A cross-sectional study of current and lifetime sexual hallucinations and delusions in Lebanese patients with schizophrenia: frequency, characterization, and association with childhood traumatic experiences and disease severity

Background: Till that date, a sparse body of research has been dedicated to perusing psychotic symptoms of sexual type, particularly in psychiatric populations. Our study's objective was to delineate psychotic symptoms with a sexual content, namely sexual delusions and hallucinations, among inpatients diagnosed with schizophrenia in Lebanon, and scrutinize their relationships with the severity of schizophrenia symptoms and childhood abusive events.

Methods: We conducted structured interviews with 167 chronic schizophrenia patients, who completed the Questionnaire for Psychotic Symptoms with a Sexual Content, the Child Abuse Self-Report Scale, and the Positive and Negative Syndrome Scale.

Results: 36.5% and 50.3% of the participants screened positive for current and lifetime episodes of sexual delusions and/or hallucinations, respectively. Alcohol drinking (aOR (adjusted odds ratio)_current = 2.17; aOR_Lifetime = 2.86) and increased psychological (aOR_current = 1.09; aOR_Lifetime = 1.09) and sexual (aOR_current = 1.23; aOR_Lifetime = 1.70) abuse were significantly associated with higher chances of experiencing current and lifetime sexual hallucinations and/or delusions. Additionally, an increased severity of schizophrenia symptoms (aOR = 1.02) was significantly associated with higher chances of current sexual hallucinations and/or delusions, whereas having a university level of education compared to primary (aOR = 0.15) was significantly associated with lower odds of current sexual hallucinations and/or delusions.

Conclusion: In sum, our findings suggest that sexual psychotic symptoms are prevalent in chronic schizophrenia patients, providing support for their associations with antecedents of childhood traumatic experiences, illness severity, and substance use disorders. They endorse the vitalness of preventive measures against abuse, in order to circumvent such phenomenological outcomes. Our study offers the first data on sexual hallucinations and delusions in a non-Western psychiatric population, thus allowing clinicians and researchers to draw featural comparisons across different cultural settings.