Clinical features and dynamics of sexual functioning in patients with opioid dependence in periods of narcotization, post-withdrawal state and remission

Objective: to study prevalence and structure of sexual disorders in patients with opioid addiction seeking for inpatient addiction treatment as well as to characterize sexual dysfunctions at different stages of the disease - in the periods of narcotization, postwithdrawal state and remission. Material: 120 inpatients with opioid addiction (F11.21) under therapy at Addictive States Department of Mental Health Research Institute and Tomsk Regional Narcological Dispensary between 2012 and 2016 were examined. The main group included 80 persons with opioid addiction and sexual disorders. Comparative group included 40 males with the same nosology without sexual dysfunctions. Methods: clinical-psychopathological, clinical-dynamic, clinical-sexological, statistical (the Mann-Whitney U test; correlation-regression analysis using the Pearson coefficient). Results: clinical-psychopathological and clinical-sexological methods were used for examination of 120 male patients with opioid addiction. With use of international diagnostic standards of sexual disadaptation, prevalence and structure of sexual disorders were investigated in the studied group. Sexual dysfunctions were revealed 67.6% of cases. Mean age of formation of sexual disorder was 23.8±2.4 years. Obtained low indices according to ’’International Index of Erectile Function” (IIEF-15) technique quantitatively confirmed presence of disorder of erectile function, sexual desire, ejaculatory disturbances and as a consequence total non-satisfaction with sexual life. Structure of sexual disadaptation in the examined patients with opioid addiction according to IIEF-15 in the period of post-withdrawal manifestations and formation of remission was represented as follows: disorder of libido - 60%; combination of disorder of libido and erectile dysfunction - 26%; orgasmic dysfunction (delayed ejaculation and anejaculatory syndrome) - 14% of cases. Conclusion: Analysis of dynamics of sexual functioning of patients reliably demonstrated manifestations of sexual disorders during narcotization (21.5±0.45 points according to International Index of Erectile Function), in the period of post-withdrawal syndrome (33.6±0.48 points) and remission (37.1±0.62 points) - norm is 65-75 points. Statistically reliable differences between groups (p