Posada Correa Ana María, Andrade Carrillo Rommel Augusto, Suarez Vega Diana Cristina, Gómez Cano Sujey, Agudelo Arango Luis Guillermo, Tabares Builes Luis Fernando, Agudelo García Ángela María, Uribe Villa Esteban, Aguirre-Acevedo Daniel Camilo, López-Jaramillo Carlos
Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Rev Colomb Psiquiatr (Engl Ed). 2020 Jan-Mar;49(1):15-22. doi: 10.1016/j.rcp.2018.04.007. Epub 2018 Jul 23.
People with schizophrenia and bipolar disorder (BD) have a high risk of unwanted pregnancies and abortions, due to their condition of vulnerability or hypersexuality (common in BD). This is associated with difficulty in planning their actions and lack of sex education and counselling by medical personnel, and can lead to adverse obstetric outcomes and inability to care adequately for their children.
To describe the characteristics in terms of sexual and reproductive health, and the use of contraception and counselling in psychiatric consultations, in a sample of patients with BD and schizophrenia in Medellin, Colombia.
Observational cross-sectional study. We included the 160 participants from the clinical trial, "The effects of a multimodal intervention programme in patients with bipolar disorder and schizophrenia", who were recruited from the mood and psychosis disorders group clinic at Hospital Universitario de San Vicente Fundación in Medellin. They were contacted by phone by a third-year psychiatry resident, who applied a survey about the characteristics of their sex life, contraception and reproduction.
Almost all of the patients with schizophrenia were single, had no undergraduate studies and were unemployed. No significant differences were found regarding the age of starting sexual relations when comparing by diagnosis and gender. Almost all patients with schizophrenia and almost half of the patients with BD reported not having an active sexual life. Almost all of those who admitted to having an active sexual life claimed to always use contraception; in the BD group, only 48.8% of single women admitted to using contraception and a little over half of men stated that they used a condom when having sex. A quarter of the pregnancies were unplanned. Although the majority of the patients stated that they had never received information about family planning in the consultations with their psychiatrist, 57.4% of the patients with BD and 78.8% of those who had schizophrenia, considered themselves to be well informed on the subject.
Patients with mental illness have cognitive and behavioural alterations that affect their sexual and reproductive lives. Psychiatrists should therefore address this issue, to ensure education in areas such as contraception, family planning and sexually transmitted diseases and help safeguard the safety and quality of life of their patients.
精神分裂症和双相情感障碍（BD）患者由于其脆弱状态或性欲亢进（在BD中常见），意外怀孕和堕胎的风险很高。这与他们在计划自身行为方面存在困难以及缺乏医务人员的性教育和咨询有关，并且可能导致不良产科结局以及无法充分照顾自己的孩子。
描述哥伦比亚麦德林市双相情感障碍和精神分裂症患者样本在性与生殖健康方面的特征，以及在精神科会诊中避孕措施的使用和咨询情况。
观察性横断面研究。我们纳入了来自临床试验“多模式干预方案对双相情感障碍和精神分裂症患者的影响”的160名参与者，这些参与者是从麦德林市圣维森特基金会大学医院的情绪和精神障碍组诊所招募的。一名三年级精神科住院医师通过电话联系他们，并应用了一项关于他们性生活、避孕和生殖特征的调查。
几乎所有精神分裂症患者都是单身，没有本科学历且失业。按诊断和性别比较时，开始性行为的年龄没有发现显著差异。几乎所有精神分裂症患者以及近一半的双相情感障碍患者报告没有活跃的性生活。几乎所有承认有活跃性生活的人都声称总是采取避孕措施；在双相情感障碍组中，只有48.8%的单身女性承认使用避孕措施，略超过一半的男性表示他们在性行为时使用避孕套。四分之一的怀孕是意外怀孕。尽管大多数患者表示他们在与精神科医生会诊时从未收到过有关计划生育的信息，但57.4%的双相情感障碍患者和78.8%的精神分裂症患者认为自己在这个问题上了解充分。
患有精神疾病的患者存在影响其性与生殖生活的认知和行为改变。因此，精神科医生应该解决这个问题，以确保在避孕、计划生育和性传播疾病等领域提供教育，并帮助保障患者的安全和生活质量。
