Advertisement

Epidemiology of Sexual Dysfunctions in Persons Suffering from Psychiatric Disorders

  • Giacomo Ciocca
  • Susana Ochoa
  • Emmanuele A. Jannini
Chapter
Part of the Trends in Andrology and Sexual Medicine book series (TASM)

Abstract

The prevalence of sexual dysfunctions is higher in persons suffering from mental illnesses. Anxiety, depression, and mood disorders are considered important comorbidity factors for sexual dysfunction in males and females. However, a part of literature is dedicated to assessing sexuality in psychotic patients. In this severe mental illness, both the psychopathology and its pharmacological treatment drastically impact on sexual functioning. In this regard, the prevalence of sexual dysfunction is very high in these patients. On the contrary, less evidence exists about the epidemiology of sexual problems among people with personality and eating disorders, above all in males.

References

  1. 1.
    Montejo AL, Majadas S, Rico-Villademoros F, Llorca G, De La Gandara J, Franco M, et al. Frequency of sexual dysfunction in patients with a psychotic disorder receiving antipsychotics. J Sex Med. 2010;7(10):3404–13.  https://doi.org/10.1111/j.1743-6109.2010.01709.x.CrossRefPubMedGoogle Scholar
  2. 2.
    Serretti A, Chiesa A. Sexual side effects of pharmacological treatment of psychiatric diseases. Clin Pharmacol Ther. 2011;89(1):142–7.  https://doi.org/10.1038/clpt.2010.70.CrossRefPubMedGoogle Scholar
  3. 3.
    Nunes LV, Moreira HC, Razzouk D, Nunes SO, Mari JJ. Strategies for the treatment of antipsychotic-induced sexual dysfunction and/or hyperprolactinemia among patients of the schizophrenia spectrum: a review. J Sex Marital Ther. 2012;38(3):281–301.  https://doi.org/10.1080/0092623X.2011.606883.CrossRefPubMedGoogle Scholar
  4. 4.
    Bourdeau G, Masse M, Lecomte T. Social functioning in early psychosis: are all the domains predicted by the same variables? Early Interv Psychiatry. 2012;6(3):317–a.  https://doi.org/10.1111/j.1751-7893.2011.00337.x.CrossRefPubMedGoogle Scholar
  5. 5.
    McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, Fisher AD, et al. Incidence and prevalence of sexual dysfunction in women and men: a consensus statement from the fourth international consultation on sexual medicine 2015. J Sex Med. 2016;13(2):144–52.  https://doi.org/10.1016/j.jsxm.2015.12.034.CrossRefPubMedGoogle Scholar
  6. 6.
    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.CrossRefPubMedGoogle Scholar
  7. 7.
    Figueira I, Possidente E, Marques C, Hayes K. Sexual dysfunction: a neglected complication of panic disorder and social phobia. Arch Sex Behav. 2001;30(4):369–77.CrossRefPubMedGoogle Scholar
  8. 8.
    Aksoy UM, Aksoy SG, Maner F, Gokalp P, Yanik M. Sexual dysfunction in obsessive compulsive disorder and panic disorder. Psychiatr Danub. 2012;24(4):381–5.PubMedGoogle Scholar
  9. 9.
    Corretti G, Pierucci S, De Scisciolo M, Nisita C. Comorbidity between social phobia and premature ejaculation: study on 242 males affected by sexual disorders. J Sex Marital Ther. 2006;32(2):183–7.  https://doi.org/10.1080/00926230500442342.CrossRefPubMedGoogle Scholar
  10. 10.
    Araujo AB, Durante R, Feldman HA, Goldstein I, McKinlay JB. The relationship between depressive symptoms and male erectile dysfunction: cross-sectional results from the Massachusetts male aging study. Psychosom Med. 1998;60(4):458–65.CrossRefPubMedGoogle Scholar
  11. 11.
    Kantor J, Bilker WB, Glasser DB, Margolis DJ. Prevalence of erectile dysfunction and active depression: an analytic cross-sectional study of general medical patients. Am J Epidemiol. 2002;156(11):1035–42.CrossRefPubMedGoogle Scholar
  12. 12.
    Shiri R, Koskimaki J, Tammela TL, Hakkinen J, Auvinen A, Hakama M. Bidirectional relationship between depression and erectile dysfunction. J Urol. 2007;177(2):669–73.  https://doi.org/10.1016/j.juro.2006.09.030.CrossRefPubMedGoogle Scholar
  13. 13.
    Collazzoni A, Ciocca G, Limoncin E, Marucci C, Mollaioli D, Di Sante D, Di Lorenzo G, Niolu C, Siracusano A, Maggi M, Castellini G, Rossi A, Jannini EA. Mating strategies and sexual functioning in personality disorders: a comprehensive review of literature. Sex Med Rev. 2017;5(4):414–28.  https://doi.org/10.1016/j.sxmr.2017.03.009.CrossRefPubMedGoogle Scholar
  14. 14.
    Brotto LA, Knudson G, Inskip J, Rhodes K, Erskine Y. Asexuality: a mixed-methods approach. Arch Sex Behav. 2010;39(3):599–618.  https://doi.org/10.1007/s10508-008-9434-x.CrossRefPubMedGoogle Scholar
  15. 15.
    Mallis D, Moysidis K, Nakopoulou E, Papaharitou S, Hatzimouratidis K, Hatzichristou D. Psychiatric morbidity is frequently undetected in patients with erectile dysfunction. J Urol. 2005;174(5):1913–6.  https://doi.org/10.1097/01.ju.0000176746.73667.3c.CrossRefPubMedGoogle Scholar
  16. 16.
    Ciocca G, Usall J, Dolz M, Limoncin E, Gravina GL, Carosa E, et al. Sexual dysfunctions in people with first-episode psychosis assessed according to a gender perspective. Riv Psichiatr. 2015;50(5):239–44.  https://doi.org/10.1708/2040.22166.CrossRefPubMedGoogle Scholar
  17. 17.
    Malik P, Kemmler G, Hummer M, Riecher-Roessler A, Kahn RS, Fleischhacker WW. Sexual dysfunction in first-episode schizophrenia patients: results from European first episode schizophrenia trial. J Clin Psychopharmacol. 2011;31(3):274–80.  https://doi.org/10.1097/JCP.0b013e3182199bcc.CrossRefPubMedGoogle Scholar
  18. 18.
    Serretti A, Chiesa A. A meta-analysis of sexual dysfunction in psychiatric patients taking antipsychotics. Int Clin Psychopharmacol. 2011;26(3):130–40.  https://doi.org/10.1097/YIC.0b013e328341e434.CrossRefPubMedGoogle Scholar
  19. 19.
    de Boer MK, Castelein S, Wiersma D, Schoevers RA, Knegtering H. The facts about sexual (Dys)function in schizophrenia: an overview of clinically relevant findings. Schizophr Bull. 2015;41(3):674–86.  https://doi.org/10.1093/schbul/sbv001.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Harley EW, Boardman J, Craig T. Sexual problems in schizophrenia: prevalence and characteristics. A cross sectional survey. Soc Psychiatry Psychiatr Epidemiol. 2010;45(7):759–66.  https://doi.org/10.1007/s00127-009-0119-0.CrossRefPubMedGoogle Scholar
  21. 21.
    Fan X, Henderson DC, Chiang E, Briggs LB, Freudenreich O, Evins AE, et al. Sexual functioning, psychopathology and quality of life in patients with schizophrenia. Schizophr Res. 2007;94(1–3):119–27.  https://doi.org/10.1016/j.schres.2007.04.033.CrossRefPubMedGoogle Scholar
  22. 22.
    Smith SM, O’Keane V, Murray R. Sexual dysfunction in patients taking conventional antipsychotic medication. Br J Psychiatry. 2002;181:49–55.CrossRefPubMedGoogle Scholar
  23. 23.
    Herzog DB, Norman DK, Gordon C, Pepose M. Sexual conflict and eating disorders in 27 males. Am J Psychiatry. 1984;141(8):989–90.  https://doi.org/10.1176/ajp.141.8.989.CrossRefPubMedGoogle Scholar
  24. 24.
    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.CrossRefPubMedGoogle Scholar
  25. 25.
    Li SH, Graham BM. Why are women so vulnerable to anxiety, trauma-related and stress-related disorders? The potential role of sex hormones. Lancet Psychiatry. 2017;4(1):73–82.  https://doi.org/10.1016/S2215-0366(16)30358-3.CrossRefPubMedGoogle Scholar
  26. 26.
    Van Minnen A, Kampman M. Interaction between anxiety and sexual functioning: a controlled study of sexual functioning in women with anxiety disorders. Sex Relation Ther. 2000;15:47–57.CrossRefGoogle Scholar
  27. 27.
    Bodinger L, Hermesh H, Aizenberg D, Valevski A, Marom S, Shiloh R, et al. Sexual function and behavior in social phobia. J Clin Psychiatry. 2002;63(10):874–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Monteiro WO, Noshirvani HF, Marks IM, Lelliott PT. Anorgasmia from clomipramine in obsessive-compulsive disorder. A controlled trial. Br J Psychiatry. 1987;151:107–12.CrossRefPubMedGoogle Scholar
  29. 29.
    Vulink NC, Denys D, Bus L, Westenberg HG. Sexual pleasure in women with obsessive-compulsive disorder? J Affect Disord. 2006;91(1):19–25.  https://doi.org/10.1016/j.jad.2005.12.006.CrossRefPubMedGoogle Scholar
  30. 30.
    Moser DA, Aue T, Suardi F, Kutlikova H, Cordero MI, Rossignol AS, et al. Violence-related PTSD and neural activation when seeing emotionally charged male-female interactions. Soc Cogn Affect Neurosci. 2015;10(5):645–53.  https://doi.org/10.1093/scan/nsu099.CrossRefPubMedGoogle Scholar
  31. 31.
    Zollman G, Rellini A, Desrocher D. The mediating effect of daily stress on the sexual arousal function of women with a history of childhood sexual abuse. J Sex Marital Ther. 2013;39(2):176–92.  https://doi.org/10.1080/0092623X.2012.691950.CrossRefPubMedGoogle Scholar
  32. 32.
    Ciocca G, Limoncin E, Di Tommaso S, Gravina GL, Di Sante S, Carosa E, et al. Alexithymia and vaginismus: a preliminary correlation perspective. Int J Impot Res. 2013;25(3):113–6.  https://doi.org/10.1038/ijir.2013.5.CrossRefPubMedGoogle Scholar
  33. 33.
    Watts G, Nettle D. The role of anxiety in vaginismus: a case-control study. J Sex Med. 2010;7(1 Pt 1):143–8.  https://doi.org/10.1111/j.1743-6109.2009.01365.x.CrossRefPubMedGoogle Scholar
  34. 34.
    Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED Jr, et al. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med. 2010;7(4 Pt 2):1598–607.  https://doi.org/10.1111/j.1743-6109.2010.01778.x.CrossRefPubMedGoogle Scholar
  35. 35.
    Lee TI, Issac J, Lin SH, Yeh TL, Lee IH, Chen PS, et al. Gender difference in antidepressant-related sexual dysfunction in Taiwan. Gen Hosp Psychiatry. 2013;35(4):407–11.  https://doi.org/10.1016/j.genhosppsych.2013.03.015.CrossRefPubMedGoogle Scholar
  36. 36.
    Atlantis E, Sullivan T. Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. J Sex Med. 2012;9(6):1497–507.  https://doi.org/10.1111/j.1743-6109.2012.02709.x.CrossRefPubMedGoogle Scholar
  37. 37.
    Kennedy SH, Rizvi S. Sexual dysfunction, depression, and the impact of antidepressants. J Clin Psychopharmacol. 2009;29(2):157–64.  https://doi.org/10.1097/JCP.0b013e31819c76e9.CrossRefPubMedGoogle Scholar
  38. 38.
    Cyranowski JM, Bromberger J, Youk A, Matthews K, Kravitz HM, Powell LH. Lifetime depression history and sexual function in women at midlife. Arch Sex Behav. 2004;33(6):539–48.  https://doi.org/10.1023/B:ASEB.0000044738.84813.3b.CrossRefPubMedGoogle Scholar
  39. 39.
    Lin C, Juang YY, Wen JK, Liu CY, Hung CI. Correlations between sexual dysfunction, depression, anxiety, and somatic symptoms among patients with major depressive disorder. Chang Gung Med J. 2012;35(4):323–31.PubMedGoogle Scholar
  40. 40.
    Lorenz T, Rullo J, Faubion S. Antidepressant-induced female sexual dysfunction. Mayo Clin Proc. 2016;91(9):1280–6.  https://doi.org/10.1016/j.mayocp.2016.04.033.CrossRefPubMedGoogle Scholar
  41. 41.
    Clayton AH, Gommoll C, Chen D, Nunez R, Mathews M. Sexual dysfunction during treatment of major depressive disorder with vilazodone, citalopram, or placebo: results from a phase IV clinical trial. Int Clin Psychopharmacol. 2015;30(4):216–23.  https://doi.org/10.1097/YIC.0000000000000075.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Miller LJ, Ghadiali NY, Larusso EM, Wahlen KJ, Avni-Barron O, Mittal L, et al. Bipolar disorder in women. Health Care Women Int. 2015;36(4):475–98.  https://doi.org/10.1080/07399332.2014.962138.CrossRefPubMedGoogle Scholar
  43. 43.
    Zanarini MC, Parachini EA, Frankenburg FR, Holman JB, Hennen J, Reich DB, et al. Sexual relationship difficulties among borderline patients and axis II comparison subjects. J Nerv Ment Dis. 2003;191(7):479–82.  https://doi.org/10.1097/01.NMD.0000081628.93982.1D.CrossRefPubMedGoogle Scholar
  44. 44.
    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.CrossRefPubMedGoogle Scholar
  45. 45.
    Sansone RA, Wiederman MW. Borderline personality symptomatology, casual sexual relationships, and promiscuity. Psychiatry (Edgmont). 2009;6(3):36–40.Google Scholar
  46. 46.
    Sansone RA, Chu JW, Wiederman MW. Sexual behaviour and borderline personality disorder among female psychiatric inpatients. Int J Psychiatry Clin Pract. 2011;15(1):69–73.  https://doi.org/10.3109/13651501.2010.507871.CrossRefPubMedGoogle Scholar
  47. 47.
    Schulte-Herbruggen O, Ahlers CJ, Kronsbein JM, Ruter A, Bahri S, Vater A, et al. Impaired sexual function in patients with borderline personality disorder is determined by history of sexual abuse. J Sex Med. 2009;6(12):3356–63.  https://doi.org/10.1111/j.1743-6109.2009.01422.x.CrossRefPubMedGoogle Scholar
  48. 48.
    Reich DB, Zanarini MC. Sexual orientation and relationship choice in borderline personality disorder over ten years of prospective follow-up. J Personal Disord. 2008;22(6):564–72.  https://doi.org/10.1521/pedi.2008.22.6.564.CrossRefGoogle Scholar
  49. 49.
    Gorton G, Akhtar S. The literature on personality disorders, 1985-88: trends, issues, and controversies. Hosp Community Psychiatry. 1990;41(1):39–51.PubMedGoogle Scholar
  50. 50.
    Jonusiene G, Griffioen T. Psychiatric disorders and sexual dysfunctions. In: Kirana PS, Tripodi F, Reisman Y, Porst H, editors. The EFS and ESSM syllabus of clinical sexology. Amsterdam: ESSM Educational Committee; 2013. p. 380–927.Google Scholar
  51. 51.
    Apt C, Hurlbert DF. The sexual attitudes, behavior, and relationships of women with histrionic personality disorder. J Sex Marital Ther. 1994;20(2):125–33.  https://doi.org/10.1080/00926239408403423.CrossRefPubMedGoogle Scholar
  52. 52.
    Acuna MJ, Martin JC, Graciani M, Cruces A, Gotor F. A comparative study of the sexual function of institutionalized patients with schizophrenia. J Sex Med. 2010;7(10):3414–23.  https://doi.org/10.1111/j.1743-6109.2010.01832.x.CrossRefPubMedGoogle Scholar
  53. 53.
    Huguelet P, Mohr S, Boucherie M, Yaron M, Perroud N, Bianchi-Demicheli F. An exploration of sexual desire and sexual activities of women with psychosis. Rev Med Suisse. 2015;11(486):1691–5.PubMedGoogle Scholar
  54. 54.
    Rubio-Abadal E, Del Cacho N, Saenz-Navarrete G, Arranz B, Cambra RM, Cuadras D, et al. How hyperprolactinemia affects sexual function in patients under antipsychotic treatment. J Clin Psychopharmacol. 2016;36(5):422–8.  https://doi.org/10.1097/JCP.0000000000000539.CrossRefPubMedGoogle Scholar
  55. 55.
    Mitchison D, Hay PJ. The epidemiology of eating disorders: genetic, environmental, and societal factors. Clin Epidemiol. 2014;6:89–97.  https://doi.org/10.2147/CLEP.S40841.CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Castellini G, Lelli L, Ricca V, Maggi M. Sexuality in eating disorders patients: etiological factors, sexual dysfunction and identity issues. A systematic review. Horm Mol Biol Clin Invest. 2016;25(2):71–90.  https://doi.org/10.1515/hmbci-2015-0055.CrossRefGoogle Scholar
  57. 57.
    Pinheiro AP, Raney TJ, Thornton LM, Fichter MM, Berrettini WH, Goldman D, et al. Sexual functioning in women with eating disorders. Int J Eat Disord. 2010;43(2):123–9.  https://doi.org/10.1002/eat.20671.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Castellini G, Lelli L, Lo Sauro C, Fioravanti G, Vignozzi L, Maggi M, et al. Anorectic and bulimic patients suffer from relevant sexual dysfunctions. J Sex Med. 2012;9(10):2590–9.  https://doi.org/10.1111/j.1743-6109.2012.02888.x.CrossRefPubMedGoogle Scholar
  59. 59.
    Raboch J, Faltus F. Sexuality of women with anorexia nervosa. Acta Psychiatr Scand. 1991;84(1):9–11.CrossRefPubMedGoogle Scholar
  60. 60.
    Morgan JF, Lacey JH, Reid F. Anorexia nervosa: changes in sexuality during weight restoration. Psychosom Med. 1999;61(4):541–5.CrossRefPubMedGoogle Scholar
  61. 61.
    Quadflieg N, Fichter MM. The course and outcome of bulimia nervosa. Eur Child Adolesc Psychiatry. 2003;12(Suppl 1):I99–109.  https://doi.org/10.1007/s00787-003-1113-9.CrossRefPubMedGoogle Scholar
  62. 62.
    Castellini G, Mannucci E, Mazzei C, Lo Sauro C, Faravelli C, Rotella CM, et al. Sexual function in obese women with and without binge eating disorder. J Sex Med. 2010;7(12):3969–78.  https://doi.org/10.1111/j.1743-6109.2010.01990.x.CrossRefPubMedGoogle Scholar
  63. 63.
    Kimmel MC, Ferguson EH, Zerwas S, Bulik CM, Meltzer-Brody S. Obstetric and gynecologic problems associated with eating disorders. Int J Eat Disord. 2016;49(3):260–75.  https://doi.org/10.1002/eat.22483.CrossRefPubMedGoogle Scholar
  64. 64.
    Madowitz J, Matheson BE, Liang J. The relationship between eating disorders and sexual trauma. Eat Weight Disord. 2015;20(3):281–93.  https://doi.org/10.1007/s40519-015-0195-y.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Giacomo Ciocca
    • 1
  • Susana Ochoa
    • 2
  • Emmanuele A. Jannini
    • 1
  1. 1.Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
  2. 2.Parc Sanitari Sant Joan de DéuInstitut de Recerca Sant Joan de Déu. CIBERSAMBarcelonaSpain

Personalised recommendations