Sexual dysfunction factors in patients with schizophrenia treated with second generation antipsychotics: not only prolactin.

INTRODUCTION: Despite the high prevalence of sexual dysfunction in patients with schizophrenia, its origins are still unclear. THE AIM OF THIS STUDY: to determine the prevalence and causal factors of sexual dysfunction in a group of outpatients with schizophrenia. METHODS: The study was designed to be cross-sectional and naturalistic, including outpatients with schizophrenia undergoing second generation antipsychotic monotherapy. Patients receiving antidepressants and/or mood stabilisers were excluded. The following data were recorded: sexual functionality, sociodemographic information, sexual history, psychotic and depressive psychopathology, metabolic syndrome and BMI. Psychotropic-Related Sexual Dysfunction Questionnaire (PR SexDQ-Salsex); Positive and Negative Syndrome Scale; Hamilton Depression Rating Scale; Plasma concentrations of prolactin, testosterone, estradiol, progesterone and the International Diabetes Federation diagnostic criteria for metabolic syndrome, were used to complete the study. RESULTS: Of the 57 patients included in the study, 80% exhibited sexual dysfunction, one-third of which suffered severe levels of dysfunction. However, only 30% of patients spontaneously reported this problem. Although there were significant differences in the prevalence of hyperprolactinemia and metabolic syndrome according to the antipsychotic received, multivariant regression analysis did not show a correlation between sexual dysfunction and prolactin, sexual hormones, type of antipsychotic received, psychotic psychopathology or metabolic syndrome. Sexual dysfunction was only associated with age, civil status and depressive psychopathology. CONCLUSIONS: There is a high prevalence of sexual dysfunction in the patients with schizophrenia who participated in the study, but it was only associated with higher age, being single or divorced or having depressive psychopathology; this suggests a multifactorial etiology for sexual dysfunction in schizophrenia.