Substance Use Disorders in Men Presenting to a Psychosexual Clinic

Introduction. Substance use disorders (SUDs) are commonly associated with a variety of psychiatric disorders. Community-based studies have found a significant association between SUDs and sexual dysfunction in men, with a possible causal relation in the case of nicotine. Methods. The case records of 105 men presenting to a clinic for patients with psychosexual disorders were reviewed. Men with and without comorbid SUDs were compared in terms of demographic, clinical, and familial variables. Results. 25 of the 105 men (23.8%) had a lifetime diagnosis of SUD, and 19 (18.1%) had a current SUD. The commonest substances involved were nicotine (n = 21, 20%) and alcohol (n = 9, 9.5%). Men with comorbid SUDs were more likely to report a family history of substance dependence, particularly alcoholism. Single men with SUDs were more likely to have a comorbid mood disorder. Conclusion. SUDs, particularly nicotine and alcohol use disorders, are common comorbidities in patients with psychosexual disorders. Identifying and treating these disorders in this population are important aspects of management. 1. Introduction Substance use disorders (SUDs) are a global health problem which present in a variety of clinical settings. Substance use may complicate an underlying medical or psychiatric disorder and can also lead to medical or psychological morbidity in its own right. High rates of substance use have been reported in patients with psychiatric syndromes such as schizophrenia [1], mood disorders [2, 3], and anxiety disorders [3]. Patients with both conditions, sometimes referred to as “dual-diagnosis” patients, have been found to have more severe symptoms and poorer outcomes [1, 4]. Psychosexual disorders, also termed psychogenic sexual disorders, are dysfunctions of the sexual response cycle that cause impaired sexual performance and distress to affected patients and their partners. These disorders can affect any phase of the sexual response cycle. The commonest sexual disorders seen in male patients are premature ejaculation [5] and erectile dysfunction [6]. Earlier studies have reported significant rates of problematic substance use in men with sexual disorders [7–9], but this association has been less well studied than in patients with other mental disorders, and its causal significance is unclear. A consistent association between erectile dysfunction and tobacco use has been found [7, 9], but the effects of alcohol use on sexual dysfunction are less clear [10]. However, this association has not been systematically examined in the Indian context. In the current