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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

While a potentially volatile subject, discussion of sex between a nurse and schizophrenic client is a key to improving the patient's overall condition. Despite fears early in the century that schizophrenia caused a breakdown of moral inhibitions, it is now believed that most schizophrenic individuals are very similar, in sexual contexts, to "normal" people. Research shows that schizophrenic men and women are still interested in sexual relations but do not know how to bring their feelings into the open. They also may be resisting neuroleptic drugs because the medication causes varying sexual dysfunction. In order to help these clients, nurses first must examine their own feelings toward clients' sexual behavior. The nurse needs to work with clients on developing social and communication skills as well as on informing them about safe methods of sexual contact.
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PMID:Sexual needs of the schizophrenic client. 167 59

These data, in combination with the literature reviewed above, demonstrate several important points for those who work in clinics where elders with sexual problems are seen: 1. The currently available literature on the relation of sexual dysfunction to psychiatric disorder in the elderly is not extensive, and much of the literature is limited by methodologic flaws. There is a clear need for improved research methods and a broader data base. Nonetheless, the existing studies indicate that psychologic disorders are found in conjunction with sexual dysfunction commonly enough that clinicians must regularly assess for their presence. 2. The cause of sexual problems is seldom simple or entirely clear. Diagnoses of psychologic concerns and disorders that might relate to sexual dysfunction are common, and most older patients' sexual dysfunction will have a mixed cause, with both medical and psychologic factors playing an important role in the development and maintenance of sexual dysfunction. In our series of patients, 52.8% had diagnosable psychologic difficulties that were assumed to be related to the sexual difficulties. Another large group (39.9%) had psychologic factors (although not diagnosable disorders) that were assumed to contribute to the current manifestation of sexual dysfunction. Thus, it should not be assumed, as it was in years past, that when one likely causative factor is identified (e.g, diabetes, performance anxiety, or depression), the cause of the dysfunction has been identified. 3. The types of psychopathology seen in sex clinics are typically fairly limited, with the largest proportions by far being alcohol abuse or depression (50.1% and 62.1%, respectively, of all psychologic diagnoses in our clinic). Major psychopathology is relatively underrepresented. We suspect this underrepresentation does not reflect a true population characteristic but, rather, a selection difference; patients with major psychopathology such as schizophrenia either do not complain of sexual dysfunction to their therapists or are not referred for treatment by their therapists. 4. The presenting complaints of patients with a psychologic disorder do not differ significantly from those of patients without a psychologic disorder in a general sexual dysfunction clinic. 5. Treatment outcome, especially the rate of successful treatment, does not differ between those with and those without psychologic diagnoses when physicians and psychologists work together on an interdisciplinary team to offer treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Psychologic disorder and sexual dysfunction in elders. 200 86

Most evaluations of the contributions of possible alterations in serotonergic neurotransmission to the etiology and treatment of neuropsychiatric disorders preceded the recent explosion of information regarding multiple serotonin (5-HT) receptors and brain 5-HT subsystems. This review provides an appraisal of some examples where drugs acting at different 5-HT receptor subtypes have provided new treatment or have contributed to the development of knowledge regarding various neuropsychiatric disorders, including anxiety, panic disorder, obsessive-compulsive disorder, depression, schizophrenia, alcoholism, migraine, sexual dysfunction, and Alzheimer's disease.
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PMID:Neuropsychiatric disorders and the multiple human brain serotonin receptor subtypes and subsystems. 207 79

The authors determined the six-month and lifetime prevalence of psychiatric disorders among 100 consecutively admitted female offenders to a prison, using Diagnostic Interview Schedule (DIS Version III) and found high prevalence rates of schizophrenia, major depression, substance use disorders, psychosexual dysfunction, and antisocial personality disorders. The prevalence rates of these disorders were significantly higher than those of the general population. The authors note the implications of their findings for treatment of women within the correctional system.
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PMID:Lifetime and six-month prevalence of psychiatric disorders among sentenced female offenders. 326 81

Lack of interest in sexual activity is one of the most prevalent psychosexual problems seen by clinicians. No consensus exists on etiology, symptomatology, appropriate therapeutic intervention, or prognosis. Desire disorders are believed to be highly refractory to treatment because of severe intrapsychic conflict, but no systematic data have been gathered about the histories of psychopathology in these individuals. Forty-six married subjects with a primary DSM-III diagnosis of global inhibited sexual desire (ISD) were compared with 36 matched controls on lifetime psychopathology, current psychological profiles, and premenstrual syndrome. A clinical interview, the Schedule for Affective Disorders and Schizophrenia-Lifetime Version and the SCL-90-R were administered to all subjects. Only ISD subjects free from any other axis I disorder, medical illness, medication use, or substance abuse were selected; controls met similar criteria but had no sexual dysfunction. Despite the fact that all ISD subjects had nearly normal psychological profiles at the time of assessment, more ISDs than controls had significantly elevated lifetime prevalence rates of affective disorder. The proportion of ISD individuals with histories of major and/or intermittent depression alone was almost twice as high as controls. Additionally, the initial episode of the depressive disorder almost always coincided with or preceded ISD onset. Significantly more ISD women than controls also had severe symptoms of premenstrual syndrome. The remarkable lifetime rate of affective illness in ISD patients suggests that there may be a common biological etiology or that affective psychopathology may be contributing to the pathogenesis of the ISD dysfunction.
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PMID:Lifetime psychopathology in individuals with low sexual desire. 377 53

To address the scarcity of literature on the sexual functioning of schizophrenic patients, two therapists interviewed 20 schizophrenic patients in a community mental health center's inpatient unit. In a context designed to make the patients feel safe and to encourage rapport, patients were asked about sexual dysfunctions, sexual norms, relationship patterns, and drug-related sexual side-effects. The therapists' impressions were that the data obtained were as reliable as similar information obtained from patients presenting to a sexual dysfunction clinic, that the incidence of sexual dysfunction among these schizophrenic patients was no different from that among the general population, and that the manifest sexual relationship problems were due to lack of social skills and deterioration of social functioning, rather than to a primary, structural impairment specific to schizophrenia.
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PMID:Schizophrenia and sexual functioning. 722 86

The aim of the study was to assess psychological contributors or correlates of sexual dysfunction in diabetic men. The study was conducted on 40 diabetic men and 40 age-matched healthy volunteers. The subjects underwent a psychosexual interview with their sexual partners and had a comprehensive medical evaluation to rule out the confounding effects of other illnesses or medications. Psychiatric, psychological and marital information was obtained with the Schedule for Affective Disorders and Schizophrenia (SADS-L), the SCL-90-R, the Derogatis Sexual Function Inventory, the Locke-Wallace Marital Adjustment test and the Dyadic Adjustment Inventory. Compared to controls, diabetic patients had significantly lower levels of erotic drive, sexual arousal, enjoyment and satisfaction. Problems in these areas coexisted with alterations in sexual attitudes and body image but were not related to group differences in marital adjustment as reported separately by the patients and their partners. There was no evidence that psychological distress or psychiatric disorders are associated with diabetes or with its effects on sexual function.
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PMID:Diabetes, psychological function and male sexuality. 763 74

The sex behaviour of patients suffering from schizophrenia has been largely overlooked. This study is aimed at describing the pattern of sexual responses and conducts in 113 inpatients with schizophrenia (DSM-III-R). A high rate of sexual dysfunction was found in both males (62.9%) and females (50%). These rates are higher than found in other previous studies. The possible cause factors of sexual dysfunctions in this group of patients and the methodological problems related to this type of study are reviewed.
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PMID:[Sexuality and schizophrenia]. 787 23

A double-blind, randomized study of parallel group design comparing remoxipride and thioridazine (dose range 150-600 mg/day of either drug) was undertaken at 11 Australian centres. A total of 144 patients (remoxipride = 73, thioridazine = 71) with DSM-III-R schizophrenia or schizophreniform disorder commenced the study, and 89 patients (remoxipride = 45, thioridazine = 44) completed the 6 weeks of the trial. The mean daily doses at last rating were 404 mg (remoxipride) and 378 mg (thioridazine). Initial Brief Psychiatric Rating Scale scores decreased by a mean 8.7 points in both remoxipride and thioridazine groups. Equivalent treatment responses were also confirmed by Clinical Global Impression. During the study, sedatives or hypnotics were needed by 68% of the remoxipride patients and 51% of the thioridazine patients. Thioridazine was associated with more postural hypotension, drowsiness, increased sleep, headache, dizziness on rising, dry mouth, sexual dysfunction and weight gain, while remoxipride patients reported more insomnia. There were no differences between remoxipride and thioridazine on dystonia, hypokinesia, dyskinesia, rigidity and akathisia. The results indicate that remoxipride has similar antipsychotic efficacy to thioridazine but causes fewer side effects.
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PMID:The Australian multicentre double-blind comparative study of remoxipride and thioridazine in schizophrenia. 787 41

During a 24-month period, 205 consecutive new referrals to Muhimbili psychiatric unit were studied. Their socio-demographic characteristics, sources of referral, types of treatment received before referral and the nature of their clinical problems were identified. Their neuropsychiatric disorders were classified according to ICD-10. The ratio of males to females was found to be 1.6:1. The average age was 29.3 years. 23.4% of adult patients were unemployed, two fifths of all patients were single and 70% of all subjects had less than eight years of formal education. Whereas 42.9% of all referrals were from other departments of Muhimbili hospital, the remaining were largely from parastatal dispensaries, district and regional hospitals within Dar es Salaam city. At least a fifth of all patients had consulted traditional healers prior to referral and antimalarials had been given inappropriately to 34 patients with mental problems. Mental disorders consisted of functional psychosis, 36.6% of which three quarters were schizophrenia, neurosis (19.5%), seizures (16.6%), substance abuse (8.8%), organic mental disorders (5.3%), headache (4.9%), sexual dysfunction (2.9%). The rest had conduct disorders and pseudocyesis. Seventeen percent of all cases had concomitant physical disorders. Most patients had delayed to seek medical help.
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PMID:Nature of referrals to the psychiatric unit at Muhimbili Medical Centre, Dar es Salaam. 868 72


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