Sexual Dysfunction in Male Psychiatric Outpatients

Abstract

SUMMARY S exual dysfunction is a common problem among those suffering from psychiatric disorders and/or receiving psychotropic drugs. This work aims to determine the prevalence and the most common types of sexual dysfunction among males in psychiatric outpatient clinic and to compare between the different psychiatric morbidities as regards the sexual dysfunction, to identify the most common causes of sexual dysfunction among males in psychiatric outpatient clinic, and to determine the effects of sexual dysfunction of the husband upon the marital relationship and upon the wife abuse. In the present cross sectional study, a convenient sample (380 male psychiatric outpatients their age ranging from 18 to 55 years old) was collected from the general psychiatric clinic, Institute of psychiatry, Ain Shams University in the duration between December 2010 to June 2013. All the cases were subjected to Psychiatric sheet of the institute of psychiatry Faculty of Medicine Ain Shams University, ICD-10 Symptom Check List for Mental Disorders, male version of Sexual Behavioral Questionnaire (SBQ). 34 married ED psychiatric outpatients were subjected to Arabic version of Marital Satisfaction Inventory (MSI). 28 wives of ED psychiatric outpatients were subjected to Arabic version of Marital Satisfaction Inventory and woman Abuse Scale. The results were analyzed using the statistical package for the social sciences (SPSS) version 16. Qualitative data was described using frequency and percentage. Quantitative data was described using mean and standard deviation. The following inferential statistical procedures were used Chi- square (x2). Overall sexual dysfunction was highly prevalent (86.3% of 380 male psychiatric outpatients) and there was high rates of various types of sexual dysfunction (from 7.6% achieve erection dysfunction to 69.5% sexual enjoyment dysfunction). The common types of sexual dysfunctions were sexual enjoyment dysfunction (69.5%-264/380), sexual desire dysfunction (68.4%-260/380), sexual dissatisfaction (66.6% -253/380) and orgasmic dysfunction (59.7%-227/380). The major sexual dysfunctions were ejaculatory dysfunction (43.1% - 164/380) and erectile dysfunction; achieve or maintain erection dysfunctions (16.5% - 63/380). As regards the association of demographic variables with sexual dysfunctions among male psychiatric outpatients: The most common age group in overall sexual dysfunction was from 18 to > 29 years (54.6%-179/328) and the prevalence decreased by increasing the age group. Also, the younger age (18 - > 39 years) suffered from sexual excitement dysfunction, erectile dysfunction and delayed ejaculation more than the older age (39 - 60 years). We didn`t find any age group more common than other in sexual desire dysfunction, sexual enjoyment dysfunction, sexual dissatisfaction, premature ejaculation and orgasmic dysfunction. Sexual desire dysfunction was highly prevalent among male psychiatric outpatients living in rural area and delayed ejaculation was highly prevalent among those living in urban area. Sexual excitement and enjoyment dysfunctions were highly prevalent among single male psychiatric outpatients whereas erectile dysfunction and delayed ejaculation were highly prevalent among married psychiatric outpatients. Light smokers even non smokers were more presented than heavy smokers in overall sexual dysfunction and in sexual desire dysfunction, sexual enjoyment dysfunction and erectile dysfunction. So, there wasn`t evidence that there was a relation between smoking and sexual dysfunction among male psychiatric outpatients. As regards level of education or work status, we didn`t find a clear relation with sexual dysfunction. As regards the sexual dysfunction in different psychiatric morbidities, psychotic disorder was the most common psychiatric disorder followed by mood disorder in sexual desire dysfunction or sexual excitement dysfunction or sexual dissatisfaction or erectile dysfunction. But, there wasn`t any psychiatric disorder more common than other in overall sexual dysfunction, sexual enjoyment dysfunction, ejaculatory dysfunction and orgasmic dysfunction. Among 214 psychotics, the most common type of sexual dysfunctions was sexual dissatisfaction 73.4% (157/214) followed by sexual desire dysfunction 72.4% (155/214), whereas overall sexual dysfunction existed in 185 (86.4%). And among 105 mood disorder patients the most common type of sexual dysfunctions was sexual enjoyment dysfunction 70.4% (74/105), whereas overall sexual dysfunction existed in 94 (98.5%). And among 18 neurotic patients the most common type of sexual dysfunctions was sexual dissatisfaction 72.2% (13/18), also overall sexual dysfunction existed in 72.2%. Among 18 substance dependent men currently abstinent, the most common type of sexual dysfunctions was. sexual desire dysfunction 77.7% (14/18), also overall sexual dysfunction existed in 77.7%. And, among ten personality disorder patients, the most common type of sexual dysfunctions was sexual dissatisfaction 100% (10/10), so all the ten (100%) patients suffered from overall sexual dysfunction. Among 15 patients suffered from organic disorder due to brain damage, the most common type of sexual dysfunctions was sexual enjoyment dysfunction 80% (12/15), also overall sexual dysfunction existed in 80%.