Sexual dysfunction and treatment compliance among patients taking antipsychotic medications at psychiatry unit in Muhimbili National Hospital, Dar es salaam, Tanzania

Abstract

Background: Sexual side-effects of antipsychotic medications may be an important cause of non- compliance to medications. Therefore understanding the prevalence of sexual dysfunction and effect on compliance to antipsychotics treatment is important because knowing the magnitude of the antipsychotics induced sexual dysfunction and its effects may contribute to the planning for improving proper management of SD in patients. Objective: To determine prevalence of Sexual Dysfunction and its effect on treatment compliance among patients taking antipsychotic medications at Psychiatric Out-patient clinic in Muhimbili National Hospital. Methods: This was a cross sectional study that took a snapshot of situation during a period of data collection. A total of 426 participants taking antipsychotic medications attending the psychiatric clinic were recruited. Standard structured questionnaire was used for interview where by the psychotropic related sexual dysfunction Questionnaire (PRSexDQ) was used - after being translated into Kiswahili language. Data were collected by the researcher and two research assistants and analyzed using computer software with SPSS version 20. For continuous variables (e.g. age) the mean, range, and standard deviation was used; categorical variables (e.g., gender) was described by absolute and relative frequencies. Sexual dysfuncton was defined as having a score equal to or greater than 1 in any of the four items of the PRSexDQ that evaluated the various dimensions of the sexual function. The potential relationship between some demographic and clinical variables (i.e., age, sex, medications and treatment duration) and the presence of sexual dysfunction was investigated using a logistic regression analysis and all comparisons were considered significant if P < 0.05. Results: Overall (63.8%) of the participants exhibited sexual dysfunction according to the assessment with PRSexDQ. Sexual dysfunction was common in both sexes with females exhibiting high prevalence of SD, 78.3% than males 57.6% (X2=16.92, P<0.001). Sexual dysfunction seems to increase as duration of treatment gets longer. Males participants found with higher rates of poor tolerance to the antipsychotic medications 69.7% compared to females 30.3%. Also 72.3% and 27.7% of males and females respectively stopped taking antipsychotic medications for sometimes due to fear of the side effects of medications on sexual dysfunction. Conclusion and Recommendations: This study showed that the prevalence of Sexual dysfunction was high in participants taking antipsychotics especially in long term treatment. All types of antipsychotics are associated with development of SD. The findings of this study may expand previous data especially on the prevalence and impact on compliance to antipsychotic medication in Tanzania. Therefore, there is a need to consider sexual dysfunction during management of patients taking antipsychotic medication with higher rates of poor tolerance to the antipsychotic medications 69.7% compared to females 30.3%. Also 72.3% and 27.7% of males and females respectively stopped taking antipsychotic medications for sometimes due to fear of the side effects of medications on sexual dysfunction. Conclusion and Recommendations: This study showed that the prevalence of Sexual dysfunction was high in participants taking antipsychotics especially in long term treatment. All types of antipsychotics are associated with development of SD. The findings of this study may expand previous data especially on the prevalence and impact on compliance to antipsychotic medication in Tanzania. Therefore, there is a need to consider sexual dysfunction during management of patients taking antipsychotic medication with higher rates of poor tolerance to the antipsychotic medications 69.7% compared to females 30.3%. Also 72.3% and 27.7% of males and females respectively stopped taking antipsychotic medications for sometimes due to fear of the side effects of medications on sexual dysfunction. Conclusion and Recommendations: This study showed that the prevalence of Sexual dysfunction was high in participants taking antipsychotics especially in long term treatment. All types of antipsychotics are associated with development of SD. The findings of this study may expand previous data especially on the prevalence and impact on compliance to antipsychotic medication in Tanzania. Therefore, there is a need to consider sexual dysfunction during management of patients taking antipsychotic medication