Angelaki Maria, Alexiou Eirini, Igoumenou Artemis, Alevizopoulos Giorgos
Department of Education, 251 Hellenic Air Force Hospital, Athens, Greece.
Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.
Front Psychiatry. 2023 Sep 1;14:1227218. doi: 10.3389/fpsyt.2023.1227218. eCollection 2023.
Patients with psychosis can develop sexual dysfunction, which may be related to the disease itself, psychosocial factors, somatic comorbidities, and the use of psychotropic medication.
We aimed to investigate the type and frequency of sexual dysfunction in patients diagnosed with schizophrenia or bipolar disorder in order to assess the side effects of antipsychotics in sexual function.
This is a multicenter, cross-sectional study, involving patients diagnosed with schizophrenia (79.3%) or bipolar disorder (20.7%) treated in the Department of Psychiatry and Community Mental Health Centers from November 2018 to December 2019. Patients were enrolled in the study after signed informed consent. Demographic and clinical data were collected from patients through a semi-structured interview. The Antipsychotics and Sexual Functioning Questionnaire (ASFQ) was administered to assess sexual function.
A total of 87 outpatients on antipsychotics were recruited in the study. The mean age was 43.6 years, while the mean duration of the disease was 16.9 years. Overall, only 9.1% of patients spontaneously reported sexual dysfunction. Patients treated with oral first-generation antipsychotics had more difficulties in achieving orgasm and decreased erection capacity. In contrast, patients treated with oral second-generation antipsychotics had decreased ejaculation capacity. Patients on antipsychotic combination therapy were associated with higher rates of sexual anhedonia.
These results suggest that sexual dysfunction is a side effect of antipsychotic treatment, which was spontaneously rarely reported by patients. It seems essential to obtain a psychosexual clinical history before initiating antipsychotic treatment to evaluate following changes and adopt an individualized strategy to manage sexual dysfunction induced by antipsychotics.
精神病患者可能会出现性功能障碍，这可能与疾病本身、心理社会因素、躯体合并症以及精神药物的使用有关。
我们旨在调查被诊断为精神分裂症或双相情感障碍患者性功能障碍的类型和频率，以评估抗精神病药物对性功能的副作用。
这是一项多中心横断面研究，纳入了2018年11月至2019年12月在精神科和社区心理健康中心接受治疗的被诊断为精神分裂症（79.3%）或双相情感障碍（20.7%）的患者。患者签署知情同意书后纳入研究。通过半结构化访谈收集患者的人口统计学和临床数据。使用抗精神病药物与性功能问卷（ASFQ）评估性功能。
本研究共招募了87名服用抗精神病药物的门诊患者。平均年龄为43.6岁，疾病平均病程为16.9年。总体而言，只有9.1%的患者自发报告性功能障碍。口服第一代抗精神病药物治疗的患者在达到性高潮和勃起能力方面存在更多困难。相比之下，口服第二代抗精神病药物治疗的患者射精能力下降。接受抗精神病药物联合治疗的患者性快感缺乏的发生率更高。
这些结果表明性功能障碍是抗精神病药物治疗的副作用，患者自发报告的情况很少。在开始抗精神病药物治疗前获取性心理临床病史似乎很有必要，以评估后续变化并采取个体化策略来处理抗精神病药物引起的性功能障碍。
