Hypersexuality and couple relationships in bipolar disorder: A review

Kopeykina, Irina; Kim, Hae-Joon; Khatun, Tasnia; Boland, Jennifer K.; Haeri, Sophia; Cohen, Lisa J.; Galynker, Igor

doi:10.1016/j.jad.2016.01.035

Cited by 66 publications

(56 citation statements)

References 49 publications

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“…Patients often present their own affective states as mania, depression or mixture of both [18, 48], they also consistently show increased sexual thoughts, desire, and activity [15, 16]. The perception, cognition and behavior under erotic stimulation, might be linked to more excitation of cerebral areas such as the prefrontal, hypothalamus and cingulate cortices [49], which in turn delayed the activation of brainstem inhibitory interneurons, thus delaying the latencies of ES1 and ES2 under erotica.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, clinically, BD I patients presented increased sexual thoughts, desire, and activity [15, 16], while BD II patients often displayed diminished libido and sexual dysfunction [17]. In neuroimaging studies, during a negative-emotional task, BD I patients displayed a reduced activation of the left insula coupled with a reduced activation of the right supramarginal gyrus [18].…”

Section: Introductionmentioning

confidence: 99%

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Inhibitory brainstem reflexes under external emotional-stimuli in bipolar I and II disorders

Zhu¹,

Wang²,

Shen³

et al. 2017

BMC Psychiatry

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BackgroundBipolar disorder types I (BD I) and II (BD II) might present different dysfunctions of the cortex and brainstem, as reflected by the second exteroceptive suppression period of temporalis muscle activity (ES2) under different stimuli of external emotions.MethodsThis study included 30 BD I and 20 BD II patients, and 40 healthy volunteers. All participants were invited to answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression inventory, as well as to undergo the ES2 test under external emotional-stimuli (emotional pictures plus sounds) of Disgust, Erotica, Fear, Happiness, and Sadness.ResultsThe scale scores were elevated in both patient groups, but were not correlated with ES2 parameters. Compared to healthy controls, BD I showed prolonged ES2 latency under Erotica, and their perceived happiness and sadness intensities were negatively correlated with the respective ES2 durations, while BD II showed prolonged ES2 latencies under Disgust and Happiness, and shortened ES2 durations under Disgust, Happiness and Sadness. Moreover, ES2 duration under Sadness was significantly shorter in BD II than that in BD I.ConclusionsThe cortico-brainstem inhibitory dysfunctions in BD I and BD II was different, and this difference was independent of the patient’s ongoing emotions. Our study thus provides some hints to distinguish the two types of bipolar disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inhibitory brainstem reflexes under external emotional-stimuli in bipolar I and II disorders

Zhu¹,

Wang²,

Shen³

et al. 2017

BMC Psychiatry

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“…Male and female patients in manic or hypomanic episodes often experience hypersexuality, with an increased incidence of risky sexual behaviours 118 . By contrast, in depressive episodes, reduction of sexual desire is common.…”

Section: Bipolar Disorder and Sexual Dysfunctionmentioning

confidence: 99%

The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management

2018

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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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“…However, in line with a recent review (Kopeykina et al 2016), although patients with BD experience disease-specific impaired sexual functions, the existing literature on patients with BD sexual behaviour is mostly outdated. Novel research is thus needed to address sexual symptomatology in BD and longitudinal studies are important to disentangle the causal relationship between sexual distress, affective symptoms and QoL.…”

Section: Discussionmentioning

confidence: 89%

Sexual distress and quality of life among women with bipolar disorder

S�rensen

Giraldi

Vinberg

2017

Int J Bipolar Disord

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BackgroundInformation on the association between bipolar disorder (BD), sexual satisfaction, sexual function, sexual distress and quality of life (QoL) is sparse. This study aims, in women with BD, to (i) investigate sexual dysfunction, sexual distress, general sexual satisfaction and QoL; (ii) explore whether sexual distress was related to affective symptoms and (iii) investigate whether QoL was associated with sexual distress. The study is a questionnaire survey in an outpatient cohort of women with BD using: Changes in Sexual Functioning Questionnaire, Female Sexual Distress Scale, Altman Self-Rating Mania Scale (ASRM), Major Depression Inventory (MDI) and The World Health Organisation Quality of Life-Brief.ResultsIn total, 61 women (age range 19–63, mean 33.7 years) were recruited. Overall, 54% reported sexual distress (n = 33) and 39% were not satisfied with their sexual life (n = 24). Women with BD were significantly more sexually distressed in comparison with Danish women from the background population but they did not have a higher prevalence of impaired sexual function. Better sexual function was positively associated with ASRM scores while MDI scores were associated with more distress. Finally, the group of non-sexually distressed women with BD reported higher QoL scores compared with the sexually distressed group.ConclusionsWomen with BD exhibited a high prevalence of sexual distress and their sexual function seemed associated with their actual mood symptoms and perception of QoL.

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Hypersexuality and couple relationships in bipolar disorder: A review

Cited by 66 publications

References 49 publications

Inhibitory brainstem reflexes under external emotional-stimuli in bipolar I and II disorders

Inhibitory brainstem reflexes under external emotional-stimuli in bipolar I and II disorders

The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management

Sexual distress and quality of life among women with bipolar disorder

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