Broaching sexual health topics during a doctor-patient encounter in ambulatory psychiatric care

Abstract

Introduction: Difficulties in sexual functioning are a frequent problem for psychiatric patients. Both the psychopathology of some psychiatric diseases as well as the side effects of medication used in psychiatry may adversely affect the patient’s sexual functioning. The aim of this study was to investigate to what extent psychiatrists raise sexual matters with patients during their encounters in psychiatric ambulatory care and what the patients’ expectations in this area are.

Material and methods: 615 psychiatric outpatients responded to the anonymous questionnaire regarding their attitudes towards their psychiatrists, their evaluation of the doctors’ ability to tactfully address sexual matters during the encounter and their expectations from such an interaction. The study was conducted in 10 out of 30 randomly chosen public mental health clinics in north-eastern Poland.

Results: In general, patients expressed a positive attitude towards their therapists. Over half of the study group revealed that the psychiatrist did not discuss with them their sexual health concerns. A quarter of the patients surveyed would have liked to talk about their sex life during their encounter with the psychiatrist whereas a quarter were not certain if they wanted to address the subject. The patient’s readiness to discuss sexual health issues was significantly correlated with the initiation of this topic by the doctor.

Conclusions: The psychiatrist as the dominant person in the doctor–patient dyad has a considerable influence on the shape of the patient’s relationship with the therapist and the initiation of sexual health topics during the doctor-patient encounter. The tactful introduction of the topic of the patient’s sexual functioning by the psychiatrist increases the patient’s willingness to discuss their sexual health concerns.