A Descriptive Analysis of Patients Presenting to Psychosexual Clinic at a Tertiary Care Center

By Verma, Rohit; Mina, Shaily et al. | Indian Journal of Psychological Medicine, July-September 2013 | Go to article overview

A Descriptive Analysis of Patients Presenting to Psychosexual Clinic at a Tertiary Care Center


Verma, Rohit, Mina, Shaily, Ul-Hassan, Shiraz, Balhara, Yatan Pal, Indian Journal of Psychological Medicine


Byline: Rohit. Verma, Shaily. Mina, Shiraz. Ul-Hassan, Yatan Pal. Balhara

Background: Psychosexual problems are very common presentation, be it with psychiatric or physical illness but there are very few studies available on psychosexual disorders especially in the Indian context. Indian society is deeply ingrained in customs and several misconceptions, myths, prejudices, and social taboos are attached to sex which makes it further very difficult to tackle. Objectives: The aim of this current study was to descriptively analyze the nature of sexual disorders in a tertiary care center. Materials and Methods: The current retrospective chart review included 698 consecutive subjects seeking treatment for their psychosexual problems at the Sexual Clinic, Department of Psychiatry, Dr. Ram Manohar Hospital, New Delhi (between 2006 and 2010). Results: This study observed erectile dysfunction (ED) (29.5%), Premature ejaculation (PME) (24.6%), Dhat syndrome (DS) (18.1%), and ED with PME (17.5%) as the common sexual dysfunctions leading to treatment seeking. DS was the major complaint among younger and unmarried individuals. We observed more married individuals seeking treatment for sexual disorders. Conclusions: These findings provide important information on a relatively under-researched area.

Introduction

Sexual disorders lay among the most prevalent psychological disorders in general population. [sup][1] Overall, studies conducted worldwide have reported the prevalence of sexual disorders in the range of 10-25% among men and 25-64% among women. [sup][2] Studies regarding prevalence of sexual problems have varied findings. Although few studies reported the most prevalent sexual problem to be premature ejaculation (PME) (30%), [sup][3] other studies report that impotence or inhibited desire to be more common. [sup][4],[5] Studies have suggested a community prevalence rate ranging from of 4-10% for male orgasmic disorder, 4-9% for male erectile disorder, 5-10% for female orgasmic disorder, and 36-38% for PME. [sup][2]

Multiple risk factors alone or in combination are associated with sexual dysfunction such as general health status of the individual, chronic illnesses particularly diabetes mellitus and cardiovascular disease, genitourinary disease, psychiatric/psychological disorders, and drugs (both prescribed and abused) and socio-demographic conditions. [sup][6] Among the psychiatric population, sexual dysfunction is attributed to disorder-related factors as well as a side effect due to medications. While being medically managed, sexual problems have been reported in about 30-60% of patients with schizophrenia, up to 78% of patients with depression, and up to 80% in patients suffering from anxiety disorders. [sup][7]

Partly as a consequence of the influence of cultural factors in their development, prevalence rates vary in different communities and due to the very nature of problems and psychological consequences, it is at times difficult to assess the exact prevalence of the sexual dysfunction. It is even more difficult in developing countries like India. In India, the pathway to care is hindered as large number of patients suffering from psychosexual problems tends to visit "quacks" and "sex clinics" rather than to the hospital setting. The problems are intensified by ill-advice from co-workers, friends, elders, and popular cheap literature on sex which heightens the fears, guilt, shame, and anxiety over the problem. Individuals then finally may turn up to hospitals for treatment seeking.

As literature lacks large-scale epidemiologic data on sexual disorders, smaller studies should be integrated to obtain population estimates regarding the prevalence of sexual disorders. We aimed to add to the existing data, the prevalence of sexual problems in patients coming to sexual clinic in a tertiary care center.

Materials and Methods

This study included 698 subjects seeking treatment for their psychosexual problems at the Sexual Clinic, Department of Psychiatry, Dr. …

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