A Systematic Review of Instruments to Measure Sexual Functioning in Patients Using Antipsychotics

Abstract

Sexual dysfunction is a frequent side effect of antipsychotics, but information is scant regarding the psychometric properties and clinical usefulness of currently existing questionnaires. This systematic review compares the psychometric properties and content of questionnaires for assessment of sexual functioning in patients using antipsychotics. A systematic literature search was performed using three electronic databases (PubMed, Embase, and PsycINFO) with predefined search terms. We identified six validated instruments for assessment of sexual functioning in patients using antipsychotics: the Antipsychotic Non-Neurological Side Effects Rating Scale (ANNSERS), the Arizona Sexual Experience Scale (ASEX), the Antipsychotics and Sexual Functioning Questionnaire (ASFQ), the Changes in Sexual Function Questionnaire-14 (CSFQ-14), the Nagoya Sexual Function Questionnaire (NSFQ), and the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ). The ASFQ, CSFQ-14, and PRSexDQ cover all stages of sexual functioning, which makes these questionnaires preferable to the other three questionnaires described. The ASFQ and PRSexDQ are clinician-administered and ask for a change in sexual functioning related to medication. The ASFQ assesses improvement as well as deterioration of sexual functioning, and includes items about hyperprolactinemia. The CSFQ-14 is useful when self-report is desired but contains more items.

Notes

ANNSERS = Antipsychotic Non-Neurological Side Effects Rating Scale; ASEX = Arizona Sexual Experience Scale; ASFQ = Antipsychotics and Sexual Functioning Questionnaire; CSFQ-14 = Changes in Sexual Function Questionnaire-14; NSFQ = Nagoya Sexual Function Questionnaire; PRSexDQ = Psychotropic-Related Sexual Dysfunction Questionnaire.

ANNSERS = Antipsychotic Non-Neurological Side Effects Rating Scale; ASEX = Arizona Sexual Experience Scale; ASFQ = Antipsy-chotics and Sexual Functioning Questionnaire; CSFQ-14 = Changes in Sexual Function Questionnaire-14; NSFQ = Nagoya Sexual Function Questionnaire; PRSexDQ = Psychotropic-Related Sexual Dysfunction Questionnaire; *Cronbach's alpha for the questionnaire as a whole.

ASFQ = Antipsychotics and Sexual Functioning Questionnaire; CSFQ-14 = Changes in Sexual Function Questionnaire-14; PRSexDQ = Psychotropic-Related Sexual Dysfunction Questionnaire.

Note. ANNSERS = Antipsychotic Non-Neurological Side Effects Rating Scale; ASEX = Arizona Sexual Experience Scale; ASFQ = Antipsychotics and Sexual Functioning Questionnaire; CGI = Clinical Global Impression of sexual functioning; CSFQ-14 = Changes in Sexual Function Questionnaire-14; DISF-SR = Derogatis Interview for Sexual Functioning, self-report version; JESS = Japanese version of the Epworth Sleepiness Scale; NSFQ = Nagoya Sexual Function Questionnaire; PRSexDQ = Psychotropic-Related Sexual Dysfunction Questionnaire; SRA = Subjects’ Response to Antipsychotics; VAS-SFA = Visual Analogue Scale for Sexual Functioning Satisfaction; UKU = Udvalg for Kliniske Undersøgelser Side Effect Rating Scale; * = correlation of total scores; ** = based on mean of correlations of items.