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Although prevalent during antidepressant treatment, sexual dysfunction (SD) is frequently ignored by both physicians and patients in Asia. In spite of impact of SD on medicated patients with major depression, sexual issues and illness remain a forbidden topic for most Asian people. The aims of this study were to: (1) estimate the prevalence of SD among stable outpatients taking different antidepressants in Taiwan; (2) investigate the factors related to SD; (3) compare physician-perceived with patient-reported prevalence rates of antidepressantassociated SD; and (4) study the differences of SD among antidepressant subgroups. In this cross-sectional observational study, 125 medicated patients with major depression were recruited. Patients were assessed using the Changes in Sexual Functioning Questionnaire (CSFQ), Taiwanese Depression Questionnaire (TDQ), Quality of Life Index (QOL), and neuroticism scores in the Maudsley Personality Inventory (MPI). Sixty-two physicians completed the Physician Antidepressant Experience Questionnaire. The estimated prevalence rate of SD was 53.6% (95% CI = 44.9-62.3%) in medicated patients with major depression. There were no significant differences in prevalence rate of SD among different antidepressants. The SD subgroup had poorer quality of life and lower moods than the non-dysfunction subgroup. An underestimation of the prevalence of SD by physicians was noted. Because antidepressant-associated SD is highly prevalent and seriously underestimated by physicians, greater physicians' recognition and better patients' education are imperative when prescribing antidepressants.