Sexual Impairment in Psychiatric Inpatients: Focus on Depression

 

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Abstract

Introduction: Although sexual side effects are a common reason for noncompliance with medication, information on impairment of sexuality in psychiatric inpatients is scarce.

Methods: In the present multi-center study, data on several aspects of sexual functioning were collected in psychiatric inpatients using a previously validated questionnaire.

Results: A high overall prevalence of sexual dysfunction was reported by participants and was highest in depressed subjects. Patients receiving antidepressants suffered from more frequent and more severe impairment of sexuality than did subjects receiving neither antidepressants nor antipsychotics or opioids.

Discussion: Judging from this data, sexual impairment appears to be a frequent and underestimated problem in psychiatric inpatients with a high prevalence across all diagnostic groups, particularly in depressed subjects. Female patients attribute this impairment mainly to their mental illness, whereas male patients tend to assign their impairments primarily to their medication.

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Appendix

(Informative) translation of the

“Essener Fragebogen zu Sexualstörungen”

THIS IS NOT A TESTED OR VALIDATED ENGLISH VERSION

Have you noticed any changes concerning your sexuality? yes/no

If you did, was it more an improvement/or an impairment?

When did you become aware of these changes?

not applicable/recently/a few weeks ago/a few months ago /a few years ago

In which situations did you become aware of these sexual changes?

not applicable/during sexual intercourse/during masturbation/during sexual fantasies

Libido (sexual interest and desire)

Have you noticed a decrease in or loss of your sexual desire (libido)? yes/no

Scale of changes: unimportant=1-2-3-4-5-6=very important

Physiological arousal

Have you noticed an impairment of your physical sexual arousal?

Questionnaire for men: e.g., of the erection of your penis? yes/no

Questionnaire for women: e.g., of the lubrication of your vagina? yes/no

Scale of changes: unimportant=1-2-3-4-5-6=very important

Physical Orgasm

Have you noticed an impairment of your physical reactions at orgasm?

Questionnaire for men: e.g., of the ejaculation? yes/no

Questionnaire for women: e.g., of rhythmic, pelvic contractions? yes/no

Scale of changes: unimportant=1-2-3-4-5-6=very important

Satisfaction

Have you noticed an impairment or loss of your emotional satisfaction during orgasm? yes/no

Scale of changes: unimportant=1-2-3-4-5-6=very important

Alterations of your body

Did you observe an alteration of your genitals? yes/no

Did you feel pain during sexual activities? yes/no

Are you suffering from galactorrhea (milk secretions/flow from your breast)? yes/no

Do you assume a causal connection between some of the following items and the changes of your sexuality?

Relationship conflicts? yes/no

Physical disease? yes/no

Stress? yes/no

Lack of a partner? yes/no

Mental illness? yes/no

Age? yes/no

Finally two questions for statistical information:

Age ___ years

Sex male/female

Following are items to be answered by the responsible physician:
Psychiatric diagnoses according to ICD10:
Somatic diagnoses according to ICD10:
Medication (agent and dosage):

Correspondence

S. Cohen

Department of Psychiatry and Psychotherapy

Rheinische Kliniken Duesseldorf

Heinrich-Heine-University Duesseldorf

Bergische Landstrasse 2

40629 Düsseldorf

Email: simon.cohen@uni-duesseldorf.de

T. J. Huber

Department of Clinical

Psychiatry and Psychotherapy

Medical School Hannover

Carl-Neuberg-Strasse 1

30625 Hannover

Email: huber.thomas@mh-hannover.de