AN EMPIRICAL EVALUATION OF THE ARIZONA SEXUAL EXPERIENCE SCALE (ASEX) QUESTION- NAIRE TO IDENTIFY SEXUAL DYSFUNCTION IN PATIENTS OF THE SCHIZOPHRENIA SPECTRUM

Objective: The main aims of this paper are threefold: a) to assess the frequency of sexual dysfunction in a sample of out-patients with schizophrenia and schizoaffective disorder under antipsychotic therapy; b) to investigate the effect of different antipsychotics on sexual function; and c) to evaluate the accuracy of the Arizona Sexual Experience Scale (ASEX) to identify sexual dysfunction. Method: A cross-sectional study of sexual function was conducted with one-year consecutive outpatients from the Schizophrenia Program of the Universidade Federal de Sao Paulo (Proesq), from February 2007 to January 2008. Patients, who met DSM IV criteria for schizophrenia or schizoaffective disorder, were asked to fulfill both the Arizona Sexual Experience Scale (ASEX) and the Dickson Glazer Scale for the Assessment of Sexual Functioning Inventory (DGSFi) at a single interview. Results: 137 patients entered the study (86 were males and 51 were females). The sensitivity and specificity of the ASEX at identification of sexual dysfunction in relation with DGSFi scores were respectively: 80.8%, (95% CI = 70.0%–88.5%) and 88.1% (95% CI = 76.5%–94.7%), and the misclassification rate was 9,5%. The ROC curve comparing the ASEX and the DGSFi scores revealed a value of 0.93 (CI = 0.879–0.970), with the optimum cutoff point of ASEX for sexual dysfunction being 14/15. Sexual dysfunction measured by ASEX was higher among females (79.2%) than for males (33.3%), and this difference was statistically significant (v 2 = 27.41, df = 1, P < .001). Conclusion: Patients under antipsychotic treatment showed a high level of sexual complaints, and the ASEX questionnaire showed to be an accurate instrument to identify sexual dysfunction in an out-patient sample of patients with schizophrenia and schizoaffective disorders. Females showed a higher frequency of sexual dysfunctions than males and sexual drive and ability to reach orgasm were the most affected areas. The use of antipsychotics, especially the combinations of medications, was more likely to impair sexual functioning. ID: 540733