High Prevalence of Sexual Dysfunction in Schizophrenia Patients: JAMA

A comprehensive study published in the Journal of American Medical Association shed light on a widely underexplored issue in the management of schizophrenia – sexual dysfunction. This systematic review and meta-analysis synthesized data from observational studies to determine the prevalence of sexual dysfunction in individuals with schizophrenia-spectrum disorders and identify associated factors.

Researchers conducted an exhaustive literature search across multiple databases, including Google, Google Scholar, PubMed/MEDLINE, Science Direct, and Université Sorbonne Paris Cité. The search encompassed studies published up to June 8, 2022. All observational studies reporting on the prevalence of sexual dysfunction in schizophrenia-spectrum disorders were included. The study included data from 72 out of 1119 studies conducted in 33 countries across six continents. These studies collectively involved 21,076 participants diagnosed with schizophrenia.

The most significant finding was the high prevalence of sexual dysfunction among individuals with schizophrenia, with a global average of 56.4%. Broken down by gender, men experienced sexual dysfunction at a rate of 55.7%, while women faced a slightly higher rate of 60.0%.

Specifically, the most common sexual dysfunction among men was erectile dysfunction (44%), followed by loss of libido (41%) and ejaculation dysfunction (39%). Among women, the primary issue was orgasm dysfunction (28%), followed by amenorrhea (25%).

Several factors were found to be associated with sexual dysfunction in this population, including study design, location, sociodemographic data, comorbid alcohol use disorder, psychiatric diagnosis, illness severity, and the use of antidepressants and anxiolytics.

Notably, sexual dysfunctions were more frequent in individuals with schizophrenia compared to those with schizoaffective disorders. Additionally, individuals with longer illness durations experienced fewer erectile disorders.

The use of antidepressants and mood stabilizers was associated with lower rates of erection and ejaculation disorders.

These findings emphasize the need for increased awareness and clinical attention to sexual dysfunction in individuals with schizophrenia. The study suggests that some dysfunctions may be attributed to schizophrenia itself, while others are likely linked to medication side effects and comorbid depression.

The association between lower rates of dysfunction and antidepressant use suggests that treating comorbid depression could be an effective strategy to improve sexual health in this population.

Reference:

Korchia, T., Achour, V., Faugere, M., Albeash, A., Yon, D. K., Boyer, L., & Fond, G. (2023). Sexual Dysfunction in Schizophrenia. In JAMA Psychiatry. American Medical Association (AMA). https://doi.org/10.1001/jamapsychiatry.2023.2696