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Sexual dysfunction and schizophrenia: psychiatrists' attitudes and training needs

  • Romanus Ndubueze Nnaji (a1) and Trevor Friedman (a2)
Abstract
Aims and Method

We conducted a survey of the knowledge, attitudes and practices of sexual dysfunction and schizophrenia of general adult psychiatrists in Leicestershire and Lincolnshire mental health trusts.

Results

Two-thirds of psychiatrists that we interviewed do not routinely enquire about sexual dysfunction in their patients and only 17% felt competent in assessing sexual dysfunction, despite 88% agreeing that good sexual function is important to patients. Most practitioners (81.6%) have had no training in this area and wanted some.

Clinical Implications

Sexual dysfunction is underrecognised and possibly under-treated; suggestions on how to address this are made in this paper.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Akhtar, S., Crocker, E., Dickey, N., et al (1977) Overt sexual behaviours among psychiatric inpatients. Diseases of the Nervous System, 38, 359361.
Baldwin, D. & Mayers, A. (2003) Sexual side-effects of antidepressant and antipsychotic drugs. Advances in Psychiatric Treatment, 9, 202210.
Bitter, I., Basson, B. R. & Dossenbach, M. R. (2005) Antipsychotic treatment and sexual functioning in first-time antipsychotic-treated schizophrenic patients. International Clinical Psychopharmacology, 20, 1921.
Clayton, A. H. (2001) Recognition and assessment of sexual dysfunction associated with depression. Journal of Clinical Psychiatry, 62 (suppl 3), s59.
Erlenmeyer-Kimling, L., Nicol, S., Rainer, J.D., et al (1969) Changes in fertility rates of schizophrenic patients in New York State. American Journal of Psychiatry, 125, 916927.
Fakhoury, W. K., Wright, D. & Wallace, M. (2001) Prevalence and extent of distress of adverse effects of antipsychotics among callers to a United Kingdom National Mental Health Helpline. International Clinical Psychopharmacology, 16(3), 153162.
Fortier, P., Mottard, J.-P., Trudel, G., et al (2003) Study of sexuality-related characteristics in young adults with schizophrenia treated with novel antipsychotics and in a comparison group of young adults. Schizophrenia Bulletin, 29, 559572.
Gott, M., Galena, E., Hinchliff, S., et al (2004) ‘Opening a can of worms’: GP and practice nurse barriers to talking about sexual health in primary care. Family Practice, 21, 528536.
Kazantzis, N., Lampropoulos, G. K., Deane, F. (2005) A national survey of practicing psychologists' use and attitudes toward homework in psychotherapy. Journal of Consulting and Clinical Psychology, 73, 742748.
Kelly, D. L. & Conley, R. R. (2004) Sexuality and schizophrenia: a review. Schizophrenia Bulletin, 30, 767779.
Macdonald, S., Halliday, J., Macewan, T., et al (2003) Nithsdale Schizophrenia Surveys 24: sexual dysfunction: case–control study. British Journal of Psychiatry, 182, 5056.
Malik, P. (2007) Sexual dysfunction in schizophrenia. Current Opinions in Psychiatry, 20, 138142.
Montejo-Gonzàlez, A. L., Llorca, G., Izquierdo, J. A., et al (1997) Fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. Journal of Sex and Marital Therapy, 23, 176194.
Perkins, D. O. (2002) Predictors of noncompliance in patients with schizophrenia. Journal of Clinical Psychiatry, 63, 11211128.
Pinderhughes, C.A., Barrabee Grace, E. & Reyna, L. J. (1972) Psychiatric disorders and sexual functioning. American Journal of Psychiatry, 128, 12761283.
Smith, S., O'Keane, V. & Murray, R. (2002) Sexual dysfunction in patients taking conventional antipsychotic medication. British Journal of Psychiatry, 181, 4955.
Stevenson, R.W. D. (2004) Sexual medicine: why psychiatrists must talk to their patients about sex. Canadian Journal of Psychiatry, 49, 673677.
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BJPsych Bulletin
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  • EISSN: 1472-1473
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Sexual dysfunction and schizophrenia: psychiatrists' attitudes and training needs

  • Romanus Ndubueze Nnaji (a1) and Trevor Friedman (a2)
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eLetters

Need for training to deal with psychosexual and relationship problems

Kiran Rele, Consultant Psychiatrist
21 July 2008

We read with interest the article on "Sexual dysfunction and schizophrenia: psychiatrists’ attitudes and training needs"

We feel that the knowledge of psychosexual development and competencyin the assessment and treatment of psychosexual disorder should be core components of a psychiatry-training curriculum.

Research indicates that many psychiatric training schemes fail to teach a broad range of human sexuality issues and that expert supervision and clinical training opportunities are lacking (Verhulst, 1992). Scheiberand colleagues (2003) have proposed that the knowledge of psychosexual development and competency in the assessment and treatment of psychosexualdisorder should be core components of a psychiatry residency curriculum.

We undertook a study that monitored the evaluation of assessment and training of psychosexual and relationship problems in the general mental health services (Rele & Wylie, 2007).

We devised a questionnaire that asked psychiatry trainees to report their perception of competency in dealing with sexual dysfunction and relationship problems; the need to discuss potential sexual side-effects before and after starting psychotropic medication and the importance of a readily available psychosexual disorder clinic. In addition, we enquired about the emphasis, or otherwise, on psychosexual disorders, and sexual medicine problems in general, and their management both in medical school and during current psychiatric training.

All psychiatry trainees (both basic and Higher Specialist trainees inAdult & Old Age Psychiatry) in the Mid-Trent rotation were invited to complete a questionnaire.

Results:Only 24% of trainees reported that they routinely ask patients about psychosexual history, 65% felt comfortable about taking a detailed psychosexual history.81% of trainees reported inadequacy whilst dealing with psychosexual disorder during their training in psychiatry. Only 30% of trainees reported asking patients about potential sexual side effects when on psychotropic medication. All the trainees (100%) preferred to refer the patient to a local psychosexual disorder clinic (if available) rather than treat the patients themselves.To our knowledge this was the first survey looking into the competency issues of UK based psychiatric trainees with regard to taking a sexual andrelationship history and management of sexual dysfunction of their patients. Taking a sexual and relationship (both past and current) historyshould be an integral part of any psychiatric assessment. The authors havefailed to highlight the importance of a healthy relationship. Health Care Professionals need to be alert to the possibility of a sexual problem and should be competent enough to be able to discuss the problem.

Clinical Implications: Taking a sexual and relationship (both past and present) history should bean integral part of any psychiatric assessment. Training in human sexuality should be introduced in medical schools as a part of the undergraduate curriculum and is a core part of psychiatric training curriculum and trainees should be tested for their competency in dealing with sexual dysfunctions.

References:RELE, K. & WYLIE, K. (2007) Management of psychosexual and relationship problems in general mental health services by psychiatry trainees. International Journal of Clinical Practice, 61,10, 1701-1704

SCHEIBER, S.C., KRAMER, TAM., ADAMOWSKI, S.E.(2003) The implications of core competencies for psychiatric education and practice in the US. CanJ Psychiatry, 48, 215-21

VERHULST, J (1992) The sexuality curriculum in residency training. Acad Psychiatry, 16, 115-7

Declaration of Interest: None
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Conflict of interest: None Declared

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