The Accuracy of the Arizona Sexual Experience Scale (ASEX) to identify sexual dysfunction in patients of the schizophrenia spectrum

Background: sexual dysfunction is frequent in patients with schizophrenia, it is reported as one of the most distressing antipsychotic’s adverse effects and it is directly related to treatment compliance. Objective: a) to assess the frequency of sexual dysfunction in a sample of outpatients with schizophrenia and schizoaffective disorder under antipsychotic therapy; b) to investigate the effect of different antipsychotics on sexual function; and c) to evaluate the accuracy of the Arizona Sexual Experience Scale (ASEX) to identify sexual dysfunction. Method: Outpatients with schizophrenia or schizoaffective disorder were asked to fulfill both the ASEX and the Dickson Glazer Scale for the Assessment of Sexual Functioning Inventory (DGSFi) at a single interview. Results: 137 patients were interwied. The sensitivity and specificity of the ASEX in relation to DGSFi were: 80.8%, (95% CI= 70.0%-88.5%) and 88.1% (95% CI= 76.5%-94.7%), and the misclassification rate was 9.5%. The ROC curve comparing the ASEX and the DGSFi scores revealed a value of 0.93 (CI= 0.879-0.970), with the optimum cut-off point of ASEX being 14/15. Sexual dysfunction measured was higher in females (79.2%) than in males (33.3%) (2 = 27.41, d.f.=1, p<0.001). Discussion: Patients under antipsychotic treatment showed a high level of sexual complaints, and the ASEX proved to be an accurate instrument to identify sexual dysfunction in an outpatient sample of patients with schizophrenia spectrum. Females showed a higher frequency of sexual dysfunctions and sexual drive and ability to reach orgasm were the most affected areas. The use of antipsychotics, especially the combinations, was more likely to impair sexual functioning.Contexto: a disfunção sexual é frequente entre pacientes com esquizofrenia, sendo relatada como um dos mais incômodos efeitos adversos dos antipsicóticos e esta diretamente relacionada com adesão ao tratamento. Objetivo: a) avaliar a frequência da disfunção sexual em uma amostra de pacientes do espectro da esquizofrenia em tratamento com antipsicóticos; b) investigar 0 efeito dos diferentes antipsicóticos na função sexual; e c) avaliar a acurácia da Escala de Experiência Sexual do Arizona (AS EX) para identificar disfunção sexual. Método: pacientes ambulatoriais com esquizofrenia ou transtorno esquizoafetivo foram entrevistados através de questionários: ASEX e Escala Dickson-Glazer (DGSFi) para avaliação do funcionamento sexual, em uma única entrevista. Resultados: 137 pacientes foram entrevistados. A sensibilidade e especificidade da ASEX em relação a DGSFi foram: 80.8% ( 95% IC= 70.0%-88.5%) e 88.1 % (95% IC=76.5%-94.7%), e a taxa de classificação incorreta foi 9.5%. A curva ROC comparando a pontuação da ASEX e DGSFi revelou valor de 0.93 (IC=0.879¬0.970) com 0 ponto de corte da ASEX encontrando sendo 14/15. A disfunção sexual foi mais alta entre as mulheres (79.2%) do que nos homens (33.3%) (X2=27.41, gl=1, p