Sexual activity and marital status have received little attention as an important aspect of schizophrenic patients’ care.

This study aimed to compare sexual activity, including sexual intercourses with a partner and masturbation, and marital relationships in patients with schizophrenia and in healthy controls.

A consecutive sample of 109 patients meeting DSM-IV criteria of schizophrenia was constituted in psychiatry department of Farhat Hached hospital (Sousse, Tunisia), during a 24 months period. They were drug naïve or drug free for at least three months. 109 age and gender matched, consenting controls were recruited among blood donors. They were free from psychotic disorders as screened by MINI-PLUS. Sexual activity assessment involved sexual intercourses with a partner and masturbation.

Patients with schizophrenia were less often married than healthy controls (18.3% vs. 54.1%; p < 10-3). Also, they had less often a sexual partner (42.2% vs. 70.8%; p < 10-3) than healthy controls. They reported similar rates of sexual activity (77.1% vs. 86.2%), but less regular sexual intercourses (11.1% vs. 48.1%; p < 10-3) than healthy controls. Also, they reported higher rate (59.6% vs. 24.8%; p < 10-3) and higher prevalence during the last month (9.7 ± 9 vs. 5.04 ± 8; p = 0.017) of masturbatory activity.

In spite of lower prevalence of marital relationships, schizophrenic patients reported as frequent sexual activity as healthy controls. This sexual activity seems to be related to higher prevalence of masturbatory activity, which may be explained by their difficulties to be involved in relationship with a sexual partner.