Sexual Dysfunction in Psychiatric Practice - A Review

Background: Sexual function is considered an important part of human experience and a determining factor of quality of life. With this in mind, sexual dysfunction (SD), which is present in a significant percentage of patients with psychiatric disorders, has been a focus of study of those who are concerned not only with the physical well-being but also with the psychological and emotional well-being of their patients. Aims: To analyze the association between SD and major psychiatric disorders, such as the various components of sexual function that may be altered in these patients and their possible causes, and finally investigate the different approaches to SD in psychiatric practice. Methods: Non-systematic review through literature research in PubMed/Medline database, using the key-words: "mental disorders", "psychiatric disorders", "sexual disorders", "sexual dysfunction", "psychotropics", "antidepressants" and "antipsychotics". The articles were selected according to their relevance to the topic. Results: According to the reviewed literature, SD is more frequent in individuals with mental disorders compared to the general population, affecting 30-60% of patients being treated with antipsychotics for schizophrenia, 70% of patients receiving antidepressants for treatment of depression and up to 80% of individuals with from anxious disorders. Sexual problems often associated with psychiatric disorders and its treatment include decreased sexual desire, difficulties in arousal, difficulty in achieving orgasm or anorgasmia in females, and erectile dysfunction and problems with ejaculation in males. Studies indicate in these patients SD may occur not only due to interpersonal and environmental factors, but also due to the influence of psychopathology on sexual function and the action of psychotropic drugs chosen for treatment. Psychotropic drug induced SD may reduce therapeutic adherence or even be associated with total discontinuation of follow-up. Conclusions: SD has a significant impact on the mental health and quality of life of many patients with psychiatric illness. It is therefore essential that the clinician is aware of this phenomenon and its possible implications, taking an informed attitude and opting for the most appropriate approach. This approach will avoid, or at least mitigate, the impact of mental illness and psychotropic drugs on sexual function and thus ensure good therapeutic adherence and an improvement in the quality of life of these patients.