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精神分裂症女性的性功能障碍、婚姻关系及主观生活质量:分析性病例对照研究

Sexual dysfunction, marital relationship, and subjective quality of life among women with schizophrenia: Analytical case-control study.

作者信息

Kumari Puja, Kumar Rajesh, Rohilla Jitendra

机构信息

College of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.

Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.

出版信息

Indian J Psychiatry. 2024 Mar;66(3):280-286. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_346_23. Epub 2024 Mar 18.

Abstract

BACKGROUND

Women with schizophrenia have a high risk of adverse sexual health outcomes. The chronic course of schizophrenia draws attention to assessing the quality of life and marital relationships of patients with schizophrenia. However, there is a crunch of data in the Indian setting. This study aimed to investigate the prevalence of sexual dysfunctions (SDs) and determine the marital relationship and quality of life among women with schizophrenia.

MATERIAL AND METHODS

The study followed an analytical case-control design. The study was conducted at the inpatient psychiatric department of one of the apex tertiary healthcare centers located at the foothills of the Northern Himalayas. The study purposively included 136 participants (68 cases and 68 controls). The control group included healthy women aged 18-45 currently staying with sexual partners. Data were collected using pretested and standardized self-report questionnaires.

RESULTS

The median age of the case group was 36 (interquartile range (IQR), 29-42) years, while that of the control group was 29 (IQR 26-34) years. The prevalence of SD was significantly higher ( = 0.001) in cases (95.3%) than in controls (73.4%). Compared to healthy controls, women with schizophrenia have a significantly higher rate of SD in sexual desire ( = 0.001), getting arousal ( < 0.001), lubrication ( < 0.001), achieving orgasm ( < 0.001), and sexual satisfaction ( < 0.001) (except pain). In addition, the marital relationship was better managed ( < 0.001) in healthy controls compared with cases. The healthy control group significantly expressed a better quality of life in physical ( < 0.001), psychological ( < 0.001), and maintaining social ( < 0.001) relationships (except environment domains). In multivariable logistic regression analysis, employment status significantly predicted SDs (odds ratio (OR), 25.78; 95% confidence interval (CI), 2.09, 318.10; < 0.05) in participants.

CONCLUSION

The prevalence of SD is significantly high among female participants. Hence, treating physicians should pay attention to sexual function during the screening and treatment of patients with schizophrenia.

摘要

背景

精神分裂症女性患者出现不良性健康结局的风险较高。精神分裂症的慢性病程促使人们关注评估精神分裂症患者的生活质量和婚姻关系。然而,在印度背景下存在数据匮乏的情况。本研究旨在调查性功能障碍(SDs)的患病率,并确定精神分裂症女性患者的婚姻关系和生活质量。

材料与方法

本研究采用分析性病例对照设计。研究在位于喜马拉雅山脉北部山麓的一家顶级三级医疗中心的住院精神科进行。本研究有意纳入了136名参与者(68例病例和68名对照)。对照组包括年龄在18 - 45岁、目前与性伴侣同住的健康女性。数据通过预先测试和标准化的自我报告问卷收集。

结果

病例组的中位年龄为36岁(四分位间距(IQR),29 - 42岁),而对照组为29岁(IQR 26 - 34岁)。病例组中SD的患病率(95.3%)显著高于对照组(73.4%)(P = 0.001)。与健康对照组相比,精神分裂症女性患者在性欲(P = 0.001)、唤起(P < 0.001)、润滑(P < 0.001)、达到性高潮(P < 0.001)和性满意度(P < 0.001)方面的SD发生率显著更高(疼痛方面除外)。此外,与病例组相比,健康对照组对婚姻关系的处理更好(P < 0.001)。健康对照组在身体(P < 0.001)、心理(P < 0.001)和维持社交(P < 0.001)关系方面(环境领域除外)显著表现出更好的生活质量。在多变量逻辑回归分析中,就业状况显著预测了参与者中的SDs(优势比(OR),25.78;95%置信区间(CI),2.09,318.10;P < 0.05)。

结论

女性参与者中SD的患病率显著较高。因此,治疗医生在精神分裂症患者的筛查和治疗过程中应关注性功能。

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