Sexual dysfunction prevalence, risk factors, and help-seeking behavior in opioid agonist treatment and general psychiatry: a cross-sectional study

Maximilian Meyer; Jean N Westenberg; Patrick Brunner; Martin Gürtler; Gerhard A Wiesbeck; Undine E Lang; Marc Vogel; Kenneth M Dürsteler

doi:10.3389/fpsyt.2023.1204236

Sexual dysfunction prevalence, risk factors, and help-seeking behavior in opioid agonist treatment and general psychiatry: a cross-sectional study

Front Psychiatry. 2023 Aug 7:14:1204236. doi: 10.3389/fpsyt.2023.1204236. eCollection 2023.

Authors

Maximilian Meyer^{1

2}, Jean N Westenberg¹, Patrick Brunner¹, Martin Gürtler³, Gerhard A Wiesbeck⁴, Undine E Lang¹, Marc Vogel¹, Kenneth M Dürsteler^{1

5}

Affiliations

¹ Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland.
² Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
³ Health Center Allschwil (Gesundheitszentrum Allschwil AG), Allschwil, Switzerland.
⁴ Department of Clinical Research, University of Basel, Basel, Switzerland.
⁵ Department for Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.

Abstract

Background: Mental disorders pose a high risk for the occurrence of sexual dysfunctions (SD). This study aimed to investigate prevalence of risk factors and help-seeking behavior for sexual dysfunctions in patients with opioid use disorder compared to patients seeking psychotherapeutic help.

Methods: Ninety-seven patients at two opioid agonist treatment (OAT) centers and 65 psychotherapeutic patients from a psychiatric practice (PP) in Switzerland were included in the study. Self-report assessments comprised sexual functioning (IIEF: International Index of Erectile Function; FSFI: Female Sexual Function Index), depressive state, psychological distress, alcohol consumption, nicotine use, and a self-designed questionnaire on help-seeking behavior. We used chi-squared and Mann-Whitney U tests for group comparisons and binary logistic regression models to identify variables predicting the occurrence of sexual dysfunctions.

Results: There was no statistically significant difference (p = 0.140) in the prevalence of SD between OAT (n = 64, 66.0%) and PP sample (n = 35, 53.8%). OAT patients scored significantly higher in scales assessing nicotine use (p < 0.001) and depressive state (p = 0.005). Male OAT patients scored significantly worse on the Erectile Function scale (p = 0.005) and female PP patients scored significantly worse on the FSFI Pain domain (p = 0.022). Opioid use disorder, higher age, and being female predicted the occurrence of SD in the total sample. In the OAT sample, only higher age remained predictive for the occurrence of SD. A lack of help-seeking behavior was observed in both groups, with only 31% of OAT patients and 35% of PP patients ever having talked about their sexual health with their treating physician.

Conclusion: SD are common among psychiatric patients receiving OAT and general psychiatric patients seeking psychotherapy. Professionals providing mental healthcare to patients must emphasize prevention and routine assessments of sexual functioning needs.

Keywords: erectile dysfunction; general psychiatry; opioid maintenance; opioid use disorder; sexual dysfunction.