A Comparative Study of the Sexual Function of Institutionalized Patients with Schizophrenia María José Acuña, MD,* Joaquín Carlos Martín, MD, PhD,* Miguel Graciani, MD, † Agustina Cruces, MD, PhD, ‡ and Francisco Gotor, MD* *Department of Psychiatry, Hospital Universitario de Valme, Seville, Spain; † Department of Psychiatry, Hospital Universitario Virgen del Rocío, Seville, Spain; ‡ Department of Psychiatry, Hospital de Cáceres, Cáceres, Spain DOI: 10.1111/j.1743-6109.2010.01832.x ABSTRACT Introduction. Sexual dysfunction occurs frequently in patients with schizophrenia. Aim. To assess the sexual function of institutionalized patients with schizophrenia and compare it to both that of noninstitutionalized schizophrenic patients as well as patients without any mental illness. Methods. A cross-sectional comparative analysis between three groups: Group A: 75 patients with schizophrenia and/or schizoaffective disorder according to the International Classification of Diseases, 10th Edition (ICD-10) criteria, admitted into public psychiatric residential facilities; Group B: 41 patients with the same diagnosis who live in the community; Group C: 152 patients with no mental illness attended to by a Primary Care Medical Center. Main Outcome Measures. The Mini-International Neuropsychiatric Interview, Positive and Negative Syndrome Scale for Schizophrenia and Changes in Sexual Function Questionnaire were used to complete the study. Results. When institutionalized patients were compared to the control group, the impairment of sexual function was identified in all areas except Arousal in women and the percentage of dysfunction in Desire-Interest for both sexes. The results for noninstitutionalized schizophrenic males indicated a deficit in Pleasure and Orgasm and in Pleasure and Desire-Frequency for females, when compared with the control group. The overall subscale indicated that 71.2% of males and 57.1% of females in the institutionalized group experienced sexual dysfunction compared with 10% of males and 50% of females in the noninstitutionalized group, and only 12.7% of women in the control group. Conclusions. Most areas of sexual function are impaired among patients with schizophrenia, especially among institutionalized patients. However, their percentage of sexual dysfunction associated with sexual thoughts or fantasies was similar to that of patients without mental illness. Acuña MJ, Martín JC, Graciani M, Cruces A, and Gotor F. A comparative study of the sexual function of institutionalized patients with schizophrenia. J Sex Med 2010;7:3414–3423. Key Words. Schizophrenia; Sexual Dysfunction; Sexuality; Group Home; Therapeutic Communities Introduction S chizophrenia is a chronic disorder often asso- ciated with sexual dysfunction. In a recent review of the subject, it was estimated that between 30% and 80% of these patients experienced sexual dysfunction [1], a figure that is considerably higher than the percentage of the overall population affected by sexual dysfunction, which is estimated between 10% and 15% [2]. Given that in the 1970s some psychiatrists believed that sexual activity could contribute to the development of the disease [3], there has been a lack of studies assessing the sexual function of patients with schizophrenia, and is therefore the reason behind such a large esti- mated range in sexual dysfunction found in the literature. Even today, the prevalence of sexual dysfunction is underestimated by psychiatrists compared with estimates put forward by the patients themselves [4]. In this way, one study con- cluded that only a quarter of patients with schizo- phrenia were asked about sexual dysfunction by 3414 J Sex Med 2010;7:3414–3423 © 2010 International Society for Sexual Medicine