A recent systematic review and meta-analysis have shed new light on the prevalence of sexual dysfunction in individuals with schizophrenia or schizoaffective disorder. The study, conducted by Théo Korchia, MD, and colleagues from Assistance Publique-Hopitaux de Marseille and Aix-Marseille University, provides essential insights into the sexual health of these patients and suggests potential avenues for improvement.
In an effort to update data on the prevalence of sexual dysfunction in schizophrenia patients, the research team reviewed 72 observational studies involving 21,076 patients from 33 countries. These studies, published between 1979 and 2021, aimed to shed light on the prevalence of sexual dysfunction in outpatients receiving treatment for schizophrenia or schizoaffective disorder. Notably, the previous meta-analysis on this topic was conducted over a decade ago, prompting the need for updated information.
The researchers used this extensive dataset to determine pooled estimates of sexual dysfunction prevalence in both men and women, as well as specific types of sexual dysfunction. They also explored factors contributing to the heterogeneity of sexual dysfunctions within this patient population.
The study’s findings revealed significant insights into the prevalence of sexual dysfunction in schizophrenia patients:
Global Prevalence: The pooled estimate for the global prevalence of sexual dysfunction was 56.4% (95% CI, 50.5-62.2). Specific dysfunctions included 40.6% for loss of libido (95% CI, 30.7-51.4), 28.0% for orgasm dysfunction (95% CI, 18.4-40.2), and 6.1% for genital pain (95% CI, 2.8-12.7). The high heterogeneity observed was attributed to various factors, including study design and sociodemographic data.
In Men: Estimates for sexual dysfunction in men were 55.7% (95% CI, 48.1-63.1), with 44.0% for erectile dysfunction (95% CI, 33.5-55.2) and 38.6% for ejaculation dysfunction (95% CI, 26.8-51.8).
In Women: Women with schizophrenia displayed a 60.0% prevalence of sexual dysfunction (95% CI, 48.0-70.8), with 25.1% experiencing amenorrhea (95% CI, 17.3-35.0) and 7.7% reporting galactorrhea (95% CI, 3.7-15.3).
Role of Antidepressants: Notably, studies with the highest proportion of antidepressant prescriptions reported lower rates of sexual dysfunctions.
Implications for Practice
The study underscores the strikingly high prevalence of sexual dysfunction in individuals with schizophrenia. It also highlights the potential role of better screening and treatment of depression in improving the sexual health of these patients. The authors emphasize that addressing depression may represent an effective strategy to enhance the overall well-being of individuals living with schizophrenia.
Source and Limitations
The study, conducted by Théo Korchia and colleagues, was published online on September 13 in JAMA Psychiatry. It should be noted that certain factors known to increase sexual dysfunction, such as hypertension, diabetes, obesity, smoking, and sleep disorders, were not extensively explored in the included studies. Furthermore, the results may not be directly applicable to continents such as Africa and Polynesia due to underrepresentation in the review. Additionally, the presence of publication bias in the meta-analysis cannot be entirely ruled out, and heterogeneity or methodological differences may have influenced the observed results.
The authors of the study have disclosed no relevant conflicts of interest. This research contributes significantly to our understanding of sexual dysfunction in schizophrenia patients and provides valuable insights for healthcare professionals and researchers seeking to improve the quality of life for individuals with schizophrenia.