The impact of affective symptoms and mood instability on sexual desire and sexual distress in newly diagnosed bipolar disorder: a longitudinal study.

BACKGROUND

Fluctuations in mood and energy are clinically acknowledged to impact sexual functioning in bipolar disorder (BD), however, research is limited, with no longitudinal studies. This study investigates the impact of affective symptoms on sexual desire and sexual distress over six months.

METHODS

Affective symptoms were assessed using the Hamilton Depression Rating Scale (HDRS-17), Young Mania Rating Scale (YMRS), and daily smartphone-based mood ratings. Sexual outcomes comprised sexual desire measured by the Changes in Sexual Functioning Questionnaire (CSFQ-14) and sexual distress measured by the Sexual Distress Scale (SDS). Linear mixed models examined associations of affective symptoms and mood instability with sexual function and distress.

RESULTS

A total of 236 individuals aged 18 to 68 years with newly diagnosed BD were included. Higher HDRS-17 scores were significantly associated with decreased sexual desire (β=-0.06, 95% CI = [-0.10, -0.02], p=0.004) and increased sexual distress (β=0.31, 95% CI = [0.22, 0.40], p < 0.001). Higher YMRS scores were significantly associated with increased sexual desire (β=0.07, 95% CI [-0.02, -0.13], p=0.011), and increased mood instability with increased sexual distress (β=1.87, 95% CI [-0.30, 03.44], p=0.020). Intraclass correlation coefficients showed that 63-67% of the variance in sexual desire and distress was due to inter-individual differences.

CONCLUSIONS

In individuals with newly diagnosed BD observed over time, sexual desire was associated with depressive and manic symptoms, while sexual distress was associated with depressive symptoms and mood instability. Association with mood instability and inter-individual variability in sexual outcomes highlights the need to address sexuality both during and between episodes.