J Korean Neuropsychiatr Assoc.  2012 Sep;51(5):263-270.

Marital and Sexual Satisfaction among Patients with Schizophrenia

• Kang T
• Kang G
• Han HR
• Roh S

Abstract

OBJECTIVES
The objectives of this study are to assess marital and sexual satisfaction among patients with schizophrenia compared to the general population and to evaluate the factors that may affect these levels.
METHODS
Marital and sexual satisfaction of 66 married schizophrenic patients and 162 married normal controls were assessed with Enriching and Nurturing Relationship Issues, Communication and Happiness and Derogatis Sexual Function Inventory. We compared the differences in marital and sexual satisfaction and influential variables between these two groups through analysis of covariance with adjustment for age and the duration of marriage. Factors associated with marital and sexual satisfaction were identified with multiple regression analysis.
RESULTS
Patients with schizophrenia showed lower satisfaction with their marriage (p=0.018) and sexual lives (p<0.001) compared to the controls. Marital satisfaction of schizophrenics was influenced by violence from spouse, whereas their sexual satisfaction was affected by age, violence from spouse, conversation frequency after sexual relations, and revealing psychiatric history to spouse before marriage. There was a significant relationship between marital and sexual satisfaction in both groups.
CONCLUSION
Patients with schizophrenia may have marital and sexual problems which can be caused directly or indirectly by symptoms and course of the disease. These results suggest that evaluation and appropriate intervention in the marriage and sexual lives of schizophrenics is necessary and important.

Keyword

Schizophrenia; Marriage; Marital satisfaction; Sex

MeSH Terms

Happiness
Humans
Marriage
Schizophrenia
Spouses
Violence

Reference

1. Statistics Korea. 2010 Annual report on the marriage and divorces statistics (based on vital registration). 2011. Daejeon: Statistics Korea.

2. Birtchnell J, Kennard J. Marriage and mental illness. Br J Psychiatry. 1983. 142:193–198.

3. Kessler RC, Walters EE, Forthofer MS. The social consequences of psychiatric disorders, III: probability of marital stability. Am J Psychiatry. 1998. 155:1092–1096.

4. Gureje O, Bamidele R. Thirteen-year social outcome among Nigerian outpatients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 1999. 34:147–151.

5. Min SK. Modern Psychiatry. 2006. 5th ed. Seoul: Ilchokak;243–273.

6. Sadock BJ, Sadock VA. Kaplan and Sadock's Synopsis of psychiatry. 2007. 10th ed. Philadelphia: Lippincott Williams & Wilkins.

7. Kim CK, Kim JW, Seo JM, Lee GZ, Kim GJ, Byun WT. Family burden of schizophrenics in the primary caregivers and siblings. J Korean Neuropsychiatr Assoc. 2000. 39:113–127.

8. Awad AG, Voruganti LN. The burden of schizophrenia on caregivers: a review. Pharmacoeconomics. 2008. 26:149–162.

9. Revenson TA, Majerovitz SD. The effects of chronic illness on the spouse. Social resources as stress buffers. Arthritis Care Res. 1991. 4:63–72.

10. Bradbury TN, Fincham FD, Beach SRH. Research on the nature and determinants of marital satisfaction: a decade in review. J Marriage Fam. 2000. 62:964–980.

11. Guo B, Huang J. Marital and sexual satisfaction in Chinese families: exploring the moderating effects. J Sex Marital Ther. 2005. 31:21–29.

12. Litzinger S, Gordon KC. Exploring relationships among communication, sexual satisfaction, and marital satisfaction. J Sex Marital Ther. 2005. 31:409–424.

13. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Text Revision. Washington, DC: American Psychiatry Association.

14. Woods SW. Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry. 2003. 64:663–667.

15. Fournier D, Olson DH, Druckman JM. Assessing marital and premarital relationships: the PREPARE-ENRICH inventories. Marriage family assessment. 1983. 229–250.

16. Olson DH. PREPARE/ENRICH counselors Manual: Version 2000. 1996. Minneapolis, MN: Life Innovation.

17. Fowers BJ, Olson DH. Enrich marital inventory: a discriminant validity and cross-validation assessment. J Marital Fam Ther. 1989. 15:65–79.

18. Derogatis LR, Melisaratos N. The DSFI: a multidimensional measure of sexual functioning. J Sex Marital Ther. 1979. 5:244–281.

19. Chang SB. [Factors influencing sexual satisfaction in women who have had a hysterectomy: a comparative group study]. J Nurs Acad Soc. 1990. 20:357–367.

20. Jarbin H, Ott Y, Von Knorring AL. Adult outcome of social function in adolescent-onset schizophrenia and affective psychosis. J Am Acad Child Adolesc Psychiatry. 2003. 42:176–183.

21. Andreasen NC. Negative symptoms in schizophrenia. Definition and reliability. Arch Gen Psychiatry. 1982. 39:784–788.

22. Saugstad LF. Social class, marriage, and fertility in schizophrenia. Schizophr Bull. 1989. 15:9–43.

23. Thara R, Srinivasan TN. Outcome of marriage in schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 1997. 32:416–420.

24. Lyketsos GC, Sakka P, Maïlis A. The sexual adjustment of chronic schizophrenics: a preliminary study. Br J Psychiatry. 1983. 143:376–382.

25. Cutler AJ. Sexual dysfunction and antipsychotic treatment. Psychoneuroendocrinology. 2003. 28:Suppl 1. 69–82.

26. Malik P. Sexual dysfunction in schizophrenia. Curr Opin Psychiatry. 2007. 20:138–142.

27. Sadow D, Corman A. Teaching a human sexuality course to psychiatric patients: the process, pitfalls, and rewards. Sex Disabil. 1983. 6:47–53.

28. Perkins DO. Predictors of noncompliance in patients with schizophrenia. J Clin Psychiatry. 2002. 63:1121–1128.

29. Baucom DH, Shoham V, Mueser KT, Daiuto AD, Stickle TR. Empirically supported couple and family interventions for marital distress and adult mental health problems. J Consult Clin Psychol. 1998. 66:53–88.

30. Nyer M, Kasckow J, Fellows I, Lawrence EC, Golshan S, Solorzano E, et al. The relationship of marital status and clinical characteristics in middle-aged and older patients with schizophrenia and depressive symptoms. Ann Clin Psychiatry. 2010. 22:172–179.

31. Bora E, Gökçen S, Veznedaroglu B. Empathic abilities in people with schizophrenia. Psychiatry Res. 2008. 160:23–29.

32. Testa M, Leonard KE. The impact of marital aggression on women's psychological and marital functioning in a newlywed sample. J Fam Violence. 2001. 16:115–130.

33. Markman HJ, Renick MJ, Floyd FJ, Stanley SM, Clements M. Preventing marital distress through communication and conflict management training: a 4- and 5-year follow-up. J Consult Clin Psychol. 1993. 61:70–77.

34. Cupach WR, Comstock J. Satisfaction with sexual communication in marriage: links to sexual satisfaction and dyadic adjustment. J Soc Pers Relat. 1990. 7:179–186.

35. Montesi JL, Fauber RL, Gordon EA, Heimberg RG. The specific importance of communicating about sex to couples' sexual and overall relationship satisfaction. J Soc Pers Relat. 2010. 28:591–609.

36. Bell CE, Wringer PH, Davidhizar R, Samuels ML. Self-reported sexual behaviors of schizophrenic clients and noninstitutionalized adults. Perspect Psychiatr Care. 1993. 29:30–36.

37. Peuskens J, Sienaert P, De Hert M. Sexual dysfunction: the unspoken side effect of antipsychotics. Eur Psychiatry. 1998. 13:1 Suppl 1. 23s–30s.

38. Verhulst J, Schneidman B. Schizophrenia and sexual functioning. Hosp Community Psychiatry. 1981. 32:259–262.

39. Lukoff D, Gioia-Hasick D, Sullivan G, Golden JS, Nuechterlein KH. Sex education and rehabilitation with schizophrenic male outpatients. Schizophr Bull. 1986. 12:669–677.