Factors associated with sexual dysfunction among schizophrenia men with nicotine dependency and non-smoking schizophrenia men

Abstract

Cigarette-smoking in schizophrenia and its associations with sexual functioning have been relatively under-examined. The study purpose was to determine the factors associated with sexual dysfunction among schizophrenia men with nicotine dependency and those non-smokers. A retrospective study was conducted in a local hospital in Malaysia over a two-year period from 2011 to 2012. There were 54 schizophrenia men with nicotine dependency and 57 non-smokers. Sexual functioning was assessed using the Malay version of the International Index of Erectile Function-15. Logistic regression analysis was employed. All the 111 schizophrenia men had at least one sexual dysfunction domain. For the group with nicotine dependency, Positive and Negative Syndrome Scale (PANSS)-positive was positively associated with the ability to achieve orgasm and ejaculation. However, age of schizophrenia onset was negatively associated with the confidence to attain and keep an erection. For the non-smoker group, married status and duration of schizophrenia were positively associated with the ability to attain erection and overall sex life satisfaction, respectively, while age of schizophrenia onset was negatively associated with the ability to attain erection and erectile sustainability during intercourse. Among the domains, only orgasmic dysfunction was significantly associated with PANSS-positive, i.e. higher PANSS-positive score was a protective factor for orgasmic dysfunction (odds ratio = 0.37; 95% confidence interval: 0.17, 0.80; p = .012). Schizophrenia men may apparently attempt to treat their orgasmic impairment due to effect from antipsychotics through smoking cigarettes. Sexual impairment among the non-smokers may be attributed mostly to relationship issues with their partner.

Keywords:

• nicotine dependence
• non-smoker
• sexual dysfunction
• Validated Malay Version of the International Index of Erectile Function-15
• male schizophrenia patients

Acknowledgement

The authors would like to thank the Director of Health Malaysia for permission to publish this article.