Sexual Dysfunctions and High-Risk Sexual Behaviors in Women with Severe Psychiatric Disorders

Background: Sexual Dysfunctions (SDs) and High-Risk Sexual Behaviors (HRSBs) are highly prevalent and substantial issues among patients with severe psychiatric disorders. However, studies exploring them are still infrequent. This study was conducted to evaluate SDs and HRSBs in women with severe psychiatric disorders. Methods: Female inpatients and outpatients of the Iran Psychiatry Hospital were selected if they were 18-60 years old, able to read, and diagnosed with schizophrenia, schizoaffective disorder, or type one Bipolar Disorder (B1D). After the initial interviews, the outcomes were assessed using the Female Sexual Function Index (FSFI), Youth Risk Behavior Surveillance System (YRBSS), and Sexual Risk Survey (SRS) questionnaires. Results: The mean (standard deviation) age of the 159 patients was 36.9 (10.1). B1D, schizophrenia, and schizoaffective disorder were diagnosed in 98, 53, and eight patients, respectively. FSFI evaluations demonstrated that several SDs, including pain and decreased sexual desire, are highly prevalent in them. Based on the results of YRBSS and SRS evaluations, the most predominant HRSBs were sexual behaviors without leading to complete intercourse, having sex without a barrier or effective contraception, using alcohol and drugs before sex, and impulsive sexual intercourse with inadequately known partners. Conclusion: All evaluated SDs had a high prevalence attributable to the pathophysiology of severe psychiatric disorders and related medications. HRSBs were also widespread due to impaired judgment, poor knowledge, or sexual characteristics of the disorders. These results support the need for further educating these patients concerning safe sexual behaviors and interactions of contraceptive medications with specific psychiatric medicines, including carbamazepine and sodium valproate.