Evaluation of sexuality in 61 subjects suffering from chronic psychosis

Summary The aim of our study was to evaluate sexuality in patients suffering from chronic psychosis, to point out the factors related to sexual dysfunctions and to propose, following our findings and the existing literature, recommendations for management and prevention. The study consisted in an investigation of outpatients who consulted in psychiatry, in May and June 2005, at the Sfax Teaching Hospital in Tunisia, and who had either schizophrenia or bipolar disorder, according to DSM-IV criteria. We used Sexual Behaviour Questionnaire as a psychometric tool. Our research was conducted on 61 cases, that we divided into two groups in order to compare them: group 1 (G1), that of patients with schizophrenia ( n  = 30), and group 2 (G2), that of patients with a bipolar disorder ( n  = 31). The average age of the studied population was 37.3. The rate of the married subjects was 47.5% (20% for G1 versus 74.2% for G2; P P  = 0.01). Despite its frequency, sexual dysfunction was not approached by the treating doctor in 79.3% of cases. All the patients in G1 and 87.1% in G2 were under classical neuroleptic treatment. We didn’t find any correlation between classical neuroleptics and sexual dysfunctions, but many writers, pleading in favour of the use of atypical neuroleptics, which have a weak interference with the prolactin metabolism, noted such a correlation. They assume that atypical neuroleptics prevent or lessen such disadvantages. Management and prevention must take into consideration information and the education of the patients with chronic psychosis as far as sexuality is concerned, within the scope of rehabilitation programmes.