Sexual Functioning in Adolescents With Major Depressive Disorder

Abstract

Objective: To examine sexual functioning in adolescents with depression.

Methods: Between September 2010 and March 2014, 235 participants who were between 15 and 20 years old and were unmedicated or within 1 month of beginning antidepressant treatment completed the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Changes in Sexual Functioning Questionnaire (CSFQ). They were also assessed to establish the presence of a DSM-IV-TR major depressive episode (MDE). The Student t test and χ² test were used to compare continuous and categorical variables, respectively, across participants with versus without MDE. Multivariable linear regression analysis examined the association between depression and sexual functioning.

Results: After the investigators controlled for age, female sex, antidepressant use, and the presence of generalized anxiety disorder, the presence of MDE was associated with a lower score on the CSFQ overall (P < .0007) and on its desire (P < .09), arousal (P < .001), and orgasm (P < .007) subscales. Antidepressants were not associated with sexual functioning either in the sample overall or in those with MDE. Beck Depression Inventory items related to affective symptoms (P < .03), rather than those tapping into neurovegetative or cognitive functioning, accounted for the association between depression and lower sexual functioning. Furthermore, with higher BDI scores, males exhibited a steeper decline than females in both the CSFQ total score and the desire subscale (sex × BDI score interaction effect: P < .03). Anxiety was not significantly associated with sexual functioning.

Conclusions: Major depressive disorder in older adolescents is associated with lower sexual functioning, particularly in males. This appears most related to affective symptoms. The potential impact of such impairment on future sexual functioning deserves further examination.

Trial registration: ClinicalTrials.gov identifier: NCT02147184.

Figure 1

Association between scores on the Beck Depression Inventory (BDI) and the Changes in Sexual functioning Questionnaire (CSFQ) for males and females. Vertical lines denote separation between adjacent categories of depression severity within the BDI. The Sex × BDI Score interaction effect was significant (p<0.04), after adjusting for age, sex, SSRI use, and BAI score. Least squares mean CSFQ scores were estimated separately for males and females for BDI score values of 7, 16, 24, and 45, representing median values of each depression severity category range.