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Shared genetic basis between reproductive behaviors and anxiety-related disorders. Mol Psychiatry 2022; 27:4103-4112. [PMID: 35750798 DOI: 10.1038/s41380-022-01667-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/17/2022] [Accepted: 06/08/2022] [Indexed: 02/07/2023]
Abstract
Reproductive behaviors are associated with risks for psychiatric disorders. Reproductive phenotypes are moderately heritable and have genetic overlaps with risks for psychiatric disorders. However, the genetic and causal relationships between anxiety-related disorders or specific anxiety disorders and reproductive phenotypes remain unknown. We utilized large-scale genome-wide association study (GWAS) results (n = 9537-542,901) for five reproductive phenotypes [age at menarche, age at first sexual intercourse (AFS), age at first birth (AFB), number of children ever born (NEB), and age at menopause] and five anxiety-related disorders [panic disorder, anxiety disorders from the ANGST and the UK biobank (UKBB), posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD)]. To assess genetic correlations and causal associations, linkage disequilibrium score regression and Mendelian randomization analyses, respectively, were performed. We found that AFS and AFB were negatively correlated with anxiety disorders ANGST (AFS: rg ± SE = -0.28 ± 0.08, p = 6.00 × 10-4; AFB: -0.45 ± 0.11, p = 3.26 × 10-5), anxiety disorders UKBB (AFS: -0.18 ± 0.03, p = 9.64 × 10-9; AFB; -0.25 ± 0.03, p = 2.90 × 10-13) and PTSD (AFS: -0.42 ± 0.12, p = 4.00 × 10-4; AFB: -0.44 ± 0.12, p = 2.00 × 10-4) and positively correlated with OCD (AFS: 0.25 ± 0.05, p = 2.46 × 10-6; AFB: 0.25 ± 0.05, p = 3.92 × 10-7). Conversely, NEB was negatively correlated with OCD (-0.28 ± 0.08, p = 6.00 × 10-4). We revealed bidirectional effects between earlier AFS and AFB and anxiety disorders (odds ratios: ORearlier AFS→Anxiety = 1.64, p = 2.27 × 10-8; ORearlier AFB→Anxiety = 1.15, p = 2.28 × 10-3; ORAnxiety→earlier AFS = 1.02, p = 6.62 × 10-8; ORAnxiety→earlier AFB = 1.08, p = 1.60 × 10-4). In contrast, we observed unidirectional effects of later AFS and AFB on OCD (ORlater AFS→OCD = 2.18, p = 2.16 × 10-6; ORlater AFB→OCD = 1.22, p = 0.016). We suggest that those who have earlier sexual debut and childbirth are prone to risk for anxiety disorders and vice versa, while those who have later sexual debut and childbirth are genetically prone to risk for OCD. Our findings further support revising the diagnostic criteria (DSM-5) such that OCD is independent from anxiety disorders.
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Du H, Xia J, Fan J, Gao F, Wang X, Han Y, Tan C, Zhu X. Spontaneous neural activity in the right fusiform gyrus and putamen is associated with consummatory anhedonia in obsessive compulsive disorder. Brain Imaging Behav 2022; 16:1708-1720. [DOI: 10.1007/s11682-021-00619-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
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Song JG, Kwon O, Hwang EM, Kim HW, Park JY. Conditional deletion of TMEM16A in cholinergic neurons of the medial habenula induces anhedonic-like behavior in mice. Behav Brain Res 2022; 426:113841. [DOI: 10.1016/j.bbr.2022.113841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/17/2022] [Accepted: 03/10/2022] [Indexed: 11/02/2022]
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Żerdziński M, Burdzik M, Żmuda R, Witkowska-Berek A, Dȩbski P, Flajszok-Macierzyńska N, Piegza M, John-Ziaja H, Gorczyca P. Sense of happiness and other aspects of quality of life in patients with obsessive-compulsive disorder. Front Psychiatry 2022; 13:1077337. [PMID: 36620674 PMCID: PMC9810625 DOI: 10.3389/fpsyt.2022.1077337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Quality of life (QoL) is the intellectual and emotional wellbeing of an individual, which is determined by many factors. The most measurable are the sense of happiness, occupational satisfaction, quality of interpersonal relationships and sex life. Obsessive-compulsive disorder (OCD) is a chronic mental disorder diagnosed by the presence of obsessions and compulsions that disrupt normal psychosocial functioning. Despite early onset, treatment is delayed (OCD-DTI) and unsatisfactory. OBJECTIVES The primary objective of this study is to assess selected correlates of the sense of happiness among patients with OCD. The secondary objective is to compare the sense of happiness with healthy people. METHODS Seventyfive OCD patients and equal number of healthy subjects were compared using a Polish adaptation of the Oxford Happiness Questionnaire (OHQ-23). RESULTS We found a significant negative correlation between sense of happiness and the severity of OCD (r = -0.479), the number of obsessive-compulsive personality traits (r = -0.323), the number of other comorbid mental disorders (r = -0.272), the level of aggression (r = -0.448), impulsivity (r = -0.301), depressiveness (r = -0.357), and the sexual dysfunctions (r = -0.279). The latter were much more common in individuals with OCD compared to healthy subjects (66.67 vs. 12%). The level of loneliness was over two times higher in the study group compared to controls (27 vs. 12%). The mean delay in treatment onset was 13 years. Conclusions. Assessment of aspects of QoL should be an integral part of the diagnostic and therapeutic process in OCD.
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Affiliation(s)
- Maciej Żerdziński
- Dr. Krzysztof Czuma's Psychiatric Center, Psychiatric Department No 2, Katowice, Poland.,Faculty of Medicine, Academy of Silesia, Katowice, Poland
| | - Marcin Burdzik
- Dr. Krzysztof Czuma's Psychiatric Center, Psychiatric Department No 2, Katowice, Poland.,Institute of Law at Faculty of Law and Administration, University of Silesia in Katowice, Katowice, Poland
| | - Roksana Żmuda
- Dr. Krzysztof Czuma's Psychiatric Center, Psychiatric Department No 2, Katowice, Poland
| | | | - Paweł Dȩbski
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Góry, Poland
| | | | - Magdalena Piegza
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Góry, Poland
| | - Hanna John-Ziaja
- Dr. Krzysztof Czuma's Psychiatric Center, Psychiatric Department No 2, Katowice, Poland
| | - Piotr Gorczyca
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Góry, Poland
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Sexual response in obsessive-compulsive disorder: the role of obsessive beliefs. CNS Spectr 2021; 26:528-537. [PMID: 32665050 DOI: 10.1017/s1092852920001649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Sexual response in obsessive-compulsive disorder (OCD) research and practice is overlooked. According to the Dual Control Model, satisfactory sexual response is based upon a balance of sexual excitation and inhibition. The assessment of sexual response in OCD may have clinical implications, such as the integration of sex therapy in psychotherapeutic intervention. The present study was aimed at comparing sexual excitation and inhibition levels between OCD patients and matched control subjects, and investigating whether obsessive beliefs might predict sexual excitation/inhibition. METHODS Seventy-two OCD patients (mean age ± standard deviation [SD]: 34.50 ± 10.39 years) and 72 matched control subjects (mean age ± SD: 34.25 ± 10.18) were included (62.50% men and 37.50% women in both groups). The Obsessive Compulsive Inventory-Revised (OCI-R), the Obsessive Beliefs Questionnaire-46 (OBQ-46), and the Sexual Inhibition/Sexual Excitation Scales (SIS/SES) were administered. RESULTS Patients with OCD showed significantly higher levels of sexual excitation, inhibition due to threat of performance failure, and inhibition due to threat of performance consequences than the controls. In addition, the patients with more severe symptoms showed lower excitation than those with less severe symptoms, and those with higher perfectionism had stronger inhibition due to threat of performance failure than those with lower perfectionism. CONCLUSIONS This is the first study exploring sexual response in OCD according to the Dual Control Model. Sexual response is an impaired quality of life outcome in OCD that should be assessed in routine clinical practice. These findings support the importance of addressing specific obsessive beliefs to improve sexuality in OCD patients.
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Pozza A, Casale S, Marazziti D, Albert U, Mucci F, Berti E, Grassi G, Prestia D, Dèttore D. Attachment styles and propensity for sexual response in adult obsessive-compulsive disorder. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1900805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Silvia Casale
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Erika Berti
- School of Psychology, University of Florence, Florence, Italy
| | | | - Davide Prestia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Infant-Maternal Science, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
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Dèttore D, Angelo NL, Marazziti D, Mucci F, Prestia D, Pozza A. A Pilot Study of Gender Differences in Sexual Arousal of Patients With OCD: The Moderator Roles of Attachment and Contamination Symptoms. Front Psychiatry 2021; 11:609989. [PMID: 33643081 PMCID: PMC7902707 DOI: 10.3389/fpsyt.2020.609989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/30/2020] [Indexed: 11/25/2022] Open
Abstract
Sexual arousal is often impaired in patients with obsessive-compulsive disorder (OCD). However, little is known about the factors related to this impairment: no study focused on the role of gender-based effects of attachment styles and contamination symptoms. The Dual Control Model assumes three processes driving sexual arousal: sexual excitation (SE), sexual inhibition (SI) due to threat of performance failure, and SI due to threat of performance consequences (e.g., getting contaminated with sexually transmitted diseases). In a group of OCD patients, we hypothesized that (a) women report lower SE and higher SI than men; (b) patients with insecure (both anxious and avoidant) attachment styles show lower SE and higher SI; (c) attachment styles moderate the relation between gender and sexual arousal (respectively, for women, higher attachment anxiety, and for men higher attachment avoidance were related to impaired sexual arousal (higher SE and SI) controlling for OCD severity); and (d) contamination symptoms moderate the relation between gender and sexual impairment (women with contamination symptoms show impaired sexual arousal). Seventy-two OCD patients (37.50% women) completed the Obsessive-Compulsive Inventory-Revised, Attachment Styles Questionnaire and Sexual Inhibition/Sexual Excitation Scales. In contrast with our hypotheses, women reported higher SE and lower SI due to threat of performance consequences than men. Patients with higher attachment avoidance (discomfort with intimacy) but also confidence in self and others had higher SE. Women with attachment avoidance (i.e., discomfort with intimacy) had lower SE, while women with attachment anxiety (i.e., preoccupations with relationships) had higher SI due to negative performance consequences. Women with contamination symptoms had higher SI due to performance failure but lower SI due to performance consequences. The present preliminary findings suggest that sexual arousal impairment should be evaluated during the assessment of OCD patients, and gender-based effects of attachment styles and contamination symptoms should be considered during personalized treatment planning.
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Affiliation(s)
- Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Davide Prestia
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
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Sexual Arousal in Obsessive-Compulsive Disorder With and Without Contamination/Washing Symptoms: A Moderating Role of Disgust Sensitivity. J Nerv Ment Dis 2020; 208:694-700. [PMID: 32366750 DOI: 10.1097/nmd.0000000000001184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Different findings would indicate that obsessive-compulsive disorder (OCD), a common psychiatric condition, might significantly impair intimate relationships and sexual well-being. The aim of the present study was to ascertain whether OCD outpatients with contamination/washing symptoms experience a lower sexual arousal than those experiencing other symptoms. In addition, we explored whether a higher disgust propensity/sensitivity might moderate the relation between contamination/washing symptoms and impaired sexual arousal. A total of 72 outpatients (27 with contamination/washing symptoms and 45 with other obsessive-compulsive symptoms) were selected for this study and assessed by a battery of specific rating scales. The results highlighted how OCD patients with contamination/washing symptoms and higher disgust sensitivity showed an increased propensity to inhibition due to threat of sexual performance failure and consequences. It may be speculated that the disgust sensitivity may be a mechanism involved in the impairment of this well-being domain. In conclusion, these findings suggest that the sexual wellbeing should be evaluated during routine clinical evaluation of OCD patients.
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Koolwal A, Agarwal S, Manohar S, Koolwal GD, Gupta A. Obsessive–Compulsive Disorder and Sexuality: A Narrative Review. JOURNAL OF PSYCHOSEXUAL HEALTH 2020. [DOI: 10.1177/2631831819896171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Obsessive–compulsive disorder (OCD) is one of the common psychiatric disorders. Despite being one of the basic aspects of biology, the sexual functioning in OCD patients has not received much attention, with there being very limited research on sexuality in these patients. In this review article, we try to take a look at the research on sexual functioning, sexual dysfunctions, and neurobiology of sexual dysfunctions in the anxiety disorders in general and in OCD specifically. We also take a look at the research on relationship functioning in the patients with OCD, a recently proposed entity, relationship-related obsessive compulsive phenomenon, at the sexual obsessions, and the sexual functioning in patients on active treatment for OCD. The overall research suggests that we should always take into account the sexual life and functioning of patients presenting with OCD.
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Affiliation(s)
- Arpit Koolwal
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Supriya Agarwal
- Department of Psychiatry, Subharti Medical College, Meerut, Uttar Pradesh, India
| | - Shivanand Manohar
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | | | - Anubha Gupta
- Department of Pathology, PGIMS, Rohtak, Haryana, India
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Slack P, Aziz VM. Sexuality and sexual dysfunctions in older people: a forgotten problem. BJPSYCH ADVANCES 2020. [DOI: 10.1192/bja.2019.80] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
SUMMARYThis article considers sexuality in older adults and the associated stereotypes and stigmas that lead to this area being underappreciated. Normal physiological changes in ageing are discussed and how they can cause sexual dysfunction. The elderly population has a higher burden of comorbid physical illness and this review considers evidence on the interplay between physical health and sexual health. Mental illness is also strongly linked with sexual functioning and is discussed, as is the evidence on psychotropics and sexual side-effects. Attitudes on sexuality in long-term care settings are highlighted and approaches to managing sexual disinhibition are included.
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Pozza A, Veale D, Marazziti D, Delgadillo J, Albert U, Grassi G, Prestia D, Dèttore D. Sexual dysfunction and satisfaction in obsessive compulsive disorder: protocol for a systematic review and meta-analysis. Syst Rev 2020; 9:8. [PMID: 31918750 PMCID: PMC6953228 DOI: 10.1186/s13643-019-1262-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/20/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is a chronic mental health condition recognized as one of the most serious causes of disability and impaired quality of life. In the literature, there is no review about sexual dysfunction and satisfaction in OCD. The current paper presents the protocol for a systematic review and meta-analysis aimed to summarize data (1) comparing the presence of sexual dysfunction between groups with OCD and non-clinical groups, (2) investigating prevalence of each one of the sexual dysfunctions in patients with OCD, (3) comparing risk for sexual dysfunction in OCD groups with the prevalence in control groups, (4) comparing sexual satisfaction between OCD groups and non-clinical groups, and (5) investigating moderators of sexual dysfunction in OCD groups as compared with control groups. Gender, age, marital status, OCD symptom severity and subtypes, comorbid depressive disorders, comorbid anxiety disorders, concurrent psychiatric medications, comorbid general medical disease, and study quality will be investigated as moderators. METHODS The protocol is reported according to PRISMA-P guidelines. The search will be conducted by independent reviewers during the second week of December 2019 by using electronic databases (Scopus, PubMed, EMBASE, PsycINFO, CINAHL, and the Cochrane Library), by contacting the authors of the included studies to identify further data, by examining the references of the included studies, and by handsearching conference proceedings and theses/doctoral dissertations. The study quality will be independently evaluated using the Newcastle-Ottawa Quality Assessment Scale. Random-effect meta-analyses will be computed. If there is insufficient data for a specific outcome, only a systematic review will be performed. DISCUSSION This review may support clinical practice highlighting the importance of the assessment of sexuality in patients with OCD and suggesting the use of therapeutic strategies dedicated to sexuality in this clinical population with the aim of improving patients' quality of life. Potential limitations will regard the heterogeneity of the studies in terms of the instruments used to assess sexual dysfunction/satisfaction and of the definitions used to conceptualize sexual dysfunction. SYSTEMATIC REVIEW REGISTRATION Prospero CRD42019132264.
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Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
| | - David Veale
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
- South London and Maudsley, NHS Trust, London, UK
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Jaime Delgadillo
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Davide Prestia
- Department of Neuroscience, Rehabilitation, Opthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa IRCCS San Martino, Genoa, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
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Xu C, Chen J, Cui Z, Wen R, Han H, Jin L, Wan G, Wei Z, Peng Z. Abnormal Anhedonia as a Potential Endophenotype in Obsessive-Compulsive Disorder. Neuropsychiatr Dis Treat 2020; 16:3001-3010. [PMID: 33324061 PMCID: PMC7733443 DOI: 10.2147/ndt.s268148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/02/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is often accompanied by cognitive, particularly executive function, impairments. Recently, anhedonia has emerged as an apparently important symptom of OCD reflecting altered emotion regulation. These two aspects are often comorbid in OCD. However, little is known about whether anhedonia may be a trait marker for OCD. METHODS To verify the role of executive function and evaluate the role of anhedonia in OCD and its relationship with OCD symptoms, we recruited 60 OCD patients, 30 unaffected first-degree relatives (FDRs), and 60 healthy controls (HCs). Participants completed psychometric testing to assess depression, anxiety, and anhedonia symptoms, as well as two cognitive tests to assess executive function, namely the Wisconsin Card Sorting Test (WCST) and the Stroop Color-Word Test (SCWT). RESULTS Compared to HCs, OCD patients and FDRs had significantly lower anticipatory and consummatory pleasure scores. The severity of anticipatory anhedonia correlated positively with obsessive-compulsive symptoms (r = 0.253, p = 0.009), even after controlling for depression and anxiety symptoms. Compared to HCs, OCD patients and FDRs made more errors and achieved fewer categories in the WCST. For all three SWCT components, OCD patients and FDRs took more time to name colors than HCs, but the three groups had similar numbers of errors. CONCLUSION This family-based study showed dampened pleasure together with cognitive dysfunction in OCD patients. The similar consummatory pleasure findings between OCD and FDR groups suggest anhedonia may be considered as a candidate OCD endophenotype.
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Affiliation(s)
- Chuanyong Xu
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Jierong Chen
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Zitian Cui
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Rongzhen Wen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Hongying Han
- Department of Psychiatry, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Lili Jin
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Guobin Wan
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Zhen Wei
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Ziwen Peng
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
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Pozza A, Marazziti D, Mucci F, Dèttore D. Propensity to Sexual Response among Adults with Obsessive-Compulsive Disorder. Clin Pract Epidemiol Ment Health 2019; 15:126-133. [PMID: 31819761 PMCID: PMC6882137 DOI: 10.2174/1745017901915010126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 11/22/2022]
Abstract
Background: Propensity to sexual excitation and inhibition is one of the key dimensions of sexuality. Clinicians working with Obsessive-Compulsive Disorder (OCD) patients rarely assess this and other aspects of sexuality, since treatment targets generally symptom reduction. Literature on sexual functioning in OCD patients is scarce and no study has focused on symptom subtypes, nor investigated the psychological processes related to sexual response. Objective: In the present short report, we describe an exploratory study investigating the association between symptom subtypes and propensity towards sexual excitation/inhibition in OCD patients, controlling for gender, age and antidepressant treatment. Methods: Seventy-two OCD patients (mean age = 34.50 years, 37.50% women) completed the Obsessive-Compulsive Inventory-Revised and the Sexual Inhibition/Sexual Excitation Scales. Results: Patients with more severe compulsive washing habit had a lower propensity towards excitation and a higher one towards inhibition due to threat of performance consequences (i.e., contamination with sexually transmitted diseases/having an unwanted pregnancy). Patients with more severe symptoms of checking showed a higher propensity towards inhibition due to the threat of performance consequences. Gender, age and antidepressant treatment were not related to sexual functioning. Conclusion: Specific OCD symptom subtypes may be associated with some psychological processes involved in sexual response. Sexual well-being should be carefully evaluated by practitioners and should be regarded as a treatment target. Future studies should investigate more comprehensively the processes involved in sexuality.
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Affiliation(s)
- Andrea Pozza
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Federico Mucci
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
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Abnormal spontaneous neural activity in the medial prefrontal cortex and right superior temporal gyrus correlates with anhedonia severity in obsessive-compulsive disorder. J Affect Disord 2019; 259:47-55. [PMID: 31437701 DOI: 10.1016/j.jad.2019.08.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 08/11/2019] [Accepted: 08/13/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUD Converging evidence indicated the presence of clinically significant anhedonia in patients with obsessive-compulsive disorder (OCD). Studying anhedonia and its neural correlates in OCD may be beneficial in understanding the pathophysiology and treatment of OCD. However, the neural mechanisms that underlie anhedonia in OCD still remain unclear. The present study was designed to bridge this research gap by using resting-state functional magnetic resonance imaging (fMRI). METHODS 29 OCD patients with anhedonia (OCD-AH), 31 OCD patients with normal hedonia (OCD-NH), and 30 healthy controls (HC) received the fMRI scan. The low-frequency fluctuation (ALFF) approach was applied to compare spontaneous neural activity among the three groups. Relationships between the regional ALFFs and anhedonia levels were examined in OCD patients. RESULT OCD-AH and OCD-NH manifested overlapping but partially distinct brain alterations. Notably, compared to OCD-NH, the OCD-AH showed decreased ALFF in right superior temporal gyrus (STG) and increased ALFF in medial prefontal cortex (MPFC). Moreover, ALFF values in the right STG were negatively correlated with social anhedonia severity, and ALFFs in the MPFC were positively correlated with both physical and social anhedonia severity in patients with OCD. LIMITATIONS Relatively small sample size; ALFF could not provide more holistic information of brain network. CONCLUSION The present study revealed that abnormal spontaneous neural activity in MPFC is associated with both physical and social anhedonia, while altered intrinsic brain function in right STG is specifically associated with social anhedonia in OCD. These findings contribute to our understandings of the neurobiological mechanisms underlying anhedonia in OCD.
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Li S, Zhang Y, Fan J, Liu W, Gan J, He J, Yi J, Tan C, Zhu X. Patients With Obsessive-Compulsive Disorder Exhibit Deficits in Consummatory but Not Anticipatory Pleasure. Front Psychol 2019; 10:1196. [PMID: 31231272 PMCID: PMC6558405 DOI: 10.3389/fpsyg.2019.01196] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 05/07/2019] [Indexed: 11/14/2022] Open
Abstract
Background: Reward dysfunctions have been reported in obsessive-compulsive disorder (OCD), which implicates a high possibility of anhedonia for this disease. However, several components of anhedonia, such as consummatory and anticipatory pleasure, has not been substantially studied in OCD patients. Methods: The Chinese version of the Temporal Experience of Pleasure Scale (CV-TEPS) was used to evaluate both the consummatory and anticipatory pleasure in 130 OCD patients, 89 major depressive disorder (MDD) patients, and 95 healthy controls (HCs). The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Beck Depression Inventory (BDI) were scored for assessing the severity of obsessive and compulsive symptoms and depressive symptoms, respectively. Analyses of covariance (ANCOVA) were used to compare the differences of anhedonia among the three groups with the severity of depression controlled. Regression analyses were also used to analyze the relationship between consummatory and anticipatory pleasure and clinical variables in OCD patients. Results: After controlling for the effect of depression, there were significant differences in TEPS scores among the three groups (p < 0.05). Compared with HCs, OCD patients had lower scores on the consummatory subscale, but not the anticipatory subscale, of the TEPS. MDD patients had lower scores on both the consummatory and anticipatory subscales than HCs. Conclusion: OCD patients exhibit deficits in consummatory but not anticipatory pleasure, which is distinct from MDD patients.
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Affiliation(s)
- Sihui Li
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Medical Psychological Institute of Central South University, Changsha, China
| | - Yi Zhang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jie Fan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wanting Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jun Gan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jing He
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jinyao Yi
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Changliang Tan
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiongzhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Medical Psychological Institute of Central South University, Changsha, China
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Montejo AL, Montejo L, Baldwin DS. The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management. World Psychiatry 2018; 17:3-11. [PMID: 29352532 PMCID: PMC5775119 DOI: 10.1002/wps.20509] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment-related sexual adverse events tend to persist over time, and are unfortunately under-recognized by clinicians and scarcely investigated in clinical trials. Treatment-emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action. Antidepressants with a predominantly serotonergic activity, antipsychotics likely to induce hyperprolactinaemia, and mood stabilizers with hormonal effects are often linked to moderate or severe sexual dysfunction, including decreased libido, delayed orgasm, anorgasmia, and sexual arousal difficulties. Severe mental disorders can interfere with sexual function and satisfaction, while patients wish to preserve a previously satisfactory sexual activity. In many patients, a lack of intimate relationships and chronic deterioration in mental and physical health can be accompanied by either a poor sexual life or a more frequent risky sexual behaviour than in the general population. Here we describe the influence of psychosis and antipsychotic medications, of depression and antidepressant drugs, and of bipolar disorder and mood stabilizers on sexual health, and the optimal management of patients with severe psychiatric illness and sexual dysfunction.
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Affiliation(s)
- Angel L Montejo
- Department of Nursing and Institute of Biomedicine of Salamanca, Neurosciences Area, University Hospital of Salamanca, Salamanca, Spain
| | - Laura Montejo
- Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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Ciocca G, Ochoa S, Jannini EA. Epidemiology of Sexual Dysfunctions in Persons Suffering from Psychiatric Disorders. TRENDS IN ANDROLOGY AND SEXUAL MEDICINE 2018. [DOI: 10.1007/978-3-319-68306-5_4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Abstract
PURPOSE OF REVIEW Sexual dysfunction is a frequent issue in patients with affective disorders, affecting its quality of life and posing challenges to the approach of these patients. RECENT FINDINGS In recent years, human sexuality has attracted interest from the scientific community, and today we have a much deeper knowledge of the mechanisms involved in the sexual response. Paraphilias or sexual dysfunctions like low sexual desire, premature ejaculation, and erectile dysfunction, are frequent in affective disorders, and the frequency of each sexual problem varies according to the affective disorder. Comparing what is currently known about the sexual response with the main neurobiological findings of depressive, anxiety, obsessive-compulsive and posttraumatic stress disorders, it is possible to better understand specific sexual complaints of patients with these disorders. SUMMARY A better understanding of sexual function in affective disorders may help clinicians to choose treatments more suited to specific needs of these patients. Although the current state of science already allows us to have some understanding about sexual function in affective disorders, this critical area of research is still in its infancy, waiting for more investment.
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Ghassemzadeh H, Raisi F, Firoozikhojastefar R, Meysamie A, Karamghadiri N, Nasehi AA, Fallah J, Sorayani M, Ebrahimkhani N. A Study on Sexual Function in Obsessive-Compulsive Disorder (OCD) Patients With and Without Depressive Symptoms. Perspect Psychiatr Care 2017; 53:208-213. [PMID: 27061854 DOI: 10.1111/ppc.12160] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/16/2016] [Accepted: 02/03/2016] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of study was to evaluate sexual function in obsessive-compulsive disorder (OCD) patients with and without depressive symptoms. DESIGN AND METHOD Fifty-six married OCD patients referred to the outpatient clinic of Roozbeh Hospital from 2011 to 2013 filled out the demographic questionnaire, obsessive compulsive inventory-revised OCI-R, Maudsley obsessional-compulsive inventory (MOCI), Beck depression inventory-II (BDI-II), international index of erectile function (IIEF), and female sexual function index (FSFI). FINDINGS In total, 80.6% of women and 25% of men had sexual dysfunction and 82% of them had depressive symptoms. Comparing sexual dysfunction in OCD patients with and without depressive symptoms demonstrated that the mean index of IIEF in subscales of erection and satisfaction without depressive symptoms (BDI-II index ≤ 15) is higher than in those with depressive symptoms and the mean index of FSFI showed a marginal significance in the pain subscale of the FSFI. PRACTICE IMPLICATIONS Regarding the possible role of the symptoms of depression on sexual function, sexual assessment in OCD patients should be considered.
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Affiliation(s)
- Habibollah Ghassemzadeh
- Habibollah Ghassemzadeh, PhD, is Professor of Psychology in the Department of Psychiatry, Roozbeh Psychiatry Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Firoozeh Raisi
- Firoozeh Raisi, MD, is Psychiatrist in Psychiatric and Clinical Psychology Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Reihaneh Firoozikhojastefar
- Reihaneh Firoozikhojastefar, MSc, is Master in Psychology in Psychosexual Department, Roozbeh Hospital, Tehran, Iran
| | - Alipasha Meysamie
- Alipasha Meysamie, MD, MPH, is Professor in Community and Preventive Medicine, Medical Faculty, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Karamghadiri
- Narges Karamghadiri, MSc, is PhD Student of Health Psychology in Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Ali Nasehi
- Abbas Ali Nasehi, MD, is Psychiatrist at Iran Helal Institute of Applied Science & Technology, Tehran, Iran
| | - Jalil Fallah
- Jalil Fallah, MD, is Psychiatrist, Department of Health, National Organization for Civil Registration, Tehran, Iran
| | - Maryam Sorayani
- Maryam Sorayani, MD, is Psychiatrist, Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Ebrahimkhani
- Narges Ebrahimkhani, BA, is Master Student of Health Psychology, Department of Clinical Psychology, Bahonar Hospital, Alborz University of Medical Sciences, Alborz, Iran
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Forbes MK, Baillie AJ, Eaton NR, Krueger RF. A Place for Sexual Dysfunctions in an Empirical Taxonomy of Psychopathology. JOURNAL OF SEX RESEARCH 2017; 54:465-485. [PMID: 28121167 PMCID: PMC5433908 DOI: 10.1080/00224499.2016.1269306] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or "spectra"). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research.
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Affiliation(s)
- Miriam K Forbes
- a Departments of Psychiatry and Psychology , University of Minnesota
| | - Andrew J Baillie
- b Centre for Emotional Health and Centre of Research Excellence in Mental Health and Substance Use , Macquarie University
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Khajehei M, Doherty M. Exploring postnatal depression, sexual dysfunction and relationship dissatisfaction in Australian women. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/bjom.2017.25.3.162] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Marjan Khajehei
- Clinical midwifery consultant – women's health research, Westmead Hospital, Westmead, Sydney, Australia
| | - Maryanne Doherty
- Associate professor, Curtin University, Perth, Western Australia
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Sabetnejad Z, Assarian F, Omidi A, Najarzadegan MR. Effectiveness of cognitive behavioral therapy and fluoxetine on sexual function of women with obsessive compulsive disorder: A double-blind randomized controlled trial. Electron Physician 2016; 8:3156-3163. [PMID: 28070247 PMCID: PMC5217806 DOI: 10.19082/3156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 07/28/2016] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is a mental health concern due to its various negative consequences, especially in sexual function. Therefore, the treatment of sexual dysfunction in women with OCD is important in order to improve the patient's marital function and mental health. OBJECTIVES To compare the sexual behavior and sexual and marital satisfaction in women with obsessive-compulsive disorder (OCD) before and after treatment with fluoxetine and cognitive behavior therapy. METHODS This randomized clinical trial was conducted at psychiatric and psychological counseling centers in Kashan (Iran) from January 2, 2014, to December 29, 2014. Fifty-eight women with OCD were included in the study. In order to compare the effectiveness of pharmacological treatment (fluoxetine) and psychological treatment, cognitive behavior therapy (CBT), 58 female patients with OCD (diagnosed based on DSM-IV-T criteria) were randomized equally to either fluoxetine (at a dose of 60-80 mg daily for 3 months) or CBT (10 45-minute sessions). OCD and sexual behavior status of the patients before and after the intervention was assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Female Sexual Function Index (FSFI) questionnaire, respectively. The data were analyzed using SPSS version 22. To compare changes between the two groups, an independent T-test was used. Finally, the effects of all potential factors on treatment outcome were analyzed using factorial ANCOVA. RESULTS The mean score for OCD in the fluoxetine group was 25.6 ± 4.8 at the beginning of the experiment and 18.79 ± 4.26 at the end of the study, while in the CBT group it was 25.6 ± 4.8 and 18.79 ± 4.26, respectively. No significant differences were found between two groups regarding obsession score changes. These scores in fluoxetine group were 58.1 and 52.8, respectively (p=0.046). There was a significant difference between the two groups in terms of sexual performance (p=0.003). CONCLUSION In this study, our findings demonstrate a significant reduction in symptom severity of OCD after treatment with fluoxetine and CBT, indicating CBT can be an alternative for fluoxetine therapy in such patients. Therefore, both pharmacotherapy and CBT can be used for this purpose in clinical practices, but more studies are needed. CLINICAL TRIAL REGISTRATION The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2013091014619N1. FUNDING The authors received no financial support for the research, authorship, and/or publication of this article.
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Affiliation(s)
- Zahra Sabetnejad
- M.D., Psychiatrist, Department of Psychiatry, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Assarian
- M.D., Psychiatrist, Assistant Professor, Department of Psychiatry, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Abdollah Omidi
- Ph.D., Psychologist, Associate Professor, Department of Clinical Psychology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Reza Najarzadegan
- M.D., Psychiatry Resident, Department of Psychiatry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Abstract
Pleasurable sexual activity is important in many human relationships and can provide a sense of physical, emotional and social well-being. Depressive symptoms and depressive illness are associated with impairments in sexual function and sexual dissatisfaction in untreated and treated patients. Most currently available antidepressant drugs are associated with development or worsening of sexual dysfunction in a substantial proportion of patients. Sexual difficulties during antidepressant treatment often resolve as depression lifts, but can persist over long periods, reducing self-esteem and affecting mood and relationships adversely. Sexual difficulties during antidepressant treatment typically have many possible causes but the incidence and nature of dysfunction varies between drugs. Many interventions can be considered when managing sexual dysfunction associated with antidepressants but no approach is 'ideal'. Because treatment-emergent sexual difficulties are less frequent with certain drugs, presumably related to differences in pharmacological properties, and since current interventions are suboptimal, a lower incidence of sexual dysfunction is a relevant tolerability target when developing novel antidepressants.
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Abstract
Sexual problems are highly prevalent among patients with psychiatric disorders. They may be caused by the psychopathology of the psychiatric disorder but also by its pharmacotherapy. Both positive symptoms (e.g., psychosis, hallucinations) as well as negative symptoms (e.g., anhedonia) of schizophrenia may negatively interfere with interpersonal and sexual relationships. Atypical antipsychotics have fewer sexual side-effects than the classic antipsychotics. Mood disorders may affect libido, sexual arousal, orgasm, and erectile function. With the exception of bupropion, agomelatine, mirtazapine, vortioxetine, amineptine, and moclobemide, all antidepressants cause sexual side-effects. Selective serotonin reuptake inhibitors (SSRIs) may particularly delay ejaculation and female orgasm, but also can cause decreased libido and erectile difficulties. SSRI-induced sexual side-effects are dose-dependent and reversible. Very rarely, their sexual side-effects persist after SSRI discontinuation. This is often preceded by genital anesthesia. Some personality characteristics are a risk factor for sexual dysfunction. Also patients with eating disorders may suffer from sexual difficulties. So far, research into psychotropic-induced sexual side-effects suffers from substantial methodologic limitations. Patients tend not to talk with their clinician about their sexual life. Psychiatrists and other doctors need to take the initiative to talk about the patient's sexual life in order to become informed about potential medication-induced sexual difficulties.
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Affiliation(s)
- Marcel D Waldinger
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of BetaSciences, Utrecht University, Utrecht, The Netherlands.
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Thiel A, Thiel J, Oddo S, Langnickel R, Brand M, Markowitsch HJ, Stirn A. Obsessive-compulsive disorder patients with washing symptoms show a specific brain network when confronted with aggressive, sexual, and disgusting stimuli. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/15294145.2014.976649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Leeners B, Hengartner MP, Rössler W, Ajdacic-Gross V, Angst J. The role of psychopathological and personality covariates in orgasmic difficulties: a prospective longitudinal evaluation in a cohort of women from age 30 to 50. J Sex Med 2014; 11:2928-37. [PMID: 25358802 DOI: 10.1111/jsm.12709] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION There are little published data on the prevalence of orgasmic difficulties in representative samples and no longitudinal data on the subject. In addition, our knowledge of the factors, which increase or protect against the risk of orgasmic difficulties, is still rudimentary. AIM The aim of this study was to evaluate the cumulative incidence rate and longitudinal course of orgasmic difficulties from age 30 to age 50, and the role of psychopathological and personality covariates in a representative population cohort of women. METHODS Semi-structured interviews with single-item questions on sexual problems in general as well as on orgasmic difficulties were conducted. Psychopathological covariates were from the Symptom Checklist 90 Revised and personality characteristics from the Freiburg Personality Inventory. Coping resources were measured by the scales of mastery and self-esteem. MAIN OUTCOME MEASURES One-year prevalences of orgasmic difficulties, associations with psychopathological and personality covariates as well as coping resources were the main outcome measures. RESULTS Orgasmic difficulties were reported annually by 7.4% to 13.5% of the women with a mean of 10.0% and a cumulative risk of 27.3% from age 30 to 50. No relation between age and the prevalence of orgasmic difficulties could be demonstrated. Psychopathological covariates such as depression, psychoticism, interpersonal sensitivity, obsessive-compulsive symptoms, and somatization were moderately associated with orgasmic difficulties. Also, personality traits, i.e., nervousness, aggressiveness, depressiveness, irritability, sociability, and openness, were related to orgasmic difficulties. CONCLUSIONS With a cumulative risk of 27.3%, orgasmic difficulties represent a frequent sexual problem. Annual prevalence rates are particularly high in women with psychopathological characteristics and modestly related to various personality traits. Our findings support the relevance of psychosocial factors in the regulation of female orgasm. More basic research is needed to better understand underlying pathophysiological mechanisms and to improve diagnostic as well as therapeutic tools for women suffering from orgasmic difficulties.
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Affiliation(s)
- Brigitte Leeners
- Division of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
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Abramovitch A, Pizzagalli DA, Reuman L, Wilhelm S. Anhedonia in obsessive-compulsive disorder: beyond comorbid depression. Psychiatry Res 2014; 216:223-9. [PMID: 24564999 DOI: 10.1016/j.psychres.2014.02.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 01/31/2014] [Accepted: 02/01/2014] [Indexed: 01/08/2023]
Abstract
Obsessive-compulsive disorder (OCD) has been linked to reward dysfunctions, highlighting a possible role of anhedonia in OCD. Surprisingly, anhedonia in OCD has never been evaluated. Moreover, although nicotine typically has anti-anhedonic effects, anecdotal reports suggest low prevalence rates of smoking in OCD. To address these two phenomena, 113 individuals with OCD completed a battery of questionnaires assessing symptom severity, anhedonia, and smoking. 28.3% of the sample met criteria for clinically significant anhedonia, which correlated with Y-BOCS scores (r=0.44), even when controlling for depressive symptoms. 13.3% of the sample endorsed current smoking, a lower rate than seen in psychiatric disorders (40-90%) and the general adult population (19%). Results highlight high rates of anhedonia and yet reduced prevalence of smoking in OCD. In contrast to the known positive association between anhedonia and smoking, a negative association emerged. Future research is needed to address the unique interface between anhedonia and reward responsiveness in OCD. Potential clinical implications are discussed.
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Affiliation(s)
- Amitai Abramovitch
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Lillian Reuman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sabine Wilhelm
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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Brotto LA, Klein C. Psychological factors involved in women’s sexual dysfunctions. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/eog.09.67] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Baldwin DS, Palazzo MC, Masdrakis VG. Reduced treatment-emergent sexual dysfunction as a potential target in the development of new antidepressants. DEPRESSION RESEARCH AND TREATMENT 2013; 2013:256841. [PMID: 23431429 PMCID: PMC3575662 DOI: 10.1155/2013/256841] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 12/18/2012] [Accepted: 01/03/2013] [Indexed: 01/12/2023]
Abstract
Pleasurable sexual activity is an essential component of many human relationships, providing a sense of physical, psychological, and social well-being. Epidemiological and clinical studies show that depressive symptoms and depressive illness are associated with impairments in sexual function and satisfaction, both in untreated and treated patients. The findings of randomized placebo-controlled trials demonstrate that most of the currently available antidepressant drugs are associated with the development or worsening of sexual dysfunction, in a substantial proportion of patients. Sexual difficulties during antidepressant treatment often resolve as depression lifts but can endure over long periods and may reduce self-esteem and affect mood and relationships adversely. Sexual dysfunction during antidepressant treatment is typically associated with many possible causes, but the risk and type of dysfunction vary with differing compounds and should be considered when making decisions about the relative merits and drawbacks of differing antidepressants. A range of interventions can be considered when managing patients with sexual dysfunction associated with antidepressants, including the prescription of phosphodiesterase-5 inhibitors, but none of these approaches can be considered "ideal." As treatment-emergent sexual dysfunction is less frequent with certain drugs, presumably related to differences in their pharmacological properties, and because current management approaches are less than ideal, a reduced burden of treatment-emergent sexual dysfunction represents a tolerability target in the development of novel antidepressants.
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Affiliation(s)
- David S. Baldwin
- Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton SO14 3DT, UK
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - M. Carlotta Palazzo
- Department of Pathophysiology and Transplantation, University of Milan and Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Vasilios G. Masdrakis
- First Department of Psychiatry, Eginition Hospital, Athens University Medical School, 11528 Athens, Greece
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Real E, Montejo Á, Alonso P, Manuel Menchón J. Sexuality and obsessive-compulsive disorder: the hidden affair. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/npy.12.72] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kendurkar A, Kaur B. Major depressive disorder, obsessive-compulsive disorder, and generalized anxiety disorder: do the sexual dysfunctions differ? PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2012; 10:299-305. [PMID: 18787674 DOI: 10.4088/pcc.v10n0405] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/24/2007] [Accepted: 01/03/2008] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD) are known to have significant impact on sexual functioning. They have been studied individually. Therefore, this study was planned to compare the sexual dysfunction between MDD, OCD, and GAD with healthy subjects as controls. METHOD Four groups (MDD, OCD, GAD, and healthy subjects), matched for age, gender, marital status, and education status were identified by using the Psychiatric Diagnostic Screening Questionnaire. Subjects in these groups were assessed for absence of any major physical and psychiatric disorders. MDD, OCD, and GAD were rated for severity of illness by using the Hamilton Rating Scale for Depression, Yale-Brown Obsessive Compulsive Scale, and Hamilton Rating Scale for Anxiety, respectively. Subjects were evaluated with the Arizona Sexual Experiences Scale for sexual dysfunction, which was defined as either a score of ≥ 5 on any item or a total score of ≥ 17. Suitable statistical analysis was used to interpret the results. The study was conducted from May 2006 through July 2007. RESULTS Fifty patients in each group were selected. The rate of sexual dysfunction was 30% in healthy controls, 76% in MDD subjects, 50% in OCD subjects, and 64% in GAD subjects. Low desire was the most commonly reported dysfunction among all the categories (p < .001). No particular dysfunction was associated with the 4 categories under study. Severity of illness did not correlate with the severity of sexual dysfunction. CONCLUSION Persons with MDD have more sexual dysfunction than those with OCD and GAD. These disorders had a pervasive affect on sexual functioning of the individuals.
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Affiliation(s)
- Arvind Kendurkar
- Ballarat Health Services Psychiatric Service, Victoria, Australia and the Department of Psychiatry, Chhatrapati Sahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India
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de Jong PJ, van Lankveld J, Elgersma HJ, Borg C. Disgust and Sexual Problems–Theoretical Conceptualization and Case Illustrations. Int J Cogn Ther 2010. [DOI: 10.1521/ijct.2010.3.1.23] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Sexual dysfunction in depression and anxiety: conceptualizing sexual dysfunction as part of an internalizing dimension. Clin Psychol Rev 2009; 29:573-85. [PMID: 19632022 DOI: 10.1016/j.cpr.2009.06.007] [Citation(s) in RCA: 143] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Revised: 06/13/2009] [Accepted: 06/15/2009] [Indexed: 12/26/2022]
Abstract
Sexual dysfunction is often implicated in depression and anxiety disorders, but the current nosology of sexual dysfunction, depression, and anxiety (i.e., DSM-IV) does not adequately address these relationships. Because recent papers (Krueger, R. F., & Markon, K. E. (2006). Reinterpreting comorbidity: A model-based approach to understanding and classifying psychopathology. Annual Review of Clinical Psychology, 2, 111-133) have suggested and provided evidence for latent internalizing and externalizing dimensions that help explain high comorbidity between mental disorders, the current paper suggests that sexual dysfunction might conceptually belong to a latent internalizing factor. To address this, evidence is presented for the relationship among disorders of sexual desire, arousal, and orgasm comorbid with depression and anxiety. A review of sexual disorders is also presented along with a critical examination of the way the current DSM is organized with respect to sexual dysfunction, depression, and anxiety.
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Braun CMJ, Léveillé C, Guimond A. An orbitofrontostriatopallidal pathway for morality: evidence from postlesion antisocial and obsessive-compulsive disorder. Cogn Neuropsychiatry 2008; 13:296-337. [PMID: 18622787 DOI: 10.1080/13546800802088580] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION A detailed proposal is made to the effect that nonlesional antisocial personality disorder (APD) is, among other things, a dysfunctional hypomoralism and that nonlesional obsessive-compulsive disorder (OCD) is, among other things, a dysfunctional hypermoralism. METHOD To provide an empirical test of this proposal, 25 previously published cases of acquired (post lesion) APD and 39 cases of acquired OCD are reviewed and compared with multivariate inference tests. RESULTS The acquired APD patients most often present putamenal or pallidal lesions. CONCLUSION The ensemble of neurobiological, endocrine, and behavioural traits in APD and OCD, as well as the distinct lesion sites in the acquired variants, support the notion of an orbitofrontostriatopallidal brain system underlying morality.
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Norberg MM, Calamari JE, Cohen RJ, Riemann BC. Quality of life in obsessive-compulsive disorder: an evaluation of impairment and a preliminary analysis of the ameliorating effects of treatment. Depress Anxiety 2008; 25:248-59. [PMID: 17352377 DOI: 10.1002/da.20298] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Despite the substantial impairments in life functioning associated with obsessive-compulsive disorder (OCD), treatment outcome evaluations have focused almost exclusively on symptom reduction, a focus that may be too narrow to determine whether clinically significant change has occurred. Quality of life (QOL) impairment was evaluated in a clinical OCD sample (N=188) using a multidimensional life satisfaction measure. Relationships between treatment response and QOL change also were evaluated with a subsample of participants (n=120). Congruent with previous studies of OCD, substantial pretreatment QOL impairment was found across all life domains. Distinct treatment change subgroups were identified: a group reporting strong symptom reduction and very good QOL gains, a second group with significant symptom reduction but less robust QOL improvements, and a third group with limited symptom gains and QOL decreases. Implications for understanding OCD-related impairment and the clinical significance of treatment outcomes are discussed.
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Affiliation(s)
- Melissa M Norberg
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
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Fontenelle LF, de Souza WF, de Menezes GB, Mendlowicz MV, Miotto RR, Falcão R, Versiani M, Figueira IL. Sexual function and dysfunction in Brazilian patients with obsessive-compulsive disorder and social anxiety disorder. J Nerv Ment Dis 2007; 195:254-7. [PMID: 17468686 DOI: 10.1097/01.nmd.0000243823.94086.6f] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We compared the history, the profile, and the severity of sexual symptoms of 31 patients with obsessive-compulsive disorder (OCD) to those of 26 patients with social anxiety disorder (SAD) by means of the Sexual Inventory of the Institute of Psychiatry of the Federal University of Rio de Janeiro, the Clinical Interview for the Diagnosis of DSM-IV Sexual Disorders, the Female Sexual Function Index, the International Index of Erectile Function, the Arizona Sexual Experience Scale, and the Sexual Behavior Inventory. Patients with OCD reported more difficulties to reach orgasm (p = 0.009), less frequent effective erections (p = 0.05), and a positive history of sexual abuse (p = 0.006) significantly more often than patients with SAD. Male patients with SAD reported not using contraceptive methods significantly more frequently than male patients with OCD (p = 0.007). Patients with OCD and patients with SAD exhibit different profiles of sexual behavior.
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Affiliation(s)
- Leonardo F Fontenelle
- Anxiety and Depression Research Program, Institute of Psychiatry, Universidade Federal of Rio de Janeiro, Rio de Janeiro, Brazil.
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