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Sexual Dysfunctions and Mood and Anxiety Disorders

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Sexual Dysfunctions in Mentally Ill Patients

Part of the book series: Trends in Andrology and Sexual Medicine ((TASM))

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Abstract

Sexual dysfunctions are frequently associated with depression and anxiety: they are reported to be two to three times more likely in depressed population then in non-depressed population, and according to literature, the existence of a bidirectional relationship between depressive symptoms, anxiety, and sexual dysfunctions should always be taken into account. The same etiological mechanisms that are responsible for mood disorders can also be at the base of sexual dysfunctions: patients with sexual dysfunctions can, in fact, more commonly develop lower sexual satisfaction and control, higher distress, and higher social anxiety. What is more, in patients with a diagnosis of bipolar disorder, a disruption in sexual functioning can often be associated with both depressive and manic episodes, and severe fluctuations in sexual life may be difficult to manage for both the patients and their partners. To make the picture even more complex, pharmacological treatments used routinely may cause alterations in desire, excitement, and orgasm. In order to define the best possible treatment for the patient, every careful clinician should routinely evaluate symptoms of mood and anxiety disorders in individuals presenting with sexual complaints.

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References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC; 2013.

    Google Scholar 

  2. Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, et al. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2016;13(4):538–71. https://doi.org/10.1016/j.jsxm.2016.01.019.

    Article  PubMed  Google Scholar 

  3. Waldinger MD. Psychiatric disorders and sexual dysfunction. Handb Clin Neurol. 2015;130:469–89. https://doi.org/10.1016/B978-0-444-63247-0.00027-4.

    Article  PubMed  Google Scholar 

  4. Mathew RJ, Weinman ML. Sexual dysfunctions in depression. Arch Sex Behav. 1982;11(4):323–8.

    Article  CAS  PubMed  Google Scholar 

  5. Casper RC, Redmond DE Jr, Katz MM, Schaffer CB, Davis JM, Koslow SH. Somatic symptoms in primary affective disorder. Presence and relationship to the classification of depression. Arch Gen Psychiatry. 1985;42(11):1098–104.

    Article  CAS  PubMed  Google Scholar 

  6. Angst J. Sexual problems in healthy and depressed persons. Int Clin Psychopharmacol. 1998;13(Suppl 6):S1–4.

    Article  PubMed  Google Scholar 

  7. Derogatis LR, Burnett AL. The epidemiology of sexual dysfunctions. J Sex Med. 2008;5(2):289–300. https://doi.org/10.1111/j.1743-6109.2007.00668.x.

    Article  PubMed  Google Scholar 

  8. Lee KC, Fahmy N, Brock GB. Sexual dysfunction in 2013: advances in epidemiology, diagnosis and treatment. Arab J Urol. 2013;11(3):194–202. https://doi.org/10.1016/j.aju.2013.06.002.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Rajkumar RP, Kumaran AK. Depression and anxiety in men with sexual dysfunction: a retrospective study. Compr Psychiatry. 2015;60:114–8. https://doi.org/10.1016/j.comppsych.2015.03.001.

    Article  PubMed  Google Scholar 

  10. Adinkrah M. Better dead than dishonored: masculinity and male suicidal behavior in contemporary Ghana. Soc Sci Med. 2012;74(4):474–81. https://doi.org/10.1016/j.socscimed.2010.10.011.

    Article  PubMed  Google Scholar 

  11. Ozbek E, Tasci AI, Tugcu V, Ilbey YO, Simsek A, Ozcan L, et al. Possible association of the 5-HTTLPR serotonin transporter promoter gene polymorphism with premature ejaculation in a Turkish population. Asian J Androl. 2009;11(3):351–5. https://doi.org/10.1038/aja.2008.3.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  12. Zhu L, Mi Y, You X, Wu S, Shao H, Dai F, et al. A meta-analysis of the effects of the 5-hydroxytryptamine transporter gene-linked promoter region polymorphism on susceptibility to lifelong premature ejaculation. PLoS One. 2013;8(1):e54994. https://doi.org/10.1371/journal.pone.0054994.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Osher Y, Hamer D, Benjamin J. Association and linkage of anxiety-related traits with a functional polymorphism of the serotonin transporter gene regulatory region in Israeli sibling pairs. Mol Psychiatry. 2000;5(2):216–9.

    Article  CAS  PubMed  Google Scholar 

  14. Wray NR, James MR, Gordon SD, Dumenil T, Ryan L, Coventry WL, et al. Accurate, large-scale genotyping of 5HTTLPR and flanking single nucleotide polymorphisms in an association study of depression, anxiety, and personality measures. Biol Psychiatry. 2009;66(5):468–76. https://doi.org/10.1016/j.biopsych.2009.04.030.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Siracusano A. Manuale di psichiatria. Roma: II Pensiero Scientifico; 2014.

    Google Scholar 

  16. Blanco C, Compton WM, Saha TD, Goldstein BI, Ruan WJ, Huang B, et al. Epidemiology of DSM-5 bipolar I disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions – III. J Psychiatr Res. 2017;84:310–7. https://doi.org/10.1016/j.jpsychires.2016.10.003.

    Article  PubMed  Google Scholar 

  17. Geller B, Zimerman B, Williams M, Delbello MP, Frazier J, Beringer L. Phenomenology of prepubertal and early adolescent bipolar disorder: examples of elated mood, grandiose behaviors, decreased need for sleep, racing thoughts and hypersexuality. J Child Adolesc Psychopharmacol. 2002;12(1):3–9. https://doi.org/10.1089/10445460252943524.

    Article  PubMed  Google Scholar 

  18. Byers ES. Relationship satisfaction and sexual satisfaction: a longitudinal study of individuals in long-term relationships. J Sex Res. 2005;42(2):113–8. https://doi.org/10.1080/00224490509552264.

    Article  PubMed  Google Scholar 

  19. Zemishlany Z, Weizman A. The impact of mental illness on sexual dysfunction. Adv Psychosom Med. 2008;29:89–106. https://doi.org/10.1159/000126626.

    Article  PubMed  Google Scholar 

  20. Kopeykina I, Kim HJ, Khatun T, Boland J, Haeri S, Cohen LJ, et al. Hypersexuality and couple relationships in bipolar disorder: a review. J Affect Disord. 2016;195:1–14. https://doi.org/10.1016/j.jad.2016.01.035.

    Article  PubMed  Google Scholar 

  21. Basco MR, Celis-de Hoyos CE. Biopsychosocial model of hypersexuality in adolescent girls with bipolar disorder: strategies for intervention. J Child Adolesc Psychiatr Nurs. 2012;25(1):42–50. https://doi.org/10.1111/j.1744-6171.2011.00312.x.

    Article  PubMed  Google Scholar 

  22. Carta MG, Massidda D, Moro MF, Aguglia E, Balestrieri M, Caraci F, et al. Comparing factor structure of the Mood Disorder Questionnaire (MDQ): in Italy sexual behavior is euphoric but in Asia mysterious and forbidden. J Affect Disord. 2014;155:96–103. https://doi.org/10.1016/j.jad.2013.10.030.

    Article  PubMed  Google Scholar 

  23. Walton MT, Cantor JM, Bhullar N, Lykins AD. Hypersexuality: a critical review and introduction to the “sexhavior cycle”. Arch Sex Behav. 2017;46(8):2231–51. https://doi.org/10.1007/s10508-017-0991-8.

    Article  PubMed  Google Scholar 

  24. Allison JB, Wilson WP. Sexual behavior of manic patients: a preliminary report. South Med J. 1960;53:870–4.

    Article  CAS  PubMed  Google Scholar 

  25. Carlson GA, Goodwin FK. The stages of mania. A longitudinal analysis of the manic episode. Arch Gen Psychiatry. 1973;28(2):221–8.

    Article  CAS  PubMed  Google Scholar 

  26. Fletcher K, Parker G, Paterson A, Synnott H. High-risk behaviour in hypomanic states. J Affect Disord. 2013;150(1):50–6. https://doi.org/10.1016/j.jad.2013.02.018.

    Article  PubMed  Google Scholar 

  27. Spalt L. Sexual behavior and affective disorders. Dis Nerv Syst. 1975;36(12):644–7.

    PubMed  CAS  Google Scholar 

  28. Sacks MH, Silberstein C, Weiler P, Perry S. HIV-related risk factors in acute psychiatric inpatients. Hosp Community Psychiatry. 1990;41(4):449–51.

    PubMed  CAS  Google Scholar 

  29. Kogan JN, Otto MW, Bauer MS, Dennehy EB, Miklowitz DJ, Zhang HW, et al. Demographic and diagnostic characteristics of the first 1000 patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Bipolar Disord. 2004;6(6):460–9. https://doi.org/10.1111/j.1399-5618.2004.00158.x.

    Article  PubMed  Google Scholar 

  30. Suppes T, Leverich GS, Keck PE, Nolen WA, Denicoff KD, Altshuler LL, et al. The Stanley Foundation Bipolar Treatment Outcome Network. II. Demographics and illness characteristics of the first 261 patients. J Affect Disord. 2001;67(1–3):45–59.

    Article  CAS  PubMed  Google Scholar 

  31. Granek L, Danan D, Bersudsky Y, Osher Y. Living with bipolar disorder: the impact on patients, spouses, and their marital relationship. Bipolar Disord. 2016;18(2):192–9. https://doi.org/10.1111/bdi.12370.

    Article  PubMed  Google Scholar 

  32. Kaplan HS. Anxiety and sexual dysfunction. J Clin Psychiatry. 1988;49(Suppl):21–5.

    PubMed  Google Scholar 

  33. Jonusiene G, Zilaitiene B, Adomaitiene V, Aniuliene R, Bancroft J. Sexual function, mood and menopause symptoms in Lithuanian postmenopausal women. Climacteric. 2013;16(1):185–93. https://doi.org/10.3109/13697137.2012.682746.

    Article  PubMed  CAS  Google Scholar 

  34. Segraves RT, Balon R. Antidepressant-induced sexual dysfunction in men. Pharmacol Biochem Behav. 2014;121:132–7. https://doi.org/10.1016/j.pbb.2013.11.003.

    Article  PubMed  CAS  Google Scholar 

  35. Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. J Clin Psychiatry. 2001;62(Suppl 3):10–21.

    PubMed  CAS  Google Scholar 

  36. Dell’Osso L. Sessualità, depressione e ansia. In: Sessuologia medica. Milano: Elsevier; 2007.

    Google Scholar 

  37. Hsu JH, Shen WW. Male sexual side effects associated with antidepressants: a descriptive clinical study of 32 patients. Int J Psychiatry Med. 1995;25(2):191–201. https://doi.org/10.2190/1DHU-Y7L7-9GKG-V7WV.

    Article  PubMed  CAS  Google Scholar 

  38. Clayton AH, Croft HA, Handiwala L. Antidepressants and sexual dysfunction: mechanisms and clinical implications. Postgrad Med. 2014;126(2):91–9. https://doi.org/10.3810/pgm.2014.03.2744.

    Article  PubMed  Google Scholar 

  39. Clayton AH, Owens JE, McGarvey EL. Assessment of paroxetine-induced sexual dysfunction using the Changes in Sexual Functioning Questionnaire. Psychopharmacol Bull. 1995;31(2):397–413.

    PubMed  CAS  Google Scholar 

  40. Segraves RT. Effects of psychotropic drugs on human erection and ejaculation. Arch Gen Psychiatry. 1989;46(3):275–84.

    Article  CAS  PubMed  Google Scholar 

  41. Finkel MS, Laghrissi-Thode F, Pollock BG, Rong J. Paroxetine is a novel nitric oxide synthase inhibitor. Psychopharmacol Bull. 1996;32(4):653–8.

    PubMed  CAS  Google Scholar 

  42. Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychopharmacol. 2009;29(3):259–66. https://doi.org/10.1097/JCP.0b013e3181a5233f.

    Article  PubMed  CAS  Google Scholar 

  43. Green B. Focus on agomelatine. Curr Med Res Opin. 2011;27(4):745–9. https://doi.org/10.1185/03007995.2011.554534.

    Article  PubMed  CAS  Google Scholar 

  44. Pereira VM, Arias-Carrion O, Machado S, Nardi AE, Silva AC. Bupropion in the depression-related sexual dysfunction: a systematic review. CNS Neurol Disord Drug Targets. 2014;13(6):1079–88.

    Article  CAS  PubMed  Google Scholar 

  45. Hisasue S. The drug treatment of premature ejaculation. Transl Androl Urol. 2016;5(4):482–6. https://doi.org/10.21037/tau.2016.06.10.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Cinzia Niolu .

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Niolu, C., Lisi, G., Siracusano, A. (2018). Sexual Dysfunctions and Mood and Anxiety Disorders. In: Jannini, E., Siracusano, A. (eds) Sexual Dysfunctions in Mentally Ill Patients. Trends in Andrology and Sexual Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-68306-5_9

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  • DOI: https://doi.org/10.1007/978-3-319-68306-5_9

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