Abstract:Background and Objective: Sexual dysfunction is a frequently overlooked but clinically significant issue in individuals suffering from major psychiatric disorders. These dysfunctions may stem from the underlying illness itself, psychological distress, or pharmacological treatment. The objective of this study was to assess the prevalence, types, and severity of sexual dysfunction among patients diagnosed with major psychiatric disorders, including schizophrenia, Major Depressive Disorder (MDD), and Bipolar Affective Disorder (BPAD), and to explore its association with psychotropic medication use.
Material and Methods: A cross-sectional observational study was conducted at a tertiary care psychiatric facility, involving 60 patients (aged 18-60 years) diagnosed with major psychiatric disorders as per DSM-5 criteria. This study was conducted at the department of Psychiatry, Annapoorna Medical College and Hospital, Kombadipatty, Veerapandi Union, Salem, Tamil Nadu, India from April 2012 to March 2013. Sexual dysfunction was assessed using the Arizona Sexual Experiences Scale (ASEX) after obtaining informed consent. Psychiatric diagnoses were confirmed using the Mini-International Neuropsychiatric Interview (MINI). Relevant clinical details, including duration of illness, medication history, and socio-demographic profile, were collected.
Results: Out of 60 patients, 38 (63.3%) reported some form of sexual dysfunction. The prevalence was highest among patients with MDD (76.9%), followed by schizophrenia (61.1%), and BPAD (52.6%). Antidepressants, particularly SSRIs, and antipsychotics with strong dopamine antagonism (e.g., risperidone) were significantly associated with higher sexual dysfunction scores (p<0.05). Common dysfunctions reported were decreased libido (48.3%), difficulty in arousal (41.7%), and anorgasmia (33.3%). Female patients reported higher distress related to sexual dysfunction compared to males. A longer duration of illness and polypharmacy were also positively correlated with the severity of dysfunction.
Conclusion: Sexual dysfunction is highly prevalent among patients with major psychiatric disorders and significantly impacts their quality of life and treatment adherence. Routine screening for sexual health, psychoeducation, and individualized pharmacological strategies are essential for holistic management. This study underscores the need for greater clinician awareness and integration of sexual health in psychiatric care protocols.
