A Comparative Study on the Sexual Functioning among Men with and without Severe Mental Illness

Objective: The aim of the study is to compare the sexual functioning among men with and without severe mental illness. Materials and Methods: The study was conducted in Psychiatry Department, Sree Balaji Medical College and hospital, Chromepet, Chennai Tamilnadu, India from the period of August 2016 to February 2018 (18 months). Cross sectional analytical study: 1. Semi structured questionnaire to capture demographic variables, illness variable, type of sexual practice and their expectations from MHPs. 2. General health questionnaire (12) tamil and English, 3. CAGE screening tool for alcohol. 4. The Brief Male Sexual Function Inventory (BMSF) for males (70). Results: The study population covered 50% of men with severe mental illness and 50% of men without severe mental illness. Among the study population regarding the educational status it was inferred that 70% were literate and only 30% were illiterate. An attempt to identify the mental illness of the study population was made and it was found that among the total cases, the prevailing mental illness was Schizophrenia (27%). Bipolar affective disorder (17%) was ranked as second highest. Delusional disorder, major depressive disorder covered up to 4% and 1% respectively. The comparisons of quantitative variable between the groups were given in Table 7. The median (range) of the age in case was 40 (29, 58) and in controls was 39 (25, 55), which shows that the median value of age between the groups was not found to be statistically significant (P>0.05). The median value of general health questionnaire among the patients with severe mental illness was 26 (18, 34) and in controls it was 1 (0, 4) which shows that this median difference was highly significant (P<0.0001). The median value of CAGE among the cases was 1 (0, 4) and in normal males was 19 (15, 29) which shows that the median difference between the groups were found to be highly significant (P<0.0001). Similarly, the median difference of variables such as BSFI sexual drive, ejection score, ejaculation score, overall satisfaction score, problem assessment score and total score was found to highly significant (P<0.0001). This implies that the sexual function of men with severe mental illness differs significantly from the normal males. Conclusion: Sexual dysfunction is common among men with severe mental illness than persons without severe mental illness. The male patients with severe mental illness such as Schizophrenia, delusional disorders, BPAD, major depressive disorder have impaired sexual function  compared with the  persons without severe mental illness study group which is evident from the BFSI score (17 in persons with severe mental illness vs 34 in persons without severe mental illness) which is clinically significant. In our study, sexual dysfunction among the men with severe mental illness is not proportional to the duration of the illness & the age of the patients. Recommendations based on gender identity development, attachment, non-sexual and sexual abuse, puberty/adolescence.