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Objectives: Obsessive compulsive disorder (OCD) and Major Depression are known to have significant impact on sexual functioning. In this study, we assessed if the sexual dysfunctions differed according to the severity and subtypes of obsessions and compulsions in OCD patients, either with a comorbid Major Depression or alone.
Method: The study population consisted of 68 outpatients between 16-61 years of age with a DSM IV diagnosis of OCD, who were followed at the anxiety outpatient unit of Psychiatry Clinic of Sisli Hamidiye Etfal Research and Teaching Hospital between 2006-2009. Patients were evaluated with Structured Clinical Interview for DSM-IV (SCID-I) for OCD diagnosis, sociodemographic form, Arizona Sexual Experiences Scale (ASEX) for sexual dysfunction, Yale-Brown Obsessive-compulsive Scale (YBOCS) to assess the severity of the illness and YBOCS checklist to assess obsession and compulsion subtypes. Patients diagnosed as alcohol or substance dependence, physical illness, dementia and mental retardation were excluded.
Results: In our population 60.3% (n=41) of the patients had sexual dysfunction (SD) and 39.7% (n=27) had not. 77.9% (n=53) of the patients were female, 22.1% (n=15) were male. Sexual dysfunction was significantly higher in women (67.9%) than in men (33.3%). Medication or YBOCS severity did not affect sexual dysfunction. However, YBOCS Obsession scores were positively correlated with the scores of sexual arousal, ability to reach orgasm, satisfaction from orgasm in ASEX and ASEX total score. In OCD subtypes, patients with fear of contamination had sexual dysfunction. When we excluded the patients with Major Depression, the relation between sexual dysfunction and the fear of contamination was still significant.
Conclusion: Major Depression comorbidity in OCD patients increases the risk of sexual dysfunction. Fear of contamination in OCD patients significantly increases the risk of sexual dysfunction even in the absence of Major Depression comorbidity. OCD patients, especially the ones with the fear of contamination should be carefully assessed for sexual dysfunction and its implications to patient’s quality of life even before starting any medication.