Faculty of Medicine, University of Queensland, Brisbane, Australia.
Faculty of Health, Queensland University of Technology, Brisbane, Australia.
Schizophr Bull. 2023 Jan 3;49(1):108-135. doi: 10.1093/schbul/sbac114.
The sexual and reproductive health (SRH) of young people with psychosis has been largely overlooked. We hypothesised that there are key deficiencies in the existing literature on the SRH of adolescents and young adults with psychotic disorders.
We conducted a systematic scoping review using Pubmed, Web of Science, Embase, PsycINFO, and CINAHL. We included empirical studies and case reports focused on SRH issues in young people (aged 14-24 years) with psychotic disorders. A qualitative synthesis was completed. Joanna Briggs Institute Critical Appraisal Tools were utilized to assess study quality.
Seventeen empirical studies and 52 case reports met inclusion criteria. Most focused on sexual dysfunction which was identified as common among this cohort and associated with both psychotic disorders and antipsychotics. The study population was more likely to engage in sexual risk-taking behavior and was at higher risk of sexually transmissible infections than those without psychosis. SRH topics of clinical relevance in older patients with psychosis such as pregnancy, abortion, sexual violence, coercion, sexual identity, and gender were poorly addressed in this younger group. We found empirical studies generally lacked identification and controlling of confounders whilst case reports provided limited description of mental health and SRH outcomes following clinical intervention.
Research and clinical practice addressing sexual and reproductive health is needed for young people living with psychosis. To address research gaps future studies should focus on women's health, sexual violence, gender, and sexuality in young people with psychosis.
年轻人的性与生殖健康（SRH）在很大程度上被忽视了。我们假设，在青少年和年轻成人精神障碍患者的 SRH 现有文献中存在一些关键的不足。
我们使用 Pubmed、Web of Science、Embase、PsycINFO 和 CINAHL 进行了系统的范围界定审查。我们纳入了以年轻（14-24 岁）精神障碍患者的 SRH 问题为重点的实证研究和病例报告。完成了定性综合。使用 Joanna Briggs 研究所的批判性评估工具来评估研究质量。
符合纳入标准的有 17 项实证研究和 52 份病例报告。大多数研究都集中在性障碍上，这在该队列中很常见，并且与精神障碍和抗精神病药物都有关。与没有精神障碍的患者相比，该研究人群更有可能从事性冒险行为，并且更有可能感染性传播感染。在老年精神病患者中具有临床相关性的 SRH 话题，如怀孕、堕胎、性暴力、胁迫、性认同和性别，在这个年轻群体中得到的关注较少。我们发现，实证研究通常缺乏对混杂因素的识别和控制，而病例报告则对精神健康和临床干预后 SRH 结果的描述有限。
需要对患有精神疾病的年轻人的性与生殖健康进行研究和临床实践。为了解决研究空白，未来的研究应侧重于年轻精神障碍患者的女性健康、性暴力、性别和性行为。
