精神疾患のある人の性と生殖に関する実態

Sexual and Reproductive Realities of Individuals With Mental Disorders

要旨

　目的：精神疾患のある人の性と生殖に関する実態を把握することを目的とした．

　方法：精神疾患のある成人にWEBアンケート調査を実施した．性と生殖に関する状況や知識，性的リスクと対処，性と生殖の悩みを尋ねた．各項目は生物学的性と性分類で比較した．

　結果：300名から回答を得た．生物学的性は男性39.7％，女性60.3％，性分類では，男性33.0％，女性48.7％，性的マイノリティ18.3％であった．予期せぬ妊娠は11.7％，性感染症罹患は10.3％が経験していた．性感染症や避妊に関する知識は，正答率が約半分であり，男性の正答率が低かった．性や生殖に関する悩みの内訳では性機能障害が最多だった．性や生殖に関する相談相手は59.0％が不在だった．49.7％が子どもをつくるかどうかの決定に精神疾患が影響している（いた）と回答した．

　結論：精神疾患に関連した悩みや知識不足に対応する性教育が必要である．

　Objective: This study aimed to clarify the situation regarding sexuality and reproduction in individuals with mental disorders.

　Methods: A web-based questionnaire regarding sexual and reproductive status, knowledge, sexual risks and coping, and sexual and reproductive concerns was administered to adults with mental disorders. Each item was compared according to sex and gender.

　Results: Responses were obtained from 300 participants; 39.7% men and 60.3% women according to sex, and 33.0% male, 48.7% female, and 18.3% sexual minorities according to gender. Unexpected pregnancy and sexually transmitted infections were experienced by 11.7% and 10.3%, respectively. Approximately 50% of the respondents answered knowledge on sexually transmitted infections and contraception correctly, with men having a low percentage of correct answers. Sexual dysfunction was the most common sexual and reproductive concern. Approximately 59.0% did not have an individual with whom to discuss about sexual and reproductive matters, and 49.7% reported that mental disorders influenced their decision to have children.

　Conclusions: Sexuality education is needed to address the concerns and lack of mental disorderrelated knowledge.