Syed Ahmer, Faheem Khan, Mukesh Bhimani.
Psychiatric presentations of sexual dysfunction in Pakistan.
J Pak Psych Soc Jan ;7(1):18-22.

Objective: To study the clinical and sociodemographic characteristics of people presenting with sexual difficulties to a psychiatric outpatient clinic. Design: Case-notes review Place & duration of study: Psychiatry outpatient clinic, Aga Khan University Hospital (AKUH), Karachi, from January 2008 to May 2009. Subjects & method: Case notes of all patients presenting to the psychiatry outpatient clinic of the AKUH for a sexual problem during the study period were reviewed. The details of socio-demographic data, presenting problems, past history, sexual history, investigations and treatment were extracted from the case notes. Results: A total of 48 patients (47 males and one female) presented to the clinic with a sexual problem during the study period. The most frequent presenting problems were erectile problems (34 %), premature ejaculation (24 %) and non-consummation of marriage (18 %). After assessment the most frequent diagnoses were erectile dysfunction (29 %), premature ejaculation (27 %) and depression (23 %). Most of the patients (64%) were prescribed SSRIs, while sex therapy was recommended in about 30 % of cases. Conclusion: The patterns of sexual dysfunction in clinical samples in Pakistan are very similar to patterns found elsewhere. However, considering the large proportions reported in surveys only a few of these people see a psychiatrist to seek appropriate help. We need to break down barriers that inhibit a patient to approaching appropriate health professionals for seeking help, and inhibit doctors in exploring these phenomena in appropriate depth.

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