June 26, 2007

Relationship and Sexual Problems Often Overlooked in Individuals with Psychosis

The annual meeting of the Royal College of Psychiatrists discussed two studies that show there may be a lack of holistic treatment for those suffering from psychosis. Holistic approaches in counseling and psychology are defined as treating the whole person rather than just the symptoms of a disease. With symptoms as severe as psychosis, everyday life problems may come second. But anyone who knows someone suffering from a psychotic illness knows that everyday stressors, relationships, and sex or intimacy can present major difficulties in their lives.

Being aware that patients with a psychotic illness are not necessarily first on the list to receive relational or sexual counseling can help clinicians as well as family members, and the patients themselves, ask for this type of therapy. The success of combined medication and psychosocial treatments, such as CBT and other therapies, may be in part a result of its ability to treat more than just the presenting psychotic symptoms.

Previous research has found high levels of sexual dysfunction amongst psychiatric in-patients, and patients living in the community, who have psychotic disorders.

Psychosexual disorders and relationship problems are not often assessed or treated in people with psychoses. 2 studies have been carried out, however, suggesting that there is a need to provide services for this vulnerable group of people.

The first study surveyed 39 men and 17 women who had been admitted to the acute psychiatric wards of an inner London psychiatric unit. The patients were seen within 7 days of their admission, and were interviewed about existing sexual and relationship problems.

The admissions consisted largely of single men with schizophrenia, and married or cohabiting women with affective disorders (such as depression).

Of the men, 62% of those with a diagnosis of schizophrenia, between 63%-75% of those with affective disorders, and 17% of those with other diagnoses reported current sexual or relationship problems.

Of the women, 25% of those with schizophrenia, 50%-100% of those with affective disorders, and 25% with other diagnoses reported a sexual or relationship problem.

The second study assessed people with severe, persistent psychoses who were under the care of a single community team.

Amongst the 40 men interviewed, sexual difficulties were reported by 47.5%. Of the 13 women assessed, 30.8% reported sexual problems.

82.5% of the men, and 38.5% of the women in this study were not in intimate relationships. 42.5% of the men, and 38.5% of the women had never had a sexual relationship.

The researchers conclude that the high levels of sexual and relationship problems among psychiatric in-patients shows that such matters should be assessed, and therapeutic interventions should be considered, at the time of hospital admission.

Amongst patients with severe psychoses living in the community, there is a high degree of unmet need for specific interventions, including assessment, talking treatments and medication. This warrants evaluation of service structures, and the development of treatment packages, tailored for this group of people.

Overall, clinical services and future research should consider the sexual and relationship needs of people with severe psychoses.

High Levels of Sexual and Relationship Problems Found Among Patients with Psychoses.Royal College of Psychiatrists

Relationship Problems Under Treated for Individuals with Psychosis PsychCentral


I am very grateful that these issues are being addressed.

Posted by: ky perraun at June 29, 2007 02:53 PM

During and after psychosis I was
sexually dead and I know it
wasn't because of the meds. Scz
is systemic and affects sexual
functioning along with everything else. Doctors don't even know where to begin in this and in every other instance.

Posted by: longnow at August 1, 2007 09:35 PM

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