Psychiatric Disorders and Sexual Dysfunctions; Chapter 38

Abstract

Sexual dysfunction is prevalent among psychiatric patients and may be related to both the psychopathology and the pharmacotherapy. Sexual function can change in all phases of sexual response separately or diffusionly. At least half of patients suffering from mood disorders have sexual difficulties. Sexual interest, arousal, orgasm can be affected by mood disorder. The relation between sexual dysfunction and mood disorders also can be bidirectional. Antidepressants can induce, impair or improve sexual dysfunction during treatment period. SD are common in anxiety disorders either. Redusing risk for anxiety, or counseling and support after a traumatic or disturbing experience can serve as a preventive agent against SD development during anxiety disorders. Psychopathology contributed to SD: positive and negative symptoms of schizophrenia limit the capability for interpersonal and sexual relationships. First and second generation antipsychotics negatively influence sexual function, the second generation less and can be an option for treatment saving sexual function. Some personality traits can predict tendencies for sexual behavior and SD development. Sexual functioning and behavior negatively related to neurorticism, histrionic traits, BPD and positively associated to extraversion. Even today, the prevalence of SD is understimated by physicians. Spontaneous refer about SD are still uncommon in individuals. Problems intervieving about sexual function occure therefore doctors and patients fears. Sexual function can improve, during appropriate treatment of mental disorders. Nevertheless, sexual adverse effects induced by psychotrops can be managed by using several treatment strategies. Importantly, to identify the specific sexual dysfunction and to treat the patient individualy according to the psychopatology, pharmacotherapy, interpersonal relationships, and mostly highlighted the expectations of the patient. Psychosexual therapy and sexual education may be helpf ul in general.