Sexual dysfunctions are associated with major depression, chronic inflammation and anticholinergic consumption in the real-world schizophrenia FACE-SZ national cohort

Prog Neuropsychopharmacol Biol Psychiatry. 2019 Aug 30;94:109654. doi: 10.1016/j.pnpbp.2019.109654. Epub 2019 May 21.


Background: Sexual dysfunctions (SD) are frequent in schizophrenia (SZ) and associated with treatment withdrawal, however they remain under-explored and under-treated. To date, most of the studies have focused on SD as antipsychotics' side effects in therapeutic trials.

Aims: The objectives of the present study were to determine the SD prevalence in stabilized SZ outpatients and their clinical, pharmacological and biological correlates.

Method: Two hundred and thirty-seven participants (61.2% men) were consecutively included and received a thorough 2 days- clinical assessment including the self-reported Sexual Functioning Questionnaire (SFQ). SD was defined by a SFQ score ≥ 8.

Results: Two hundred and thirty-seven subjects were recruited in the FACE-SZ cohort, 41% of them reported sexual dysfunctions. In multivariate analyses, SD have been associated with current major depressive disorder (adjusted odd ratio aOR = 2.29[1.08-4.85], p = .03), anticholinergic prescription (aOR = 2.65, p = .02) and chronic low-grade inflammation (aOR = 2.09, p = .03) independently of age, gender, current cannabis use disorder and olanzapine prescription. No antipsychotic has been associated with increased or decreased SD rate.

Conclusions: SD are frequent in SZ subjects. Major depression, anticholinergic prescription and chronic low-grade peripheral inflammation may be the three targets of interest for addressing this specific issue.

Keywords: Antipsychotics; Inflammation; Major depression; Schizophrenia; Sexual dysfunctions.

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects
  • Case-Control Studies
  • Cholinergic Antagonists / adverse effects*
  • Chronic Disease / epidemiology*
  • Comorbidity
  • Depressive Disorder, Major / epidemiology*
  • Female
  • France / epidemiology
  • Humans
  • Inflammation / epidemiology*
  • Male
  • Risk Factors
  • Schizophrenia / epidemiology*
  • Sexual Dysfunctions, Psychological / epidemiology*
  • Young Adult


  • Antipsychotic Agents
  • Cholinergic Antagonists