗的精神分裂症门诊患者。排除正在接受抗抑郁药和/或心境稳定剂治疗的患者。记录以下数据：性功能、社会人口学信息、性病史、精神病性和抑郁性精神病理学、代谢综合征及体重指数。使用精神药物相关性性功能障碍问卷（PR SexDQ-Salsex）、阳性和阴性症状量表、汉密尔顿抑郁量表、催乳素、睾酮、雌二醇、孕酮的血浆浓度以及代谢综合征的国际糖尿病联盟诊断标准来完成本研究。
在纳入研究的57例患者中，80%存在性功能障碍，其中三分之一存在严重性功能障碍。然而，只有30%的患者主动报告了这个问题。尽管根据所使用的抗精神病药物不同，高催乳素血症和代谢综合征的患病率存在显著差异，但多变量回归分析未显示性功能障碍与催乳素、性激素、所使用的抗精神病药物类型、精神病性精神病理学或代谢综合征之间存在相关性。性功能障碍仅与年龄、婚姻状况和抑郁性精神病理学相关。
参与本研究的精神分裂症患者性功能障碍患病率很高，但仅与年龄较大、单身或离异或存在抑郁性精神病理学相关；这提示精神分裂症患者性功能障碍存在多因素病因。
