Sexual Health in Psychiatry: Bridging the Communication Gap and Training Needs between Patients and Clinicians - A...

Sexual health is integral to mental well-being, yet it remains under-addressed in psychiatric care. Mental disorders and psychotropic medications can cause sexual dysfunctions. Despite its clinical relevance, sexual health is often not routinely assessed or discussed in psychiatric assessment and treatment, possibly due to insufficient training, stigma, and clinicians' uncertainty. This pilot study examined how sexuality is addressed in psychiatric treatment and how relevant the topic is perceived, integrating patient and clinician perspectives. A cross-sectional, anonymous online survey was conducted between February and July 2025 in two German academic psychiatric hospitals. Psychiatric patients and mental-health professionals completed questionnaires tailored to their perspectives. Patients completed measures of sexual functioning, well-being, and communication about sexuality, whereas mental-health professionals completed measures of attitudes, clinical practice, and professional training. Data were analysed using descriptive and inferential statistics. A total of 231 patients and 194 clinicians participated. Nearly all patients reported at least one sexual dysfunction (100% women, 97% men), while only 18.7% reported being sexually satisfied. Although most patients (62.0%) considered sexuality an important topic, only 12.5% reported that it had been addressed. Clinicians reported addressing sexuality more frequently (psychotherapists: 44.0%; specialists: 62.1%). Among physicians, confidence and years of professional experience predicted actively discussing sexual issues (p = .013). More than 80% of clinicians reported insufficient coverage of sexual health during their education. Sexual health remains a neglected domain in psychiatric care despite being recognized as important by both patients and clinicians. Strengthening clinicians' confidence through targeted training, routine screening, and institutional support may help normalize the assessment of sexual health as part of holistic, patient-centred psychiatric care.