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Review of Sexual Dysfunction in Male Schizophrenics (남자 정신분열병 환자에서 성기능장애에 대한 검토)

  • Choi, Yeong Tae;Cheon, Jin Sook;Oh, Byoung Hoon
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.85-98
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    • 2000
  • Objective : There are four possible explanations for the sexual dysfunction of schizophrenics. The first is the possibility of a real structural aspect. The second possibility is that sexual function changes secondary to the illness. The third possibility is that there are medical and sociocultural barriers to sexual expression for chronic schizophrenics. The fourth possibility is that sexual dysfunction due to antipsychotic medication. However, we didn't know the precise cause of sexual dysfunction in schizophrenics. Therefore, the purpose of this study was to explore the mechanism of illness itself and antipsychotics on sexual dysfunction in male schizophrenics. Methods : The serum prolactin(PRL), testosterone(TST), and the plasma serotonin(5-HT) concentrations were measured by radioimmunoassay and high performance liquid chromatography method for 100 healthy male schizophrenics according to the DSM-IV. Concomitantly, the severity of psychotic symptoms using Clinical Global Impression(CGI), Brief Psychiatric Rating Scale(BPRS), Positive and Negative Syndrome Scale(PANSS), and the severity of side effects for antipsychotics using Extrapyramidal Side Effects Scale(EPSE), Anticholinergic Side Effects Scale(ACSE), the cognitive function using PANSS-Cognitive Function(PANSS-CF), Mini Mental State Exam-Korean(MMSE-K), and the sexual dysfunction using Sexual Functioning Questionnaire(SFQ), Questionnaire for Sexual Dysfunction in Men were assessed. The PRL, TST, and 5-HT levels of 50 healthy male controls who had no medical, neurological, and psychiatric illnesses were evaluated. The sexual function using SFQ(items FGa, FNa) were also assessed. Furthermore, the correlation with age, education, religion, economic status, age at onset, duration of illnesses, duration of admission, levels of PRL, TST, 5-HT, antipsychotic dosages, potency, benztropine, total duration of medication, EPSE, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K and sexual dysfunctions were identified in male schizophrenics. Results : 1) The frequencies of sexual dysfunctions for schizophrenics(80%) were significantly(p<0.001) higher than those for controls(42%). The sexual dysfunctions according to sexual response cycle were 'low sexual desire' 76%, 'impairment of achieving erection' 75%, 'impairment of maintaining erection' 75%, 'impairment of obtaining orgasm' 32%, 'impairment in the quality of orgasm' 61%, 'impairment in quantity of ejaculate' 44%, 'premature ejaculation' 15%, and 'delayed ejaculation' 50%. 2) The PRL, 5-HT levels of schizophrenics($28.5{\pm}20.6ng/ml$, $298.5{\pm}89.1ng/ml$) were significantly(p<0.001) higher than those of controls($10{\pm}5.6ng/ml$, $169.2{\pm}37.8ng/ml$), while the TST levels of schizophrenics($4.3{\pm}1.5ng/ml$) and controls($4.5{\pm}1.2ng/ml$) were not significantly different. The sexual dysfunctions of schizophrenics who had abnormal 5-HT levels($4.7{\pm}1.3$ scores) were significantly(p<0.05) higher than those of who had normal 5-HT levels($3.8{\pm}1.6$ scores) on item D7. 3) The sexual dysfunctions of unmarried schizophrenics were significantly(p<0.01 : p<0.05) higher than those of married schizophrenics($6.1{\pm}2.8$ scores, $4.7{\pm}1.3$ scores on item FGa : ${\beta}$=-0.211 on item FNa). The sexual dysfunctions were positively correlated with the rise of 5-HT levels(r=0.209, p<0.05 on item D4 and r=0.241, p<0.05 on item D7), the higher age at onset(r=0.275, p<0.01 on item FNa : r=-0.202, p<0.05 on item FDa), the longer duration of illnesses(r=0.237, p<0.05 on item D6), the longer duration of admission(r=0.234, p<0.05 on item D4 : r=0.328, p<0.05 on item D6), the longer total duration of medication(r=0.237, p<0.05 on item D6). However, age, education, religion, economic status, PRL, TST levels, antipsychotics dosage, potency, benztropine, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K scores were not correlated with increased sexual dysfunctions. Conclusions : Male schizophrenics have significantly more sexual dysfunction to compare with controls. The higher frequencies of sexual dysfunctions were low sexual desire and erectile disorder. The unmarried, higher age at onset, and longer duration of diseases were positively correlated with increased sexual dysfunctions. Also high 5-HT levels were positively correlated with increased sexual dysfunctions. This means that studies of plasma 5-HT levels, albeit questionable indicators of central 5-HT function, offer some additional support for the association of sexual dysfunction with excess 5-HT activity as primary pathology of schizophrenia. Our findings suggest that excess 5-HT activity seems to affect the patient's sexual function.

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The Determinants of Health Promoting Behavior in Students on Dept of Dental Hygiene (치위생과 학생의 건강증진행위 결정요인에 관한 연구)

  • Kim, Eun-Mi;Lee, Hyang-Nim
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.141-148
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    • 2004
  • This study was examed in order to determine influential factors of health promoting behavior on Dental Hygiene students the health promoting behavior. So examed students' health promoting behavior, self-efficacy, perceived benefit, perceived barrier, a health locus of control, self-esteem. A the result of this study were as follows: (1) Performance mean score in health promoting behavior was 2.60, self achievement score was 2.89, health responsibility score was 2.12, exercise score was 1.89, nutrition score was 2.45, interpersonal support score was 2.97, stress management score was 2.63. Performance mean score in self-efficacy was 2.56, perceived benefit was 3.45, perceived barrier was 2.32, a health locus of control score was 3.04, self-esteem score was 2.81. (2) Performance in health promoting behavior was significant differences in year, religion, economical level, experience of disease on family, perceived health status(p<0.05), perceived oral health status(p<0.001). Performance in self achievement was significant differences in year, economical level, perceived health status(p<0.05), religion, perceived oral health status(p<0.01). Performance in health responsibility was significant differences in year, religion, economical level, BMI(p<0.05) and experience of disease on myself, perceived oral health status(p<0.001). Performance in excercise was significant differences in mother's educational level, experience of disease on family, perceived oral health status(p<0.05) and nutrient was economical level, perceived oral health status(p<0.01), perceived health status(p<0.05). Performance in interpersonal relations was only significant differences perceived oral health status(p<0.05) and in stress management was year, perceived oral health status(p<0.05). (3) Performance in self-efficacy was significant differences in economical level, health status(P<0.05) and perceived health status, perceived oral health status(p<0.01). Performance in perceived benefit was significant differences in religion(p<0.05). Performance in perceived barrier was significant differences economical level, perceived oral health status(p<0.05), experience of disease on myself(p<0.01). Performance in a health locus of control was significant differences year(p<0.05), performance in a perceived oral health status(p<0.01). (4) Performance in health promoting behavior was significantly correlated with self-efficacy(r=0.376), perceived benefit(r=0.188), perceived barrier(r=-0.155), a health locus of control (r=0.064), self-esteem(r=0.318). (5) Self-efficacy was the highest factor predicting health promoting behavior.

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Literature Analysis of Radiotherapy in Uterine Cervix Cancer for the Processing of the Patterns of Care Study in Korea (한국에서 자궁경부알 방사선치료의 Patterns of Care Study 진행을 위한 문헌 비교 연구)

  • Choi Doo Ho;Kim Eun Seog;Kim Yong Ho;Kim Jin Hee;Yang Dae Sik;Kang Seung Hee;Wu Hong Gyun;Kim Il Han
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.61-70
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    • 2005
  • Purpose: Uterine cervix cancer is one of the most prevalent women cancer in Korea. We analysed published papers in Korea with comparing Patterns of Care Study (PCS) articles of United States and Japan for the purpose of developing and processing Korean PCS. Materials and Methods: We searched PCS related foreign-produced papers in the PCS homepage (212 articles and abstracts) and from the Pub Med to find Structure and Process of the PCS. To compare their study with Korean papers, we used the internet site 'Korean Pub Med' to search 99 articles regarding uterine cervix cancer and radiation therapy. We analysed Korean paper by comparing them with selected PCS papers regarding Structure, Process and Outcome and compared their items between the period of before 1980's and 1990's. Results: Evaluable papers were 28 from United States, 10 from the Japan and 73 from the Korea which treated cervix PCS items. PCS papers for United States and Japan commonly stratified into $3\~4$ categories on the bases of the scales characteristics of the facilities, numbers of the patients, doctors, Researchers restricted eligible patients strictly. For the process of the study, they analysed factors regarding pretreatment staging in chronological order, treatment related factors, factors in addition to FIGO staging and treatment machine. Papers in United States dealt with racial characteristics, socioeconomic characteristics of the patients, tumor size (6), and bilaterality of parametrial or pelvic side wail invasion (5), whereas papers from Japan treated of the tumor markers. The common trend in the process of staging work-up was decreased use of lymphangiogram, barium enema and increased use of CT and MRI over the times. The recent subject from the Korean papers dealt with concurrent chemoradiotherapy (9 papers), treatment duration (4), tumor markers (B) and unconventional fractionation. Conclusion: By comparing papers among 3 nations, we collected items for Korean uterine cervix cancer PCS. By consensus meeting and close communication, survey items for cervix cancer PCS were developed to measure structure, process and outcome of the radiation treatment of the cervix cancer. Subsequent future research will focus on the use of brachytherapy and its impact on outcome including complications. These finding and future PCS studies will direct the development of educational programs aimed at correcting identified deficits in care.