Erez Galit, Pilver Corey E, Potenza Marc N
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Shalvata Mental Health Center, Hod Hasharon, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
J Psychiatr Res. 2014 Aug;55:117-25. doi: 10.1016/j.jpsychires.2014.04.009. Epub 2014 Apr 19.
Sexual impulsivity (SI) has been associated with conditions that have substantial public health costs, such as sexually transmitted infections and unintended pregnancies. However, SI has not been examined systematically with respect to its relationships to psychopathology. We aimed to investigate associations between SI and psychopathology, including gender-related differences.
We performed a secondary data analysis of Wave-2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national sample of 34,653 adults in the United States. DSM-IV-based diagnoses of mood, anxiety, drug and personality disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Scheduled DSM-IV Version.
The prevalence of SI was considerable (14.7%), with greater acknowledgment by men than women (18.9% versus 10.9%; p < 0.0001). For both women and men, SI was positively associated with most Axis-I and Axis-II psychiatric disorders (OR range: Women, Axis-I:1.89-6.14, Axis-II:2.10-10.02; Men, Axis-I:1.92-6.21, Axis-II:1.63-6.05). Significant gender-related differences were observed. Among women as compared to men, SI was more strongly associated with social phobia, alcohol abuse/dependence, and paranoid, schizotypal, antisocial, borderline, narcissistic, avoidant and obsessive-compulsive personality disorders.
The robust associations between SI and psychopathology across genders suggest the need for screening and interventions related to SI for individuals with psychiatric concerns. The stronger associations between SI and psychopathology among women as compared to men emphasize the importance of a gender-oriented perspective in targeting SI. Longitudinal studies are needed to determine the extent to SI predates, postdates or co-occurs with specific psychiatric conditions.
性冲动(SI)与诸如性传播感染和意外怀孕等有着巨大公共卫生成本的情况相关联。然而,SI与精神病理学之间的关系尚未得到系统研究。我们旨在调查SI与精神病理学之间的关联,包括性别相关差异。
我们对全国酒精及相关状况流行病学调查(NESARC)的第二波数据进行了二次分析,该调查是对美国34,653名成年人的全国性抽样。使用酒精使用障碍及相关残疾访谈表DSM-IV版对基于DSM-IV的情绪、焦虑、药物和人格障碍诊断进行评估。
SI的患病率相当高(14.7%),男性的承认率高于女性(18.9%对10.9%;p<0.0001)。对于男性和女性而言,SI与大多数轴I和轴II精神障碍呈正相关(OR范围:女性,轴I:1.89 - 6.14,轴II:2.10 - 10.02;男性,轴I:1.92 - 6.21,轴II:1.63 - 6.05)。观察到显著的性别相关差异。与男性相比,女性中的SI与社交恐惧症、酒精滥用/依赖以及偏执、分裂样、反社会、边缘性、自恋、回避型和强迫型人格障碍的关联更强。
SI与跨性别精神病理学之间的紧密关联表明,对于有精神问题的个体,需要进行与SI相关的筛查和干预。与男性相比,女性中SI与精神病理学之间更强的关联强调了在针对SI时采用性别导向视角的重要性。需要进行纵向研究以确定SI在特定精神状况之前、之后或与之同时出现的程度。