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Zhang L, Chen Y, Sun Y, Zhou Y, Li Q, Jia Y. Prevalence of sexual dysfunction in Chinese patients with schizophrenia: a systematic review and meta-analysis. Sex Med 2024; 12:qfae009. [PMID: 38562621 PMCID: PMC10982523 DOI: 10.1093/sexmed/qfae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/11/2024] [Accepted: 02/01/2024] [Indexed: 04/04/2024] Open
Abstract
Background There may be a higher risk of sexual dysfunction in the schizophrenia population. China has made significant contributions to the global community of patients with schizophrenia. Currently, there is no estimation of the prevalence of sexual dysfunction in Chinese patients with schizophrenia. Aim We conducted a meta-analysis to pool the evaluated prevalence of sexual dysfunction in Chinese patients with schizophrenia. Methods We systematically searched PubMed, Web of Science, Embase, PsycINFO, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Medical Network, and Huayi Academic Literature Database from inception to September 2023. Meta-analysis was conducted with R version 4.3.1. Outcomes To examine the pooled prevalence of sexual dysfunctions among Chinese patients with schizophrenia. Results In our meta-analysis, we included 16 studies with 5417 participants, among whom 1727 experienced sexual dysfunction. The results of the meta-analysis reveal that the prevalence of sexual dysfunction in Chinese patients with schizophrenia is 50.43% (95% CI, 37.86%-62.95%). Subgroup analysis results indicate that various factors-including the specific type of dysfunction, duration of illness, assessment tools, mean ages, study region, gender, research setting, marital status, publication years, and type of antipsychotics-all have a particular impact on the occurrence rate of sexual dysfunction in Chinese patients with schizophrenia. Female patients had a slightly higher prevalence of sexual dysfunction than male patients (65.22% vs 54.84%). Clinical Implications The findings of this study can be used in high-quality nursing care for the schizophrenia population, particularly for the care of specific sexual dysfunction nursing. Strengths and Limitations This meta-analysis is the first to evaluate the prevalence of sexual dysfunction in China among patients with schizophrenia. The limited number of studies is the most important limitation. Conclusions The pooled prevalence of sexual dysfunction in Chinese patients with schizophrenia is relatively high, and the prevention and intervention of individual sexual dysfunctions in schizophrenia are advised.
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Affiliation(s)
- Linghui Zhang
- Department of Nursing, Harbin Medical University, Harbin, 150081, China
| | - Yubin Chen
- Department of Nursing, Harbin Medical University, Harbin, 150081, China
| | - Yujing Sun
- Department of Nursing, Harbin Medical University, Harbin, 150081, China
| | - Yuqiu Zhou
- Department of Medical, Huzhou University, Huzhou, Zhejiang 313000, China
| | - Qi Li
- Department of Nursing, Harbin Medical University, Harbin, 150081, China
| | - Yannan Jia
- Department of Nursing, Harbin Medical University, Harbin, 150081, China
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Xiong Y, Zhang F, Zhang Y, Wang W, Ran Y, Wu C, Zhu S, Qin F, Yuan J. Insights into modifiable risk factors of erectile dysfunction, a wide-angled Mendelian Randomization study. J Adv Res 2024; 58:149-161. [PMID: 37236543 PMCID: PMC10982860 DOI: 10.1016/j.jare.2023.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/02/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION The causal association between modifiable risk factors and erectile dysfunction (ED) remains unclear, which hinders the early identification and intervention of patients with ED. The present study aimed to clarify the causal association between 42 predominant risk factors and ED. METHODS Univariate Mendelian Randomization (MR), multivariate MR, and mediation MR analyses were used to investigate the causal association between 42 modifiable risk factors and ED. Combined results were pooled from two independent ED genome-wide association studies to verify the findings. RESULTS Genetically predicted body mass index (BMI), waist circumference, trunk fat mass, whole body fat mass, poor overall health rating, type 2 diabetes, basal metabolic rate, adiponectin, cigarette consumption, insomnia, snoring, hypertension, stroke, ischemic stroke, coronary heart disease, myocardial infarction, heart failure, and major depressive disorder were found to increase the risk of ED (all P < 0.05). Additionally, genetic liability to higher body fat percentage and alcohol consumption were suggestively associated with an increased risk of ED (P < 0.05 and adjusted P > 0.05). Genetic predisposition to higher sex hormone-binding globulin (SHBG) levels could decrease the risk of ED (P < 0.05). No significant association was detected between lipid levels and ED. Multivariate MR identified type 2 diabetes, basal metabolic rate, cigarette consumption, hypertension, and coronary heart disease as risk factors for ED. The combined results confirmed that waist circumference, whole body fat mass, poor overall health rating, type 2 diabetes, basal metabolic rate, adiponectin, cigarette consumption, snoring, hypertension, ischemic stroke, coronary heart disease, myocardial infarction, heart failure, and major depressive disorder could increase the risk of ED (all P < 0.05), while higher SHBG decreased the risk of ED (P = 0.004). There were suggestive significances of BMI, insomnia, and stroke on ED (P < 0.05 and adjusted P > 0.05). CONCLUSION This comprehensive MR study supported the causal role of obesity, type 2 diabetes, basal metabolic rate, poor self-health rating, cigarette and alcohol consumption, insomnia and snoring, depression, hypertension, stroke, ischemic stroke, coronary heart disease, myocardial infarction, heart failure, SHBG, and adiponectin in the onset and development of ED.
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Affiliation(s)
- Yang Xiong
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Fuxun Zhang
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yangchang Zhang
- Department of Public Health, Capital Medical University, Beijing 100000, China
| | - Wei Wang
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yuxin Ran
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, Chongqing 401331, China
| | - Changjing Wu
- Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Shiyu Zhu
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Feng Qin
- Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jiuhong Yuan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China.
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Akbari M, Jamshidi S, Sheikhi S, Alijani F, Kafshchi P, Taylor D. Aripiprazole and its adverse effects in the form of impulsive-compulsive behaviors: A systematic review of case reports. Psychopharmacology (Berl) 2024; 241:209-223. [PMID: 38227009 DOI: 10.1007/s00213-024-06529-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/06/2024] [Indexed: 01/17/2024]
Abstract
Aripiprazole is an efficacious treatment for both the positive and negative symptoms of schizophrenia and is also commonly used as a mood stabilizer. It is associated with better tolerability compared with other antipsychotics. However, there are reports of patients who experience problem gambling, hypersexuality, obsessive-compulsive symptoms, and other impulsive and/or compulsive behaviors as a result of aripiprazole administration and/or dosage increase. We aimed to do a systematic review of case reports published in this regard. After screening more than 6000 titles and abstracts in ten scientific search engines, we found 35 related records comprising 59 cases. The majority of cases (n = 42, 71.18%) were male, the mean age was 33.83 years (± 13.40), and the average daily dose of aripiprazole was 11.63 mg (± 6.94). The results of our review showed that the most frequently published impulsivity adverse effect of aripiprazole is gambling, followed by hypersexuality, obsessive-compulsive symptoms/disorder, problem eating, trichotillomania, problem shopping, and kleptomania. These symptoms were experienced both by patients who had previous problems in these areas and those who did not. In the majority of cases, the symptoms appeared within 30 days after aripiprazole administration started and ceased within 30 days of its discontinuation and/or dose decrease. Clinicians should be aware of impulsivity adverse effects, monitor them, and educate both patients and the family about them.
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Affiliation(s)
- Mehdi Akbari
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, No.43. South Mofatteh Ave, Tehran, Iran.
| | - Shiva Jamshidi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, No.43. South Mofatteh Ave, Tehran, Iran
| | - Sonay Sheikhi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, No.43. South Mofatteh Ave, Tehran, Iran
| | - Farhad Alijani
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, No.43. South Mofatteh Ave, Tehran, Iran
| | - Parsa Kafshchi
- Department of Human Sciences, Faculty of Psychology, Islamic Azad University, Zanjan, Iran
| | - David Taylor
- Pharmacy Department, Maudsley Hospital, Denmark Hill, London, SE5 8AF, England, UK
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Korchia T, Achour V, Faugere M, Albeash A, Yon DK, Boyer L, Fond G. Sexual Dysfunction in Schizophrenia: A Systematic Review and Meta-Analysis. JAMA Psychiatry 2023; 80:1110-1120. [PMID: 37703012 PMCID: PMC10500435 DOI: 10.1001/jamapsychiatry.2023.2696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 06/04/2023] [Indexed: 09/14/2023]
Abstract
Importance In individuals with schizophrenia, antipsychotic-induced dysfunctions are frequent but often underexplored in clinical practice. Objective To synthetize the data of observational studies exploring the prevalence of sexual dysfunction in individuals with schizophrenia-spectrum disorders as well as associated factors. Data Sources A systematic literature search without language or time restrictions was conducted in Google, Google Scholar, PubMed/MEDLINE, Science Direct, and Université Sorbonne Paris Cité for studies published up to June 8, 2022. Study Selection All observational studies reporting a prevalence of sexual dysfunction in schizophrenia-spectrum disorder were included. Data Extraction and Synthesis The MOOSE guidelines with independent extraction by 2 observers and random-effects models were used. Main Outcomes and Measures The prevalence of sexual dysfunction and each specific dysfunction. Results A total of 72 of 1119 studies from 33 countries on 6 continents published from inception to June 2022 were included with a total of 21 076 participants with schizophrenia. The pooled global prevalence of sexual dysfunctions was 56.4% (95% CI, 50.5-62.2), with a prevalence of 55.7% (95% CI, 48.1-63.1) for men and 60.0% (95% CI, 48.0-70.8) for women. The most frequent sexual dysfunction was erectile dysfunction in men (44%; 95% CI, 33.5-55.2), followed by loss of libido in men (41%; 95% CI, 30.7-51.4), ejaculation dysfunction in men (39%; 95% CI, 26.8-51.8), orgasm dysfunction in women (28%; 95% CI, 18.4-40.2), and amenorrhea in women (25%; 95% CI, 17.3-35.0). Factors associated with heterogeneity were study design, time and location, sociodemographic data, alcohol use disorder, psychiatric diagnosis, illness severity, and the use of antidepressants and anxiolytics. Sexual dysfunctions were more frequent in schizophrenia vs schizoaffective disorders, and erectile disorders were less frequent in individuals with longer illness duration. Antidepressant and mood stabilizer prescriptions were associated with lower rates of erection disorders (β, -6.30; 95% CI, -10.82 to -1.78); P = .006 and -13.21; 95% CI, -17.59 to -8.83; P < .001, respectively) and ejaculation disorders (β, -6.10; 95% CI, -10.68 to -1.53; P = .009 and β, -11.57; 95% CI, -16.34 to -6.80; P < .001, respectively). No obvious improvements in the rates of sexual dysfunction at other times were found, and there were conflicting results regarding antipsychotic classes. Conclusions and Relevance This systematic review and meta-analysis found a high prevalence of sexual dysfunction among individuals with schizophrenia, with considerable heterogeneity in associated factors. The findings also suggest that some dysfunctions may be explained by schizophrenia. The association between lower rates of dysfunction and antidepressant use suggests that treating comorbid depression could be an effective strategy to improve sexual health. A lack of data on metabolic parameters and physical health in general was also noted, while these issues are frequent in the care of schizophrenia.
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Affiliation(s)
- Théo Korchia
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - Vincent Achour
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - Mélanie Faugere
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
- FondaMental Foundation, Creteil, France
| | - Ali Albeash
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Laurent Boyer
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
- FondaMental Foundation, Creteil, France
| | - Guillaume Fond
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, CEReSS - Health Service Research and Quality of Life Center, Marseille, France
- FondaMental Foundation, Creteil, France
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Martinez J, Verot E. Nurses' and auxiliary nurses' beliefs and attitudes regarding the sexual health of patients with severe mental illness: A qualitative study. J Psychiatr Ment Health Nurs 2023. [PMID: 37897106 DOI: 10.1111/jpm.12989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/01/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023]
Abstract
INTRODUCTION Sexual health is essential to the overall health. People suffering from severe mental illness (SMI) experience a deterioration in their sexual health. These patients and their caregivers seem unwilling to engage in a dialogue concerning sexual health within the context of mental health care. AIM The study investigated nurses' and care assistants' beliefs and attitudes regarding the sexual health of people with SMI on the psychiatric care pathway. METHODS Twenty semi-structured interviews were conducted with nurses and care assistants. Data were subject to a thematic analysis. RESULTS Three main themes emerged: (1) The formalization of the care approach towards people with a SMI in hospitals; (2) the place given to sexual health in psychiatry units; (3) nurses and care assistants are not equipped to deal with patients' sexual health. DISCUSSION Caregivers consider that sexual health is a fundamental right and an indicator of good health. They nevertheless believe that the psychiatric hospital remains a place of acute care where sexual health is not considered. IMPLICATION FOR PRACTICE This research justifies that it is necessary to question the representations of nurses and care assistants before implementing a tailored intervention that integrates the consideration of sexual health into the holistic care of the patient on the psychiatric care pathway.
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Affiliation(s)
| | - Elise Verot
- Faculty of Medicine, Jean Monnet University, Saint-Etienne, France
- Systemic Health Pathway Laboratory (P2S) UR4129, University of Lyon, Lyon, France
- PRESAGE Institut, University of Saint-Etienne, Saint-Etienne, France
- CIC1408 Inserm, CHU de Saint-Etienne, Saint-Etienne, France
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Angelaki M, Alexiou E, Igoumenou A, Alevizopoulos G. Frequency of sexual dysfunction in outpatients with severe mental illness in Greece. Front Psychiatry 2023; 14:1227218. [PMID: 37720899 PMCID: PMC10503055 DOI: 10.3389/fpsyt.2023.1227218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction 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. Objective 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. Methods 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. Results 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. Discussion 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.
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Affiliation(s)
- Maria Angelaki
- Department of Education, 251 Hellenic Air Force Hospital, Athens, Greece
| | - Eirini Alexiou
- Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
- Center for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Artemis Igoumenou
- Division of Psychiatry, University College London, London, United Kingdom
| | - Giorgos Alevizopoulos
- Department of Psychiatry, Agioi Anargyroi Hospital, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
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Karslioğlu EH, Kolcu Z, Karslioğlu Nİ, Çayköylü A. Prospective analysis of serum prolactin levels, clinical symptomatology and sexual functions in patients with schizophrenia switched to paliperidone palmitate 3-monthly from paliperidone palmitate 1-monthly: Preliminary findings of the first 3 months. Hum Psychopharmacol 2022; 37:e2827. [PMID: 34787912 DOI: 10.1002/hup.2827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/20/2021] [Accepted: 11/03/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Long-acting injectable (LAI) antipsychotics were developed to improve adherence to schizophrenia treatment. Paliperidone palmitate (PP) has two LAI forms: Monthly (PP1M) and three-monthly (PP3M). PP3M shows less difference in Peak-to-Trough drug concentration levels. This could be related to a lower incidence of hyperprolactinemia, which may negatively affect adherence. We aimed to compare prolactin levels and investigate relationships between prolactin levels, symptomatology and sexual function in patients with schizophrenia after switching from PP1M to PP3M. METHODS Twenty-five patients were enrolled. The sociodemographic data form, the Positive and Negative Syndromes Scale (PANSS) and the Arizona Sexual Experience Scale (ASEX) were used. Morning blood samples were drawn to determine prolactin levels. RESULTS Prolactin level (p < 0.001), the total score and arousal sub-score of ASEX (respectively; p = 0.015, p = 0.020) and the total score and positive scale of PANSS (respectively; p = 0.017, p = 0.021) were decreased on the 90th day (±15 days). CONCLUSIONS After switching to PP3M, the decreases in prolactin levels and potentially related sexual side effects was statistically significant. There may be a difference between two formulations of the same drug in terms of side effects, and there is a need for prospective follow-up studies with larger samples.
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Affiliation(s)
| | - Zeynep Kolcu
- Department of Psychiatry, Ankara Oncology Research and Training Hospital, Ankara, Turkey
| | | | - Ali Çayköylü
- Department of Psychiatry, Ankara Oncology Research and Training Hospital, Yıldırım Beyazıt University, Ankara, Turkey
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Chaudhury S, Dhamija S, Davis S, Gupta N, Mujawar S, Saldanha D. Prevalence of sexual dysfunction in women with schizophrenia: A prospective study. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_917_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Brand E, Nagaraj D, Ratsch A, Heffernan E. A Qualitative Study on Sexuality and Sexual Experiences in Community Forensic Mental Health Patients in Queensland, Australia. Front Psychiatry 2022; 13:832139. [PMID: 35432027 PMCID: PMC9008211 DOI: 10.3389/fpsyt.2022.832139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/09/2022] [Indexed: 11/23/2022] Open
Abstract
This qualitative study reports on the sexuality and sexual experiences of community-based forensic mental health participants. The findings indicate that these participants feel the need for intimacy and want to engage in sexual activity more often than their neurotypical Australian peers. Participants identified their mental health and the side effects of compliance with prescribed psychotropic medications were barriers to achieving their desired level of sexual activity. Participants supported the notion that mental health teams were positioned to assist patients navigate the psychological, cultural, education and physical barriers to achieving sexual health and wellbeing. We propose several interventions to support these participants and other community forensic mental health patients in attaining healthy relationships, understanding their sexual health, and gaining more fulfilling sexual experiences. These interventions, which include sex education, upskilling in socialization and communication, and regular medication reviews, could be delivered as part of the holistic care provided by mental health teams. Mental health clinicians should be offered appropriate training to assess patients and have discussions related to sexuality, sexual experiences and sexual health needs.
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Affiliation(s)
- Elnike Brand
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Dinesh Nagaraj
- Community Mental Health and Addiction Services, Waikato District Health Board, Hamilton, New Zealand
| | - Angela Ratsch
- Wide Bay Hospital and Health Service, Research Services, Hervey Bay Hospital, Hervey Bay, QLD, Australia.,Rural Clinical School, The University of Queensland, Brisbane, QLD, Australia
| | - Edward Heffernan
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Colonnello E, Limoncin E, Ciocca G, Sansone A, Mollaioli D, Balercia G, Porst H, Zhang H, Yu X, Zhang Y, Jannini EA. The Lost Penis Syndrome: A New Clinical Entity in Sexual Medicine. Sex Med Rev 2021; 10:113-129. [PMID: 34620562 DOI: 10.1016/j.sxmr.2021.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/22/2021] [Accepted: 08/28/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The "lost penis syndrome" (LPS) is a term often used in non-clinical settings to describe the subjective perception of the loss of cutaneous and proprioceptive feelings of the male organ during vaginal penetration. Although deserving clinical attention, this syndrome did not receive any consideration in the medical literature. Notwithstanding, it represents a relatively unexceptional condition among patients in sexual medicine clinics, and it is often reported together with other sexual dysfunctions, especially delayed ejaculation, anejaculation, male anorgasmia and inability to maintain a full erection. OBJECTIVES To draft a new conceptual characterization of the LPS, defined as a lack of penile somesthetic sensations during sexual penetration due to various causes and leading to several sexual consequences in both partners. METHODS Based on an extensive literature review and physiological assumptions, the mechanisms contributing to friction during penovaginal intercourse, and their correlation to LPS, have been explored, as well as other nonanatomical factors possibly contributing to the loss of penile sensations. RESULTS Efficient penile erection and sensitivity, optimal vaginal lubrication and trophism contribute to penovaginal friction. Whenever one of these processes does not occur, loss of penile sensation defined as LPS can occur. Sociocultural, psychopathological and age-related (ie, couplepause) factors are also implicated in the etiology. Four types of LPS emerged from the literature review: anatomical and/or functional, behavioral, psychopathological and iatrogenic. According to the subtype, a wide variety of treatments can be employed, including PDE5i, testosterone replacement therapy and vaginal cosmetic surgery, as well as targeted therapy for concomitant sexual comorbidity. CONCLUSION We held up the mirror on LPS as a clinically existing multifactorial entity and provided medical features and hypotheses contributing to or causing the occurrence of LPS. In the light of a sociocultural and scientific perspective, we proposed a description and categorization of this syndrome hypothesizing its usefulness in daily clinical practice. Colonnello E, Limoncin E, Ciocca G, et al. The Lost Penis Syndrome: A New Clinical Entity in Sexual Medicine. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Elena Colonnello
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Erika Limoncin
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy; Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Giacomo Ciocca
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Andrea Sansone
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Daniele Mollaioli
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Hartmut Porst
- European Institute for Sexual Health (EISH), Hamburg, Germany
| | - Hui Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, PRC
| | - Xi Yu
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, PRC
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, PRC
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Căpățînă O, Stănculete MF, Micluția I. Behavioral outputs of negative symptom domains of schizophrenia. Exp Ther Med 2021; 22:805. [PMID: 34093761 PMCID: PMC8170643 DOI: 10.3892/etm.2021.10237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/31/2021] [Indexed: 11/05/2022] Open
Abstract
The present study aimed to validate the hypothesis that negative symptoms of schizophrenia encompass two domains, namely avolition-apathy (AA) and diminished expression (DE), and to investigate the relationship of these domains with behavioral outputs which imply hedonic activities: Cigarette use and weight gain. A total of 106 consecutive schizophrenia outpatients with primary negative symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS), the Negative Symptoms Assessment Scale (NSA-16), the Calgary Depression Scale for Schizophrenia (CDSS), and the Simpson-Angus Scale (SAS). A semi-structured interview was used to assess demographic features, the number of cigarettes smoked per day, and body mass index. Data were analyzed using descriptive statistics, principal component analysis, analysis of variance, and covariance. A two-factor solution was revealed for the negative symptoms of schizophrenia represented by AA and DE. Analyses of variance and covariance suggested that higher AA scores were associated with normal weight and non-smoking status. No significant differences were revealed regarding DE scores in relationship with the same behavioral hedonic outputs. The present results indicated the AA and DE domains exhibit meaningful differences concerning the outcome, which may imply the need for different approaches regarding rating and treatment.
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Affiliation(s)
- Octavia Căpățînă
- Department of Neurosciences, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Mihaela Fadgyas Stănculete
- Department of Neurosciences, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Ioana Micluția
- Department of Neurosciences, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Liu D, Liu S, Xiu M, Deng H, Guo H, Liu W, Zhang D, Mao Z, Huang D, Huang D, Miao Q, Qiu L, Zhao NO, Wu HE, Zhang X. Sexual Dysfunction in Chronically Medicated Male Inpatients With Schizophrenia: Prevalence, Risk Factors, Clinical Manifestations, and Response to Sexual Arousal. Front Psychiatry 2021; 12:761598. [PMID: 35095591 PMCID: PMC8795612 DOI: 10.3389/fpsyt.2021.761598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/23/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Sexual dysfunction is a common symptom in patients with schizophrenia, especially in chronically medicated patients. However, the relationship between sexual dysfunction and emotional response to sexual arousal in male patients with schizophrenia remains unclear. This study aimed to assess the incidence, risk factors of sexual dysfunction in males, and their clinical correlations to sexual arousal in male patients with schizophrenia in China. METHODS A total of 162 male patients, aged 18-50 years, with schizophrenia were recruited from a psychiatric hospital in Ganzhou. The clinical symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). The Arizona Sexual Experience Scale was utilized to evaluate sexual dysfunction. Erotic images were selected from International Affective Picture System (IAPS). Sixty-eight out of the 162 subjects completed the erotic pictures reactivity task. RESULTS Overall, 48 (29.6%) patients were measured as having global sexual dysfunction, 72 (44.4%) patients as having strength of sex drive dysfunction, 51 (31.5%) patients as having sexual arousal dysfunction, 55 (34.0%) patients as having penile erection dysfunction, 60 (37.0%) patients as having reached orgasm dysfunction, and 60 (37.0%) patients as having satisfaction with orgasm dysfunction. The sexual dysfunction patients had significantly higher scores on the negative symptoms of the PANSS. The only important predictor of sexual dysfunction was the severity of PANSS negative factor. The sense of pleasure and arousal post viewing erotic images in the sexual dysfunction group were lower compared to the non-sexual dysfunction group. The sense of pleasure and approach motivation were significantly negatively correlated with the severity of sexual dysfunction. CONCLUSIONS This study shows that nearly one-third of young and middle-aged chronically medicated male inpatients with schizophrenia suffer from sexual dysfunction. The negative factor of the PANSS can be regarded as the risk factor of sexual dysfunction. Schizophrenia patients with sexual dysfunction experienced lower pleasure and higher avoidance motivation than non-sexual dysfunction patients when exposed to erotic stimuli.
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Affiliation(s)
- Dianying Liu
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Shaohua Liu
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Meihong Xiu
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Hongdong Deng
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Huiyun Guo
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Wanglin Liu
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Delong Zhang
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Zhongzhen Mao
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Dan Huang
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Donghua Huang
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Qiumei Miao
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Lijuan Qiu
- Ganzhou City Key Laboratory of Mental Health, The Third People's Hospital of Ganzhou City, Ganzhou, China
| | - Ning Olivia Zhao
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Hanjing Emily Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Xiangyang Zhang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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A Paradigmatic Case of Postselective Serotonin Reuptake Inhibitors Sexual Dysfunction or Withdrawal After Discontinuation of Selective Serotonin Reuptake Inhibitors? J Clin Psychopharmacol 2020; 40:93-95. [PMID: 31834096 DOI: 10.1097/jcp.0000000000001154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Elnazer HY, Baldwin DS. Structured review of the use of the Arizona sexual experiences scale in clinical settings. Hum Psychopharmacol 2020; 35:e2730. [PMID: 32236977 DOI: 10.1002/hup.2730] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Approximately 40% of women and 30% of men describe sexual dysfunction, although recognition in medical settings is suboptimal, due to problems in reporting and eliciting concerns relating to sexual function and satisfaction. Screening questionnaires may help to support this aspect of clinical practice. The Arizona sexual experiences scale (ASEX) includes items that quantify sex drive, arousal, vaginal lubrication or penile erection, ability to reach orgasm, and satisfaction from orgasm. METHOD We investigated the validity and other psychometric properties of the ASEX, and the findings from the populations in which it has been employed, by searching MEDLINE, EMBASE, and Google Scholar using the terms, Arizona sexual experiences scale, Arizona Sexual Experience Questionnaire, and ASEX. We eliminated duplications, letters, and papers not available in English, and grouped the remaining papers into the categories of psychometric, epidemiological, and outcome-based studies. RESULTS After elimination of letters and duplicates, papers not in English, and preclinical and irrelevant studies, 104 papers were analyzed. The ASEX has excellent internal consistency, scale reliability and strong test-retest reliability. Analyses of variance reveal significant differences in total ASEX scores between patients and controls and between females and males. ASEX appears to be useful in a range of clinical situations including patients with primary sexual dysfunction, specific psychiatric disorders, specific physical illnesses, and treatment emergent sexual dysfunction. DISCUSSION The ASEX appears to be a reliable instrument for identifying and quantifying sexual dysfunction across a range of populations in various clinical settings. Little is known about its utility in patients with anxiety disorders or relationships between ASEX scores and biological parameters.
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Affiliation(s)
- Hesham Y Elnazer
- Faculty of Medicine, Clinical and Experimental Sciences (CNS and Psychiatry). Academic Department, University of Southampton, Southampton, UK
| | - David S Baldwin
- Faculty of Medicine, Clinical and Experimental Sciences (CNS and Psychiatry). Academic Department, University of Southampton, Southampton, UK
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Dumontaud M, Korchia T, Khouani J, Lancon C, Auquier P, Boyer L, Fond G. Sexual dysfunctions in schizophrenia: Beyond antipsychotics. A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2020; 98:109804. [PMID: 31711954 DOI: 10.1016/j.pnpbp.2019.109804] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/10/2019] [Accepted: 11/05/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Sexual dysfunctions (SD) in schizophrenia are frequent with strong impact on adherence and quality of life. Current recommendations stipulate to switch to prolactin-sparing antipsychotic in case of SD. OBJECTIVES To synthetize in a systematic review data on the SD prevalence and the associated risk factors in schizophrenia (SZ). METHODS Medline, Google Scholar, PsychInfo, and Cochrane were explored, without any year or language restriction. RESULTS Overall, 89 studies and 25,490 participants were included in the present review. SZ subjects aged 18-70 reported high SD frequency [30%-82%] (men [33%- 85%]; women [25%- 85%]). For SZ men erectile dysfunction [31%-95%] was the most frequent SD vs. loss of libido for women [31%-100%]. The following risk factors were associated with increased SD: 1. Illness severity (including psychotic symptomatology, early age at SZ onset, negative symptomatology, and continuous illness course), 2. Depressive symptomatology 3. Antipsychotics (especially first generation antipsychotics, risperidone and antipsychotic polytherapy). Switching to prolactin-sparing antipsychotics has shown effectiveness in some studies (especially aripiprazole). Antidepressants were not found to be associated with SD in SZ subjects. CONCLUSION The prevalence of SD is high in SZ subjects. In addition to the current guidelines, the present review suggests that treating depressive symptoms may be a major intervention to improve SD in SZ subjects. Sociodemographic variables, physical illnesses, metabolic syndrome and peripheral inflammation have been poorly or never explored and should be included in future studies.
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Affiliation(s)
- Marion Dumontaud
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France
| | - Théo Korchia
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France
| | - Jérémy Khouani
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France
| | - Christophe Lancon
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Sainte-Marguerite Hospital, Marseille, France
| | - Pascal Auquier
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France
| | - Laurent Boyer
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France
| | - Guillaume Fond
- Aix-Marseille Univ, CEReSS-Health Service Research and Quality of Life Center, School of Medicine-La Timone Medical, Marseille, France; Aix-Marseille Univ, APHM, Department of Medical Information and Public Health, Marseille, France.
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16
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Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. Medical conditions and sexual dysfunction in post-menopausal women. SEXUAL AND RELATIONSHIP THERAPY 2019. [DOI: 10.1080/14681994.2019.1672866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Soheila Nazarpour
- Department of Midwifery, Chalous Branch, Islamic Azad University, Chalous, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Fond G, Godin O, Dumontaud M, Faget C, Schürhoff F, Berna F, Aouizerate B, Capdevielle D, Chereau I, D'Amato T, Dubertret C, Dubreucq J, Leignier S, Mallet J, Misdrahi D, Passerieux C, Rey R, Schandrin A, Szoke A, Urbach M, Vidailhet P, Leboyer M, Lançon C, Boyer L, Llorca PM. Sexual dysfunctions are associated with major depression, chronic inflammation and anticholinergic consumption in the real-world schizophrenia FACE-SZ national cohort. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109654. [PMID: 31125587 DOI: 10.1016/j.pnpbp.2019.109654] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Sexual dysfunctions (SD) are frequent in schizophrenia (SZ) and associated with treatment withdrawal, however they remain under-explored and under-treated. To date, most of the studies have focused on SD as antipsychotics' side effects in therapeutic trials. AIMS The objectives of the present study were to determine the SD prevalence in stabilized SZ outpatients and their clinical, pharmacological and biological correlates. METHOD Two hundred and thirty-seven participants (61.2% men) were consecutively included and received a thorough 2 days- clinical assessment including the self-reported Sexual Functioning Questionnaire (SFQ). SD was defined by a SFQ score ≥ 8. RESULTS Two hundred and thirty-seven subjects were recruited in the FACE-SZ cohort, 41% of them reported sexual dysfunctions. In multivariate analyses, SD have been associated with current major depressive disorder (adjusted odd ratio aOR = 2.29[1.08-4.85], p = .03), anticholinergic prescription (aOR = 2.65, p = .02) and chronic low-grade inflammation (aOR = 2.09, p = .03) independently of age, gender, current cannabis use disorder and olanzapine prescription. No antipsychotic has been associated with increased or decreased SD rate. CONCLUSIONS SD are frequent in SZ subjects. Major depression, anticholinergic prescription and chronic low-grade peripheral inflammation may be the three targets of interest for addressing this specific issue.
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Affiliation(s)
- G Fond
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France.
| | - O Godin
- Fondation FondaMental, Créteil, France; Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75013 Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013 Paris, France
| | - M Dumontaud
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - C Faget
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France; INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil, France; DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Université Paris-Est Créteil, Créteil, France
| | - F Berna
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France; INRA, NutriNeuro, University of Bordeaux, U1286, F-33076 Bordeaux, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - S Leignier
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - J Mallet
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France; CNRS UMR 5287-INCIA, F-33076 Bordeaux, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - R Rey
- Fondation FondaMental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - A Schandrin
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - A Szoke
- Fondation FondaMental, Créteil, France; INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil, France; DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Université Paris-Est Créteil, Créteil, France
| | - M Urbach
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - P Vidailhet
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil, France; DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Université Paris-Est Créteil, Créteil, France
| | - C Lançon
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - L Boyer
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
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Prata Ribeiro H, Figueiredo IC, Vitória-Silva J, Barata P, Fernandes EP, Marques TR. Translation and cross-cultural adaptation of the Arizona Sexual Scale (ASEX) into Portuguese. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2019; 41:247-253. [PMID: 31390459 DOI: 10.1590/2237-6089-2018-0056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 12/13/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Sexual dysfunction is common in individuals with psychiatric disorders and under psychotropic medication such as antidepressants and antipsychotics. Several scales have been developed to assess sexual function in these patients. The Arizona Sexual Scale (ASEX) is a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. We describe the translation and cross-cultural adaptation of the ASEX into the Portuguese language, with the goal of contributing to the assessment of sexual function in Portuguese-speaking psychiatric patients under treatment with psychotropic drugs. METHODS The translation and cross-cultural adaptation process thoroughly followed the steps recommended by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), namely: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing, finalization, proofreading, and final version. RESULTS The process was successfully completed and no major differences were found between the translation, reconciliation and back-translation phases, with only small adjustments being made. CONCLUSION The translation of the ASEX was completed successfully, following international reference guidelines. The use of these guidelines is a guarantee of a Portuguese version that is qualitatively and semantically equivalent to the original scale. This availability of this new scale version will enable studies evaluating the sexual function of Portuguese-speaking psychiatric patients. Future studies may assess the validity of the scale for Portuguese-speaking populations.
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Affiliation(s)
| | - Inês Carreira Figueiredo
- Clínica 3, Centro Hospitalar Psiquiátrico de Lisboa , Lisboa , Portugal .,Department of Psychosis studies , Institute of Psychiatry, Psychology and Neuroscience , King's College , London , UK
| | | | - Pedro Barata
- Hospital Professor Doutor Fernando Fonseca , Amadora , Portugal
| | - Eduardo Palha Fernandes
- Departamento de Psiquiatria e Saúde Mental , Unidade Local de Saúde do Alto Minho , Viana do Castelo , Portugal
| | - Tiago Reis Marques
- Department of Psychosis studies , Institute of Psychiatry, Psychology and Neuroscience , King's College , London , UK
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Huang YH, Hou CL, Ng CH, Chen X, Wang QW, Huang ZH, Jia FJ. Sexual dysfunction in Chinese rural patients with schizophrenia. BMC Psychiatry 2019; 19:218. [PMID: 31299942 PMCID: PMC6624902 DOI: 10.1186/s12888-019-2205-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 07/08/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Sexual dysfunction is common in patients with schizophrenia, however it is poorly studied in China, especially in primary health care institutions in rural areas. We investigated the prevalence of sexual dysfunction and its correlates including quality of life (QoL), in schizophrenia patients treated in primary care in a rural area in China. METHOD By using a random numbers table, 21 small town primary care service centers (from 63 totally) were selected in the study. Data of 720 community-dwelling patients with schizophrenia in rural area with diagnoses according to DSM -IV or ICD-10 were collected by interviews. Data on socio-demographic and clinical characteristics including sexual dysfunction and quality of life (QoL) were collected using a standardized protocol and data collection procedure. Data were analyzed using chi-square tests, t-tests, U-tests, ANCOVA and multiple logistic regression as appropriate by SPSS 21.0.The level of significance was set at 0.05 (two-tailed). RESULTS In this sample, sexual dysfunction was found in 71.3% of the whole sample, 82.7% of female patients and 64.5% of male patients. Multiple logistic regression analysis showed that older age (OR = 1.06, P<0.001, 95%CI: 1.04-1.09) and higher Brief Psychotic Rating Scale (negative domain) score (OR = 1.16, P = 0.01, 95%CI: 1.02-1.31) were significantly associated with sexual dysfunction. Contrary to previous findings, sexual dysfunction was not associated with quality of life after controlling for confounding variables. CONCLUSIONS More than 2/3 of schizophrenia patients living in a rural area complained of sexual dysfunction, which was associated with older age and more negative psychotic symptoms. Primary care physicians should pay attention to sexual dysfunction during the assessment and treatment of patients with schizophrenia in rural areas in China.
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Affiliation(s)
- Ying-Hua Huang
- Shantou University Medical College, Shantou, Guangdong Province China
- Guangdong Provincial People’s Hospital, Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province China
| | - Cai-Lan Hou
- Guangdong Provincial People’s Hospital, Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province China
| | - C. H. Ng
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria Australia
| | - Xie Chen
- Shantou University Medical College, Shantou, Guangdong Province China
- Guangdong Provincial People’s Hospital, Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province China
| | - Qian-Wen Wang
- Guangdong Provincial People’s Hospital, Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province China
| | - Zhuo-Hui Huang
- Guangdong Provincial People’s Hospital, Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province China
| | - Fu-Jun Jia
- Guangdong Provincial People’s Hospital, Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province China
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Downing L, Kim DD, Procyshyn RM`, Tibbo P. Management of sexual adverse effects induced by atypical antipsychotic medication. J Psychiatry Neurosci 2019; 44:287-288. [PMID: 31245972 PMCID: PMC6606426 DOI: 10.1503/jpn.190053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Laura Downing
- From the Department of Psychiatry, Dalhousie University, Halifax, NS, Canada (Downing, Tibbo); the Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada (Kim); and the Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada (Procyshyn)
| | - David D. Kim
- From the Department of Psychiatry, Dalhousie University, Halifax, NS, Canada (Downing, Tibbo); the Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada (Kim); and the Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada (Procyshyn)
| | - Ric M. ` Procyshyn
- From the Department of Psychiatry, Dalhousie University, Halifax, NS, Canada (Downing, Tibbo); the Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada (Kim); and the Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada (Procyshyn)
| | - Philip Tibbo
- From the Department of Psychiatry, Dalhousie University, Halifax, NS, Canada (Downing, Tibbo); the Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada (Kim); and the Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada (Procyshyn)
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Ghormode D, Gupta P, Ratnani D, Aneja J. Evaluation of sexual dysfunction and quality of life in patients with severe mental illness: A cross-sectional study from a tertiary care center in Chhattisgarh. Ind Psychiatry J 2019; 28:75-81. [PMID: 31879451 PMCID: PMC6929216 DOI: 10.4103/ipj.ipj_16_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/15/2019] [Accepted: 08/19/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Sexual dysfunctions (SDs) are common and lead to psychological distress and impair quality of life (QOL). However, little attention has been paid to explore SD in severe mental illnesses (SMIs). Hence, this study aimed to evaluate the occurrence of SD and its impact on the QOL in persons suffering from schizophrenia, bipolar disorder, and depression and compare it with healthy controls. MATERIALS AND METHODS In this cross-sectional study, 79 clinically stable patients and 50 healthy controls underwent evaluation for SD on the Arizona Sexual Experience Scale, and their QOL was measured using the WHO QOL-BREF scale. Chi-square test was used for the categorical variables, whereas comparison of continuous variables was done by t-test with post hoc corrections. RESULTS Compared to healthy controls, patients with depression had significantly higher rates of SD in the domain of obtaining penile erection (P = 0.019), ability to reach orgasm (P = 0.03), and satisfaction from orgasm (P = 0.01). Patients with schizophrenia had higher rates of problems in achieving arousal (P < 0.01), penile erection (P = 0.03), and satisfaction from orgasm (P = 0.03), whereas those with bipolar disorder only differed significantly on the domain of ability to reach orgasm (P = 0.03). However, patients fared better than the controls on various domains of QOL (except social domain). CONCLUSION A significant number of patients with SMI suffer from SD. Hence, it should be made a routine practice to evaluate and address the problem of SDs in patients with SMI.
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Affiliation(s)
- Deepak Ghormode
- Department of Psychiatry, CCM Medical College, Durg, Chhattisgarh, India
| | - Pramod Gupta
- Department of Psychiatry, Central Institute of Mental Health and Neuro-Sciences, Durg, Chhattisgarh, India
| | - Devendra Ratnani
- Department of Psychiatry, CCM Medical College, Durg, Chhattisgarh, India
| | - Jitender Aneja
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Sexualité de la femme schizophrène en Tunisie : étude cas–témoins. SEXOLOGIES 2018. [DOI: 10.1016/j.sexol.2017.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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23
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Quinn C, Platania-Phung C, Bale C, Happell B, Hughes E. Understanding the current sexual health service provision for mental health consumers by nurses in mental health settings: Findings from a Survey in Australia and England. Int J Ment Health Nurs 2018; 27:1522-1534. [PMID: 29575550 DOI: 10.1111/inm.12452] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2018] [Indexed: 11/26/2022]
Abstract
Nurses in mental health settings avoid talking to consumers about sexual health concerns. It is unclear whether this avoidance prevents the provision of sexual healthcare. The present study gathered information about how mental health nurses respond to sexual health issues within their routine practice, what issues they address, and their view on their role in promoting sexual health for consumers. A cross-sectional study using an electronic survey questionnaire, originally generated from a previous study in the united kingdom, was employed. The study occurred in four National Health Service Trusts in England and a national call for participants in Australia. Participants were nurse clinicians (n = 303) who self-selected by completing surveys available via email and newsletters containing links to the survey. The results demonstrated that mental health nurses do not routinely include sexual health in their practice and are poorly prepared in knowing what to do with a sexual health issue, and what services to assist consumers to use. In conclusion, it has been well established in the literature that mental health consumers experience high sexual health needs that potentially impact on health and recovery. Mental health nurses are ideally placed to promote sexual health and refer consumers to sexual health and family planning services. Training to improve the confidence and responsiveness of mental health nurses to sexual health is an urgent need.
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Affiliation(s)
- Chris Quinn
- Nursing and Practice Development Unit, Forensicare, Fairfield, Victoria, Australia.,University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Chris Platania-Phung
- SYNERGY: Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Woden, Australian Capital Territory, Australia
| | | | - Brenda Happell
- SYNERGY: Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Woden, Australian Capital Territory, Australia
| | - Elizabeth Hughes
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
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24
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The 2018 Revision to the Process of Care Model for Evaluation of Erectile Dysfunction. J Sex Med 2018; 15:1280-1292. [DOI: 10.1016/j.jsxm.2018.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/25/2018] [Accepted: 06/07/2018] [Indexed: 10/28/2022]
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25
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Ma MC, Chao JK, Hung JY, Sung SC, Chao IHC. Sexual Activity, Sexual Dysfunction, and Sexual Life Quality Among Psychiatric Hospital Inpatients With Schizophrenia. J Sex Med 2018; 15:324-333. [DOI: 10.1016/j.jsxm.2018.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 01/08/2018] [Accepted: 01/14/2018] [Indexed: 12/22/2022]
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Montejo AL, Montejo L, Baldwin DS. The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management. World Psychiatry 2018; 17:3-11. [PMID: 29352532 PMCID: PMC5775119 DOI: 10.1002/wps.20509] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment-related sexual adverse events tend to persist over time, and are unfortunately under-recognized by clinicians and scarcely investigated in clinical trials. Treatment-emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action. Antidepressants with a predominantly serotonergic activity, antipsychotics likely to induce hyperprolactinaemia, and mood stabilizers with hormonal effects are often linked to moderate or severe sexual dysfunction, including decreased libido, delayed orgasm, anorgasmia, and sexual arousal difficulties. Severe mental disorders can interfere with sexual function and satisfaction, while patients wish to preserve a previously satisfactory sexual activity. In many patients, a lack of intimate relationships and chronic deterioration in mental and physical health can be accompanied by either a poor sexual life or a more frequent risky sexual behaviour than in the general population. Here we describe the influence of psychosis and antipsychotic medications, of depression and antidepressant drugs, and of bipolar disorder and mood stabilizers on sexual health, and the optimal management of patients with severe psychiatric illness and sexual dysfunction.
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Affiliation(s)
- Angel L Montejo
- Department of Nursing and Institute of Biomedicine of Salamanca, Neurosciences Area, University Hospital of Salamanca, Salamanca, Spain
| | - Laura Montejo
- Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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Sexual dysfunctions in drug-naive male patients with first-episode schizophrenia. MIDDLE EAST CURRENT PSYCHIATRY 2017. [DOI: 10.1097/01.xme.0000520063.00808.3d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Das S, Chatterjee SS, Bagewadi V. Aripiprazole induced hypersexuality, when we should be cautious? Asian J Psychiatr 2017; 29:162-163. [PMID: 29061419 DOI: 10.1016/j.ajp.2017.05.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 05/28/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Soumitra Das
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India
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Terevnikov V, Stenberg JH, Tiihonen J, Burkin M, Joffe G. Add-on mirtazapine improves orgasmic functioning in patients with schizophrenia treated with first-generation antipsychotics. Nord J Psychiatry 2017; 71:77-80. [PMID: 27701952 DOI: 10.1080/08039488.2016.1233996] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIM Sexual dysfunction, common in schizophrenia, may be further exaggerated by antipsychotics, especially those of First Generation (FGAs), and antidepressants, such as Selective Serotonin Reuptake Inhibitors (SSRs). Mirtazapine, an antidepressant characterized by its different action mechanism compared with that of the majority of other antidepressants, may improve SSRI-induced sexual dysfunction in patients with depression. It is unknown, however, whether mirtazapine improves sexual functioning in schizophrenia. METHODS This study randomly assigned FGA-treated patients with schizophrenia to receive either an add-on mirtazapine (n = 20) or a placebo (n = 19) for 6 weeks. Sexual functioning was prospectively measured using five relevant items from the Udvalg for Kliniske Undersogelser side-effect rating scale (UKU-SERS). RESULTS Orgasmic function improved with statistical significance in the mirtazapine group (p = .03), with no changes in any other sexual functions in either group. CONCLUSION Add-on mirtazapine appears to relieve orgasmic dysfunction in FGA-treated patients with schizophrenia.
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Affiliation(s)
| | - Jan-Henry Stenberg
- b Department of Psychiatry , Helsinki University Central Hospital, and University of Helsinki , Helsinki , Finland
| | - Jari Tiihonen
- c Department of Forensic Psychiatry , University of East Finland, Niuvanniemi Hospital , Finland.,d Department of Mental Health and Alcohol Research , National Institute for Health and Welfare , Helsinki , Finland.,e Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Mark Burkin
- f Department of Psychiatry , University of Petrozavodsk , Petrozavodsk , Russia
| | - Grigori Joffe
- b Department of Psychiatry , Helsinki University Central Hospital, and University of Helsinki , Helsinki , Finland
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Simiyon M, Chandra PS, Desai G. Sexual dysfunction among women with Schizophrenia-A cross sectional study from India. Asian J Psychiatr 2016; 24:93-98. [PMID: 27931918 DOI: 10.1016/j.ajp.2016.08.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/17/2016] [Accepted: 08/30/2016] [Indexed: 01/23/2023]
Abstract
UNLABELLED Sexual dysfunction among women usually has a multifactorial etiology and is also difficult to study in cultures where open discussions about sexuality are not common. Not much is known about sexual function in women with schizophrenia even though it may have a significant impact on their quality of life and maybe influenced by several factors. AIMS AND OBJECTIVES This study aimed to assess the frequency and nature of sexual dysfunction in women with schizophrenia and study its association with marital quality, illness, treatment, and socio-demographic factors. METHODOLOGY This was a cross sectional, hospital-based study conducted among 63 women with schizophrenia attending the outpatient services of a tertiary care psychiatric hospital. Sexual dysfunction was assessed using the Female Sexual Function Index (FSFI). Side effects of medications, psychopathology, and marital quality were assessed using standard scales. RESULTS Among the 63 women assessed, 44 (70%) reported sexual dysfunction. Impaired desire was reported by all women, impaired arousal by 58 (92.1%), poor lubrication by 30 (47.6%), impaired orgasm by 48(76.2%) poor satisfaction by 44(69.8%) and pain by 23(36.5%). Poor Marital quality ('p' value-0.001), higher scores on general psychopathology of the Positive and Negative symptoms scale of schizophrenia (PANSS) ('p' value-0.049) and side effects such as weight gain, menstrual disturbances, galactorrohea and dry vagina were significantly associated with Female Sexual Dysfunction (FSD) in univariate analysis. However, multivariate analysis found marital quality alone to be significantly related to FSD.
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Affiliation(s)
- Manjula Simiyon
- Department of Psychiatry, Pondicherry Institute of medical sciences, Pondicherry, 605014, India, India.
| | - Prabha S Chandra
- Professor of psychiatry, Department of psychiatry, National Institute of Mental Health and Neuro sciences, Bangalore, Karnataka,India(1).
| | - Geetha Desai
- Professor of psychiatry, Department of psychiatry, National Institute of Mental Health and Neuro sciences, Bangalore, Karnataka,India(1).
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Bacconi L, Gressier F. [Efficacy and tolerance of PDE-5 in the treatment of erectile dysfunction in schizophrenic patients: A literature review]. Encephale 2016; 43:55-61. [PMID: 27658991 DOI: 10.1016/j.encep.2016.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 12/07/2015] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Sexual dysfunction is an important public health problem in men and is associated with reduced quality of life. It is more common in patients with schizophrenia. It is well-established that antipsychotic drugs cause sexual dysfunction with consequences on the quality of life of patients, adherence to treatment, and public health costs. Phosphodiesterase type 5 inhibitors (PDE5 inhibitors) are indicated for the management of erectile dysfunction. However, there is little information on such treatment in schizophrenic patients. This literature review aimed to summarize the current data on the efficacy and tolerability of PDE-5 inhibitors in the erectile dysfunction in schizophrenic patients. MATERIAL AND METHODS PubMed, PsycInfo and Cochrane databases were searched for studies published until August 2014. RESULTS Only 6 studies met the inclusion criteria. Three were randomized, double-blind, cross-over, placebo-controlled trials and three were open studies. Various scales were used to measure erectile and orgasmic function, desire, satisfaction during intercourse, overall satisfaction, quality of life and intensity of schizophrenic symptoms. In the 3 randomized studies (one with sildenafil 25-50 mg, one with lodenafil carbonate 80 mg/j and the last one with tadalafil 10 mg), the rate of participants who completed the trial was high (around 95 %). All three included patients with schizophrenia or schizophrenia spectrum disorders. Patients reported significant improvement on sexual dysfunction. However, no statistical difference was reported between lodenafil and placebo, on different scales, suggesting a very important placebo effect in patients with schizophrenia. All three found a good tolerance of PDE-5 inhibitors. Side effects were rare and were mainly nasal congestion, headaches, nausea and dizziness. There were no major side effects or drug interactions. Considering the 3 open studies, 2 involved sildenafil and one tadalafil. All concluded in improved erectile and orgasmic function, desire, satisfaction during intercourse, overall satisfaction, and even the quality of life when it was studied. However, very few patients were included. DISCUSSION Little data are available on the use of PDE5 inhibitors in schizophrenic patients. The 6 studies included few patients which reduces the power and the scope of their conclusions. There is also an important bias due to the use of self-questionnaires. The methodologies of the studies differ in many aspects which limits the comparability. Inclusion and exclusion criteria, drugs used and scales varied among the studies. However, the management of erectile disorder seems to be a consistent target in an integrative approach for the overall well-being of schizophrenic patients. PDE-5 inhibitors appear to be safe and could improve erectile function in schizophrenic patients. CONCLUSION In total, the current data suggest efficiency and good tolerance of the use of PDE-5 inhibitors in schizophrenic patients with erectile dysfunction. However, further studies focusing on PDE-5 inhibitors are needed to more deeply assess their efficacy and safety in patients with schizophrenia.
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Affiliation(s)
- L Bacconi
- Service de psychiatrie d'adultes, pôle V(e)-VI(e) arr., CHU Sainte-Anne, 1, rue Cabanis, 75014 Paris, France.
| | - F Gressier
- Inserm UMR 1178, université Paris Sud, service de Psychiatrie d'adultes, CHU de Bicêtre, Assistance publique-hôpitaux de Paris, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France
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Abstract
Sexual functioning is important to assess in patients with psychiatric illness as both the condition and associated treatment may contribute to sexual dysfunction (SD). Antidepressant medications, mood stabilizers, antipsychotics, and antianxiety agents may be associated with SD related to drug mechanism of action. Sexual adverse effects may be related to genetic risk factors, impact on neurotransmitters and hormones, and psychological elements. Effective strategies to manage medication-induced sexual dysfunction are initial choice of a drug unlikely to cause SD, switching to a different medication, and adding an antidote to reverse SD. Appropriate interventions should be determined on a clinical case-by-case basis.
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Affiliation(s)
- Anita H Clayton
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, 1215 Lee Street, Charlottesville, VA 22903, USA.
| | - Andrew R Alkis
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, 1215 Lee Street, Charlottesville, VA 22903, USA
| | - Nishant B Parikh
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, 1215 Lee Street, Charlottesville, VA 22903, USA
| | - Jennifer G Votta
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, 1215 Lee Street, Charlottesville, VA 22903, USA
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Montejo ÁL, Arango C, Bernardo M, Carrasco JL, Crespo-Facorro B, Cruz JJ, del Pino J, García Escudero MA, García Rizo C, González-Pinto A, Hernández AI, Martín Carrasco M, Mayoral Cleries F, Mayoral van Son J, Mories MT, Pachiarotti I, Ros S, Vieta E. Spanish consensus on the risks and detection of antipsychotic drug-related hyperprolactinaemia. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.rpsmen.2016.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Montejo ÁL, Arango C, Bernardo M, Carrasco JL, Crespo-Facorro B, Cruz JJ, Del Pino J, García Escudero MA, García Rizo C, González-Pinto A, Hernández AI, Martín Carrasco M, Mayoral Cleries F, Mayoral van Son J, Mories MT, Pachiarotti I, Ros S, Vieta E. Spanish consensus on the risks and detection of antipsychotic drug-related hyperprolactinaemia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2016; 9:158-73. [PMID: 26927534 DOI: 10.1016/j.rpsm.2015.11.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 09/28/2015] [Accepted: 11/16/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Iatrogenic hyperprolactinaemia (IHPRL) has been more frequently related to some antipsychotic drugs that provoke an intense blockade of dopamine D2 receptors. There is a wide variation in clinical practice, and perhaps some more awareness between clinicians is needed. Due to the high frequency of chronic treatment in severe mental patients, careful attention is recommended on the physical risk. IHPRL symptoms could be underestimated without routine examination. METHODOLOGY An intense scientific literature search was performed in order to draw up a multidisciplinary consensus, including different specialists of psychiatry, endocrinology, oncology and internal medicine, and looking for a consensus about clinical risk and detection of IHPRL following evidence-based medicine criteria levels (EBM I- IV). RESULTS Short-term symptoms include amenorrhea, galactorrhoea, and sexual dysfunction with decrease of libido and erectile difficulties related to hypogonadism. Medium and long-term symptoms related to oestrogens are observed, including a decrease bone mass density, hypogonadism, early menopause, some types of cancer risk increase (breast and endometrial), cardiovascular risk increase, immune system disorders, lipids, and cognitive dysfunction. Prolactin level, gonadal hormones and vitamin D should be checked in all patients receiving antipsychotics at baseline although early symptoms (amenorrhea-galactorrhoea) may not be observed due to the risk of underestimating other delayed symptoms that may appear in the medium term. Routine examination of sexual dysfunction is recommended due to possible poor patient tolerance and low compliance. Special care is required in children and adolescents, as well as patients with PRL levels >50ng/ml (moderate hyperprolactinaemia). A possible prolactinoma should be investigated in patients with PRL levels >150ng/ml, with special attention to patients with breast/endometrial cancer history. Densitometry should be prescribed for males >50 years old, amenorrhea>6 months, or early menopause to avoid fracture risk.
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Affiliation(s)
- Ángel L Montejo
- Área de Neurociencias, Instituto de Biomedicina de Salamanca (IBSAL), Universidad de Salamanca, Servicio de Psiquiatría, Hospital Universitario de Salamanca, España.
| | - Celso Arango
- Departamento de Psiquiatría Infanto-Juvenil, Hospital General Universitario Gregorio Marañón (IiSGM). Facultad de Medicina, Universidad Complutense, CIBERSAM, Madrid, España
| | - Miguel Bernardo
- Unidad Esquizofrenia Clínic, Instituto Clínic de Neurociencias, Hospital Clínic. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
| | - José L Carrasco
- Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, CIBERSAM, Madrid, España
| | - Benedicto Crespo-Facorro
- Departamento de Medicina y Psiquiatría, Universidad de Cantabria. Hospital Universitario Marqués de Valdecilla, IDIVAL, CIBERSAM, Santander, España
| | - Juan J Cruz
- Servicio de Oncología Médica, Hospital Universitario de Salamanca, Universidad de Salamanca (IBSAL), España
| | - Javier Del Pino
- Servicio Medicina Interna, Hospital Clínico Universitario, Universidad de Salamanca, España
| | | | - Clemente García Rizo
- Unidad Esquizofrenia Clínic, Instituto Clínic de Neurociencias, Hospital Clínic. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
| | - Ana González-Pinto
- International Mood Disorders Research Centre, CIBERSAM, Hospital Santiago Apóstol, Universidad del País Vasco, Vitoria, España
| | - Ana I Hernández
- FEA Psiquiatría, Red de Salud Mental de Guipúzcoa, San Sebastián, España
| | - Manuel Martín Carrasco
- Instituto de Investigaciones Psiquiátricas, Fundación María Josefa Recio, Bilbao, España; Clínica Psiquiátrica Padre Menni, CIBERSAM, Pamplona, España
| | - Fermin Mayoral Cleries
- UGC Salud Mental, Hospital Regional Universitario, Instituto de Biomedicina de Málaga, Málaga, España
| | | | - M Teresa Mories
- Servicio de Endocrinología y Nutrición, Hospital Universitario de Salamanca, España
| | - Isabella Pachiarotti
- Programa de Trastornos Bipolares, Departamento de Psiquiatría, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, España
| | - Salvador Ros
- Instituto Internacional de Neurociencias Aplicadas, Barcelona, España
| | - Eduard Vieta
- Programa de Trastornos Bipolares, Departamento de Psiquiatría, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, España
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Hou CL, Zang Y, Rosen RC, Cai MY, Li Y, Jia FJ, Lin YQ, Ungvari GS, Ng CH, Chiu HFK, Xiang YT. Sexual dysfunction and its impact on quality of life in Chinese patients with schizophrenia treated in primary care. Compr Psychiatry 2016; 65:116-21. [PMID: 26773999 DOI: 10.1016/j.comppsych.2015.11.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 11/10/2015] [Accepted: 11/11/2015] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Sexual dysfunction in schizophrenia patients is common. In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. Illness- or treatment-related sexual dysfunction in this patient population has been never studied. This study describes the prevalence and correlates of sexual dysfunction and its impact on quality of life (QOL) in patients with schizophrenia treated in primary care in China. METHOD A total of 607 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. Patients' socio-demographic and clinical characteristics including sexual function and QOL were recorded using a standardized protocol and data collection. RESULTS Sexual dysfunction was present in 69.9% of all patients; 60.7% in males and 80.6% in females. Multiple logistic regression analysis revealed that female gender, being single, older age and use of first-generation antipsychotics were independently and significantly associated with more sexual dysfunction accounting for 23.5% of its variance (P<0.001). Unexpectedly, sexual dysfunction was not associated with lower QOL. CONCLUSIONS High rate of sexual dysfunction was reported in the majority of patients with schizophrenia treated in primary care in China. Given its negative impact on social adjustment, QOL and treatment adherence, efforts should be made to address sexual dysfunction in this patient population.
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Affiliation(s)
- Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Yu Zang
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - R C Rosen
- Ningxia Mental Health Center, Ningxia Ning-An Hospital, Ningxia Province, China
| | - Mei-Ying Cai
- Guangzhou Yuexiu Center for Disease Control and Prevention, Guangdong Province, China
| | - Yan Li
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of WA, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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Lee JY, Kim SW, Lee YH, Kang HJ, Kim SY, Bae KY, Kim JM, Shin IS, Yoon JS. Factors associated with self-rated sexual function in Korean patients with schizophrenia receiving risperidone monotherapy. Hum Psychopharmacol 2015; 30:416-24. [PMID: 26123060 DOI: 10.1002/hup.2489] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 01/11/2015] [Accepted: 04/26/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aims to investigate the factors associated with sexual function in Korean patients with schizophrenia. METHODS This study evaluated 169 patients with schizophrenia who were receiving risperidone monotherapy. The Visual Analog Scale was used to assess sexual function in terms of sexual desire, sexual arousal, and sexual satisfaction. The Positive and Negative Syndrome Scale, the Beck Depression Inventory, the Korean version of the Subjective Well-being under Neuroleptic Treatment-Brief Form (SWN-K) scale, and the Drug Attitude Inventory (DAI) were also administered. RESULTS Sexual function was negatively associated with age, duration of illness, gender (female), marital status (single), the presence of tardive dyskinesia, and Beck Depression Inventory score, but positively associated with the SWN-K and DAI scores. A linear regression analysis revealed that being male and married had significant positive associations with sexual arousal, sexual satisfaction, and/or sexual desire, while the presence of tardive dyskinesia and a longer duration of illness were associated with poor sexual arousal and/or sexual desire. Additionally, sexual function was significantly associated with the SWN-K and DAI scores in multivariate analysis. CONCLUSIONS The acknowledgement and management of sexual dysfunction in patients with schizophrenia by clinicians may be important for improvement of their quality of life and adherence to medication.
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Affiliation(s)
- Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Yo-Han Lee
- Department of Psychiatry, St. John Hospital, Gwangju, Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung-Yeol Bae
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
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Sexual dysfunction related to typical and atypical antipsychotics in drug naive psychotic patients. MIDDLE EAST CURRENT PSYCHIATRY 2015. [DOI: 10.1097/01.xme.0000461673.36113.c8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hocaoglu C, Celik FH, Kandemir G, Guveli H, Bahceci B. Sexual dysfunction in outpatients with schizophrenia in Turkey: a cross-sectional study. SHANGHAI ARCHIVES OF PSYCHIATRY 2014; 26:347-56. [PMID: 25642109 PMCID: PMC4311108 DOI: 10.11919/j.issn.1002-0829.214101] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 12/14/2014] [Indexed: 11/03/2022]
Abstract
BACKGROUND Sexual dysfunction is one of several factors related to medication compliance in patients taking antipsychotic medication but the magnitude of this problem is unknown. AIM Compare the self-reported sexual functioning of clinically stable patients with schizophrenia taking antipsychotic medication to that of healthy controls using the Turkish version of the 5-item Arizona Sexual Experience Scale (ASEX). This scale, which has previously been validated in Turkey, assesses 5 components of sexual function: sex drive, sexual arousal, vaginal lubrication/penile erection, ability to achieve orgasm, and satisfaction with orgasm. METHODS The Scale for the Assessment of Positive Symptoms, the Scale for Assessment of Negative Symptoms, and ASEX were administered to 101 clinically stable outpatients with schizophrenia (38 females and 63 males). The ASEX was also administered to 89 control subjects (41 females and 48 males) without a history of mental illness. Respondents were classified as having sexual dysfunction if ASEX total score (range 5-30) >18, if any ASEX item score (range 1-6) ≥ 5, or if 3 or more ASEX items ≥4. RESULTS Male patients with schizophrenia have significantly more self-reported sexual dysfunction than healthy controls (46% vs. 8%). The prevalence of sexual dysfunction is higher in female patients than in male patients (68% vs. 46%), but it was also very high in healthy female controls (68%), so the sexual dysfunction of female patients cannot be attributed to their illness or to the medications they are taking. Within the patient group, there was no significant relationship between the severity of positive or negative symptoms and the severity of sexual dysfunction, and the severity of sexual function was not different between patients taking first-generation or second-generation antipsychotic medications. CONCLUSIONS The very different findings by gender in Turkey highlights the importance of assessing location-specific and gender-specific sexual norms when trying to assess the role of mental illness and medications on sexual functioning. Prospective studies are needed to distinguish the relative importance of cultural norms, the schizophrenic illness, and the use of antipsychotic medication in the etiology and course of sexual dysfunction among individuals with schizophrenia.
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Affiliation(s)
- Cicek Hocaoglu
- Department of Psychiatry,Recep Tayyip Erdogan University, Rize, Turkey
| | - Fatmagul H Celik
- Department of Psychiatry,Recep Tayyip Erdogan University, Rize, Turkey
| | - Gokhan Kandemir
- Department of Psychiatry,Recep Tayyip Erdogan University, Rize, Turkey
| | - Hulya Guveli
- Istanbul University Oncology Enstitude, Department of Psychiatry, Istanbul, Turkey
| | - Bulent Bahceci
- Department of Psychiatry,Recep Tayyip Erdogan University, Rize, Turkey
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The Relationship between Neovascular Age-Related Macular Degeneration and Erectile Dysfunction. J Ophthalmol 2013; 2013:589274. [PMID: 24191192 PMCID: PMC3804368 DOI: 10.1155/2013/589274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 08/26/2013] [Indexed: 11/17/2022] Open
Abstract
Purpose. To evaluate association between erectile dysfunction (ED) and neovascular age-related macular degeneration (AMD). Methods. 195 men enrolled in this cross-sectional study. 90 of them had neovascular AMD and 105 of them were healthy volunteers. The International Index of Erectile Function (IIEF) questionnaire's erectile function (EF) domain was used to assess ED. The patients in the study and control groups were statistically compared according to visual acuity, EF score, and body mass index. Results. The mean ages were 62 (54.5–73) and 60 (54–68), in the neovascular AMD and control groups, respectively. The total EF scores were 9 (6–16) in neovascular AMD and 18 (9.5–27) in control group. The results of IIEF questionnaire on neovascular AMD patients revealed that 85 men (94.4%) had some degree of ED, whereas 68 men (64.8%) had some degree of ED on control group. Patients with neovascular AMD had a significantly higher incidence of ED than control patients (P < 0.01). There was a significant association between ED and neovascular AMD (P < 0.01). Conclusions. Our results suggested that neovascular AMD has a high association with ED.
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Seyam R. A systematic review of the correlates and management of nonpremature ejaculatory dysfunction in heterosexual men. Ther Adv Urol 2013; 5:254-97. [PMID: 24082920 DOI: 10.1177/1756287213497231] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION A better understanding of ejaculatory disorders has led to an increasing interest in nonpremature ejaculatory dysfunction (non-PE EjD). Current reviews on the subject use a symptom-based classification to describe ejaculatory dysfunction even when it is a single case report. While these reviews provide important information on the disorder, a clearer picture of the prevalence of non-PE EjD in relation to the community and various pathophysiologic states is needed. OBJECTIVES The objective of this study was to provide a systematic review of studies of non-PE EjD excluding single case reports. METHODS A systematic review of Medline for terms including ejaculation, orgasm or hematospermia. Association with terms delay, pain or headache was made. The search was restricted to male gender and articles written in English. Abstracts were reviewed and those mainly concerned with premature ejaculation were excluded. RESULTS A total of 333 articles on non-PE EjD were identified. The condition was reported in community-based studies. In certain patient populations, non-PE EjD was commonly reported in association with antidepressant and antipsychotic treatments, in patients with chronic prostatitis/chronic pelvic pain syndrome, patients with lower urinary tract symptoms particularly in association with medical or surgical treatment, patients with retroperitoneal surgery and in patients with neurological diseases. Few articles were concerned with treatment options. CONCLUSION There is a significant prevalence of non-PE EjD in the community and in association with particular disease states or as a side effect of medical or surgical interventions. There is a need to direct efforts to prevent and treat these conditions.
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Affiliation(s)
- Raouf Seyam
- King Faisal Specialist Hospital and Research Center, PO Box 3354, MBC 83, Riyadh 11211, Saudi Arabia
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Kelly DL, Wehring HJ, Earl AK, Sullivan KM, Dickerson FB, Feldman S, McMahon RP, Buchanan RW, Warfel D, Keller WR, Fischer BA, Shim JC. Treating symptomatic hyperprolactinemia in women with schizophrenia: presentation of the ongoing DAAMSEL clinical trial (Dopamine partial Agonist, Aripiprazole, for the Management of Symptomatic ELevated prolactin). BMC Psychiatry 2013; 13:214. [PMID: 23968123 PMCID: PMC3766216 DOI: 10.1186/1471-244x-13-214] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 08/07/2013] [Indexed: 01/01/2023] Open
Abstract
Prolactin elevations occur in people treated with antipsychotic medications and are often much higher in women than in men. Hyperprolactinemia is known to cause amenorrhea, oligomenorrhea, galactorrhea and gynecomastia in females and is also associated with sexual dysfunction and bone loss. These side effects increase risk of antipsychotic nonadherence and suicide and pose significant problems in the long term management of women with schizophrenia. In this manuscript, we review the literature on prolactin; its physiology, plasma levels, side effects and strategies for treatment. We also present the rationale and protocol for an ongoing clinical trial to treat symptomatic hyperprolactinemia in premenopausal women with schizophrenia. More attention and focus are needed to address these significant side effects and help the field better personalize the treatment of women with schizophrenia.
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Affiliation(s)
- Deanna L Kelly
- School of Medicine, Maryland Psychiatric Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA.
| | - Heidi J Wehring
- School of Medicine, Maryland Psychiatric Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Amber K Earl
- School of Medicine, Maryland Psychiatric Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Kelli M Sullivan
- School of Medicine, Maryland Psychiatric Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA
| | | | - Stephanie Feldman
- School of Medicine, Maryland Psychiatric Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Robert P McMahon
- School of Medicine, Maryland Psychiatric Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Robert W Buchanan
- School of Medicine, Maryland Psychiatric Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Dale Warfel
- School of Medicine, Maryland Psychiatric Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - William R Keller
- School of Medicine, Maryland Psychiatric Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Bernard A Fischer
- School of Medicine, Maryland Psychiatric Research Center, University of Maryland Baltimore, Baltimore, Maryland, USA,VA Capital Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, Maryland, USA
| | - Joo-Cheol Shim
- Department of Psychiatry and Clinical Trial Center, Busan Paik Hospital, Inje University, Busan, South Korea
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Hui CLM, Lee EHM, Chang WC, Chan SKW, Li YK, Lee JTM, Chen EYH. Sexual dysfunction in Chinese patients with first-episode psychosis: prevalence, clinical correlates and functioning. Schizophr Res 2013; 148:181-2. [PMID: 23791026 DOI: 10.1016/j.schres.2013.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 05/10/2013] [Accepted: 06/02/2013] [Indexed: 11/24/2022]
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Ben Mahmoud S, Zouari L, Dammak M, Ben Thabet J, Zouari N, Maâlej M. Evaluation of sexuality in 61 subjects suffering from chronic psychosis. SEXOLOGIES 2013. [DOI: 10.1016/j.sexol.2012.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ben Mahmoud S, Zouari L, Dammak M, Ben Thabet J, Zouari N, Maâlej M. Évaluation de la sexualité d’une série de 61 sujets atteints de psychose chronique. SEXOLOGIES 2013. [DOI: 10.1016/j.sexol.2012.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Peluso MJ, Lewis SW, Barnes TRE, Jones PB. Non-neurological and metabolic side effects in the Cost Utility of the Latest Antipsychotics in Schizophrenia Randomised Controlled Trial (CUtLASS-1). Schizophr Res 2013; 144:80-6. [PMID: 23313462 DOI: 10.1016/j.schres.2012.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 11/15/2012] [Accepted: 12/17/2012] [Indexed: 12/25/2022]
Abstract
The impact of non-neurological and metabolic side effects (NNSEs) on the prescription of antipsychotics in real clinical practice remains unclear. We conducted an intention-to-treat, secondary analysis of data from a randomised, controlled trial (CUtLASS-1; n=227) to examine NNSEs emergent at 12 weeks and 52 weeks. A clinically significant difference was defined as double or half the symptoms in groups prescribed first- versus second-generation antipsychotics, represented by odds ratios greater than 2.0 (indicating advantage for first-generation drugs) or less than 0.5 (indicating advantage for the newer drugs). There were no differences between the treatment groups at baseline. At both 12 and 52 weeks follow-up, patients on second-generation drugs were more likely than their first-generation counterparts to experience cardiovascular problems and anticholinergic side effects, as well as increased sexual side effects in men. Objective weight gain was equivalent between the two groups at 12 weeks, but by one year fewer patients in the second-generation arm experienced weight gain and there was no significant difference with regard to percent change in BMI. These results suggest that there may be clinically significant increases in anticholinergic, cardiovascular, and sexual side effects for patients on second-generation drugs. The expected increased weight gain in the second-generation arm did not occur. This study provides evidence that clinicians should take a more nuanced approach toward expert antipsychotic prescription, rather than viewing the drugs as distinct classes.
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Affiliation(s)
- Michael J Peluso
- Yale School of Medicine, 367 Cedar Street, New Haven CT 06511, USA.
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Bushong ME, Nakonezny PA, Byerly MJ. Subjective quality of life and sexual dysfunction in outpatients with schizophrenia or schizoaffective disorder. JOURNAL OF SEX & MARITAL THERAPY 2013; 39:336-346. [PMID: 23421823 DOI: 10.1080/0092623x.2011.606884] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The objective of this research was to examine the association between sexual dysfunction and subjective quality of life in outpatients with schizophrenia and schizoaffective disorder. The authors evaluated a sample of 238 adult outpatients with diagnoses of schizophrenia or schizoaffective disorder who took quetiapine, olanzapine, or risperidone at study entry with a 1-time rating of the Arizona Sexual Experience Scale and the general life satisfaction scale item of the quality of life index. The authors used multiple linear robust regression and Spearman partial correlation coefficient to examine the relation between subjective quality of life (measured by the general life satisfaction scale item) and sexual functioning (measured by the Arizona sexual experience scale). The authors found a significant negative linear relation between the Arizona Sexual Experience Scale total score and the general life satisfaction scale item for the overall sample (r(s) = -0.16, p = .01), but not separately for men or women. Sexual dysfunction in men and women with schizophrenia and schizoaffective disorder is associated with decreased subjective quality of life, although the magnitude of the effect size was relatively small. Improving clinicians' awareness of the importance of sexual dysfunction in patients may improve tolerability and subsequent treatment outcomes.
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Affiliation(s)
- Mark E Bushong
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Schmidt HM, Hagen M, Kriston L, Soares-Weiser K, Maayan N, Berner MM. Management of sexual dysfunction due to antipsychotic drug therapy. Cochrane Database Syst Rev 2012; 11:CD003546. [PMID: 23152218 PMCID: PMC7003677 DOI: 10.1002/14651858.cd003546.pub3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Psychotropic drugs are associated with sexual dysfunction. Symptoms may concern penile erection, lubrication, orgasm, libido, retrograde ejaculation, sexual arousal, or overall sexual satisfaction. These are major aspects of tolerability and can highly affect patients' compliance. OBJECTIVES To determine the effects of different strategies (e.g. dose reduction, drug holidays, adjunctive medication, switching to another drug) for treatment of sexual dysfunction due to antipsychotic therapy. SEARCH METHODS An updated search was performed in the Cochrane Schizophrenia Group's Trials Register (3 May 2012) and the references of all identified studies for further trials. SELECTION CRITERIA We included all relevant randomised controlled trials involving people with schizophrenia and sexual dysfunction. DATA COLLECTION AND ANALYSIS We extracted data independently. For dichotomous data we calculated random effects risk ratios (RR) with 95% confidence intervals (CI), for crossover trials we calculated Odds Ratios (OR) with 95% CI. For continuous data, we calculated mean differences (MD) on the basis of a random-effects model. We analysed cross-over trials under consideration of correlation of paired measures. MAIN RESULTS Currently this review includes four pioneering studies (total n = 138 , duration two weeks to four months), two of which are cross-over trials. One trial reported significantly more erections sufficient for penetration when receiving sildenafil compared with when receiving placebo (n = 32, MD 3.20 95% CI 1.83 to 4.57), a greater mean duration of erections (n = 32, MD 1.18 95% CI 0.52 to 1.84) and frequency of satisfactory intercourse (n = 32, MD 2.84 95% CI 1.61 to 4.07). The second trial found no evidence for selegiline as symptomatic treatment for antipsychotic-induced sexual dysfunction compared with placebo (n = 10, MD change on Aizenberg's sexual functioning scale -0.40 95% CI -3.95 to 3.15). No evidence was found for switching to quetiapine from risperidone to improve sexual functioning (n = 36, MD -2.02 95% CI -5.79 to 1.75). One trial reported significant improvement in sexual functioning when participants switched from risperidone or an typical antipsychotic to olanzapine (n = 54, MD -0.80 95% CI -1.55 to -0.05). AUTHORS' CONCLUSIONS We are not confident that cross-over studies are appropriate for this participant group as they are best for conditions that are stable and for interventions with no physiological and psychological carry-over. Sildenafil may be a useful option in the treatment of antipsychotic-induced sexual dysfunction in men with schizophrenia, but this conclusion is based only on one small short trial. Switching to olanzapine may improve sexual functioning in men and women, but the trial assessing this was a small, open label trial. Further well designed randomised control trials that are blinded and well conducted and reported, which investigate the effects of dose reduction, drug holidays, symptomatic therapy and switching antipsychotic on sexual function in people with antipsychotic-induced sexual dysfunction are urgently needed.
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Affiliation(s)
- Hannah M Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg im Breisgau, Germany.
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Abstract
BACKGROUND A lack of human and financial resources, as well as effective health systems, leads to a worldwide treatment gap for schizophrenia. The aim of this paper is to propose evidence-based antipsychotics interventions for people with schizophrenia with special focus in low and middle income countries (LAMIC) reality. METHOD A comprehensive search was conducted to locate the main clinical trials, reviews and relevant meta-analyses, and a number of the main recent international clinical practice guidelines. RESULTS First- and second-generation antipsychotics are similarly effective in the acute treatment of psychotic symptoms. In LAMIC, the treatment of choice for medical treatment of psychotic conditions is the group of so-called 'first generation antipsychotics' (FGAs) preferentially delivered in a community-based service model. CONCLUSIONS Although the symptomatic control is essential, it is not the ultimate goal of treatment. The main aim of treatment is to improve functional recovery and social reintegration of patients.
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Affiliation(s)
- Ary Gadelha
- Department of Psychiatry, Universidade Federal de São Paulo, Brazil
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Marques TR, Smith S, Bonaccorso S, Gaughran F, Kolliakou A, Dazzan P, Mondelli V, Taylor H, Diforti M, McGuire PK, Murray RM, Howes OD. Sexual dysfunction in people with prodromal or first-episode psychosis. Br J Psychiatry 2012; 201:131-6. [PMID: 22700081 DOI: 10.1192/bjp.bp.111.101220] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Sexual dysfunction is common in psychotic disorder but it is not clear whether it is intrinsic to the development of the illness or secondary to other factors. AIMS To compare sexual function in people at ultra-high risk (UHR) of a psychotic disorder, patients with first-episode psychosis predominantly taking antipsychotic drugs and healthy volunteers. METHOD Sexual function was assessed in a UHR group (n = 31), a group with first-episode psychosis (n = 37) and a matched control group of healthy volunteers (n = 56) using the Sexual Function Questionnaire. RESULTS There was a significant effect of group on sexual function (P<0.001). Sexual dysfunction was evident in 50% of the UHR group, 65% of first-episode patients and 21% of controls. Within the UHR group, sexual dysfunction was more marked in those who subsequently developed psychosis than in those who did not. Across all groups the severity of sexual dysfunction was correlated with the severity of psychotic symptoms (P<0.001). Within the first-episode group there was no significant difference in sexual dysfunction between patients taking prolactin-raising v. prolactin-sparing antipsychotics. CONCLUSIONS Sexual dysfunction is present prior to onset of psychosis, suggesting it is intrinsic to the development of illness unlikely to be related to the prolactin-raising properties of antipsychotic medication.
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Affiliation(s)
- Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK.
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