Advertisement

Sexual Dysfunctions and Mood and Anxiety Disorders

  • Cinzia Niolu
  • Giulia Lisi
  • Alberto Siracusano
Chapter
Part of the Trends in Andrology and Sexual Medicine book series (TASM)

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.

References

  1. 1.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC; 2013.Google Scholar
  2. 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.CrossRefPubMedGoogle Scholar
  3. 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.CrossRefPubMedGoogle Scholar
  4. 4.
    Mathew RJ, Weinman ML. Sexual dysfunctions in depression. Arch Sex Behav. 1982;11(4):323–8.CrossRefPubMedGoogle Scholar
  5. 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.CrossRefPubMedGoogle Scholar
  6. 6.
    Angst J. Sexual problems in healthy and depressed persons. Int Clin Psychopharmacol. 1998;13(Suppl 6):S1–4.CrossRefPubMedGoogle Scholar
  7. 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.CrossRefPubMedGoogle Scholar
  8. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 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.CrossRefPubMedGoogle Scholar
  10. 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.CrossRefPubMedGoogle Scholar
  11. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 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.CrossRefPubMedGoogle Scholar
  14. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Siracusano A. Manuale di psichiatria. Roma: II Pensiero Scientifico; 2014.Google Scholar
  16. 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.CrossRefPubMedGoogle Scholar
  17. 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.CrossRefPubMedGoogle Scholar
  18. 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.CrossRefPubMedGoogle Scholar
  19. 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.CrossRefPubMedGoogle Scholar
  20. 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.CrossRefPubMedGoogle Scholar
  21. 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.CrossRefPubMedGoogle Scholar
  22. 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.CrossRefPubMedGoogle Scholar
  23. 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.CrossRefPubMedGoogle Scholar
  24. 24.
    Allison JB, Wilson WP. Sexual behavior of manic patients: a preliminary report. South Med J. 1960;53:870–4.CrossRefPubMedGoogle Scholar
  25. 25.
    Carlson GA, Goodwin FK. The stages of mania. A longitudinal analysis of the manic episode. Arch Gen Psychiatry. 1973;28(2):221–8.CrossRefPubMedGoogle Scholar
  26. 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.CrossRefPubMedGoogle Scholar
  27. 27.
    Spalt L. Sexual behavior and affective disorders. Dis Nerv Syst. 1975;36(12):644–7.PubMedGoogle Scholar
  28. 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.PubMedGoogle Scholar
  29. 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.CrossRefPubMedGoogle Scholar
  30. 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.CrossRefPubMedGoogle Scholar
  31. 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.CrossRefPubMedGoogle Scholar
  32. 32.
    Kaplan HS. Anxiety and sexual dysfunction. J Clin Psychiatry. 1988;49(Suppl):21–5.PubMedGoogle Scholar
  33. 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.CrossRefPubMedGoogle Scholar
  34. 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.CrossRefPubMedGoogle Scholar
  35. 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.PubMedGoogle Scholar
  36. 36.
    Dell’Osso L. Sessualità, depressione e ansia. In: Sessuologia medica. Milano: Elsevier; 2007.Google Scholar
  37. 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.CrossRefPubMedGoogle Scholar
  38. 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.CrossRefPubMedGoogle Scholar
  39. 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.PubMedGoogle Scholar
  40. 40.
    Segraves RT. Effects of psychotropic drugs on human erection and ejaculation. Arch Gen Psychiatry. 1989;46(3):275–84.CrossRefPubMedGoogle Scholar
  41. 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.PubMedGoogle Scholar
  42. 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.CrossRefPubMedGoogle Scholar
  43. 43.
    Green B. Focus on agomelatine. Curr Med Res Opin. 2011;27(4):745–9.  https://doi.org/10.1185/03007995.2011.554534.CrossRefPubMedGoogle Scholar
  44. 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.CrossRefPubMedGoogle Scholar
  45. 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.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Cinzia Niolu
    • 1
    • 2
  • Giulia Lisi
    • 1
  • Alberto Siracusano
    • 1
    • 2
  1. 1.Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor VergataRomeItaly
  2. 2.Psychiatry, Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly

Personalised recommendations