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Sexual dysfunction in people with prodromal or first-episode psychosis

  • Tiago Reis Marques (a1), Shubulade Smith (a2), Stefania Bonaccorso (a1), Fiona Gaughran (a1), Anna Kolliakou (a1), Paola Dazzan (a1), Valeria Mondelli (a3), Heather Taylor (a1), Marta DiForti (a1), Philip K. McGuire (a1), Robin M. Murray (a1) and Oliver D. Howes (a1)...
Abstract
Background

Sexual dysfunction is common in psychotic disorder but it is not clear whether it is intrinsic to the development of the illness or secondary to other factors.

Aims

To compare sexual function in people at ultra-high risk (UHR) of a psychotic disorder, patients with first-episode psychosis predominantly taking antipsychotic drugs and healthy volunteers.

Method

Sexual function was assessed in a UHR group (n = 31), a group with first-episode psychosis (n = 37) and a matched control group of healthy volunteers (n = 56) using the Sexual Function Questionnaire.

Results

There was a significant effect of group on sexual function (P<0.001). Sexual dysfunction was evident in 50% of the UHR group, 65% of first-episode patients and 21% of controls. Within the UHR group, sexual dysfunction was more marked in those who subsequently developed psychosis than in those who did not. Across all groups the severity of sexual dysfunction was correlated with the severity of psychotic symptoms (P<0.001). Within the first-episode group there was no significant difference in sexual dysfunction between patients taking prolactin-raising v. prolactin-sparing antipsychotics.

Conclusions

Sexual dysfunction is present prior to onset of psychosis, suggesting it is intrinsic to the development of illness unlikely to be related to the prolactin-raising properties of antipsychotic medication.

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Copyright
Corresponding author
Dr Tiago Reis Marques, PO Box 063, Department of Psychosis Studies, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: tiago.marques@kcl.ac.uk
Footnotes
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The Improving Physical Health and Reducing Substance Use in Severe Mental Illness study is funded by the National Institute of Health Research (NIHR). This paper presents independent research commissioned by the NIHR under its Program Grants for Applied Research scheme (RP-PG-0606-1049).

Declaration of interest

R.M.M. has received honoraria for lectures from Janssen, AstraZeneca, Lilly, Novartis and Bristol-Myers Squibb. F.G. has a family member employed by GlaxoSmithKline and has received honoraria for talks and advisory work from Roche and Bristol-Myers Squibb.

Footnotes
References
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Sexual dysfunction in people with prodromal or first-episode psychosis

  • Tiago Reis Marques (a1), Shubulade Smith (a2), Stefania Bonaccorso (a1), Fiona Gaughran (a1), Anna Kolliakou (a1), Paola Dazzan (a1), Valeria Mondelli (a3), Heather Taylor (a1), Marta DiForti (a1), Philip K. McGuire (a1), Robin M. Murray (a1) and Oliver D. Howes (a1)...
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eLetters

Sexual Dysfunction in first- episode Psychosis

Manjeet S. Bhatia
05 December 2012

This is an important study comprising of sexual dysfunctions in first-episode psychotics versus controls and whether there was any association between sexual dysfunction, psychosis and type of anti-psychotic drug taken. There were some drawbacks which include small sample size; assessment on SPQ for only last one month;less mean duration and no mention if there was any change in sexual dysfunction after withdrawal of drug or remission of psychosis. Some more information such as mentioning of any change in sexual dysfunction with improvement of psychosis; intake of anticholinergic antiparkinsonians or benzodiazepines; inclusion of another psychiatric group e.g. depression and analysis of type of sexual dysfunction or change in from one type to another and comparison of type of sexual dysfunction according to type of antipsychotic and prolactin levels would have made the study more informative.

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Conflict of interest: None declared

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