Abstract Introduction Sexuality is a key indicator of overall and mental health; impairments in sexual functioning or behavior increase the risk of developing mental disorders. In this regard, evidence suggests that individuals at risk for psychosis already show sexual impairments, particularly those who later develop psychosis, and that the severity of these dysfunctions correlates with the intensity of psychopathological symptoms. Moreover, some findings indicate a positive association between attenuated psychotic symptoms and hypersexual behavior. Objective This cross-sectional study aims to analyze the relation between sexual functioning and problematic sexual behavior with attenuated psychotic symptoms, as assessed by the Prodromal Questionnaire–16 item version (PQ-16). Methods We collected a convenience sample of 462 subjects (313 female, 149 males), 153 (113 females and 40 males) of whom were identified as experiencing more psychotic-like experiences (PLEs) using a cut-off of 6 in the PQ-16 Absence/Presence subscale. In addition, we asked them to complete a self-report psychometric protocol assessing sexual function, hypersexual behavior, problematic pornography use and psychotic prodromes. Results The presence of attenuated psychotic symptoms correlated significantly with hypersexuality (ρs = 0.276; p .001), problematic pornography use (ρs = 0.186; p .001), and difficulties in reaching orgasm (ρs = 0.105; p = .024). Distress associated with attenuated psychotic symptoms correlated significantly with hypersexuality (ρs = 0.313; p .001), problematic pornography use (ρs = 0.167; p .001), difficulties in reaching orgasm (ρs = 0.144; p = .002), and achieving and/or maintaining an erection or lubrication (ρs = 0.111; p = .017). When comparing subjects experiencing more psychotic-like experiences with control subjects, the former were found to exhibit more hypersexuality (rrb = 0.381; p .001) and problematic pornography use (rrb = 0.295; p .001) and poorer sexual function related to difficulties in orgasm attainment (rrb = 0.187; p .001). The difference in problematic pornography use was maintained even when the analysis was limited to the female group (rrb = 0.295; p .001) or male group (rrb = 0.257; p = .017), while the difference in orgasm attainment was confirmed only in the female group (rrb = 0.147; p = .024). Conclusions Individuals who report more psychotic-like experiences exhibit more compromised sexual functioning than those not at risk. Both problematic sexual behavior and sexual dysfunction increase with the severity of psychotic prodromes. Sexological aspects related to behavior appear to be those in which individuals who report more psychotic-like experiences differ most from controls. Based on our results, problematic sexuality could be considered a potential early indicator of psychotic risk. Therefore, incorporating the assessment of sexual behavior into mental health screening practices is advisable. Disclosure No
Doroldi et al. (Mon,) studied this question.