Sexual dysfunction in patients with schizophrenia and schizoaffective disorder and its association with adherence to antipsychotic medication

Background: Antipsychotic-induced sexual dysfunction is a common complaint among patients with psychotic disorders. However, few papers have discussed its impact on treatment adherence. Aims: The aim of the study was to determine the prevalence of antipsychotic induced sexual dysfunction in patients with schizophrenia and schizoaffective disorder and assess its impact on treatment adherence. Methods: Nighty-five outpatients treated with antipsychotics for at least four weeks were recruited. Sexual dysfunction was assessed using a questionnaire inspired from the Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale and the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ). An Arabic version of the Medication Adherence Rating Scale (MARS) was used to assess treatment adherence. Results: The prevalence of sexual dysfunction was 57.9%, of which 65.5% attributed it to treatment. Reduced desire was the mostly reported sexual dysfunction in males and females. Number, dose and duration of antipsychotics were not associated with sexual dysfunction. MARS score was associated with the presence of sexual dysfunction (p = 0.0001) and its attribution to antipsychotic medication (p = 0.0003), the latter being an independent associated variable (p = 0.001). Conclusion: Sexual dysfunction is prevalent in patients with schizophrenia and schizoaffective disorder treated with antipsychotic drugs. Clinicians should ask about sexual dysfunction and discuss its different causes with patients in order to improve adherence.