Two recent studies suggest psychosexual disorders and relationship problems are often not assessed or treated in people with psychoses.

The finding comes despite previous research that found high levels of sexual dysfunction amongst psychiatric in-patients, and patients living in the community, who have psychotic disorders.

The British studies suggest a strong 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 percent of those with a diagnosis of schizophrenia, between 63 -75 percent of those with affective disorders, and 17 percent of those with other diagnoses reported current sexual or relationship problems.

Of the women, 25 percent of those with schizophrenia, 50-100 percent of those with affective disorders, and 25 percent 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 percent. Of the 13 women assessed, 30.8 percent reported sexual problems.

82.5 percent of the men, and 38.5 percent of the women in this study were not in intimate relationships. 42.5 percent of the men, and 38.5 percent 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.

Source: The Royal College of Psychiatrists