Department of Psychology, Doha Institute for Graduate Studies, Doha, Qatar
Movement Disorders Group, Department of Neurology, University of Sao Paulo, Sao Paulo, Brazil.
BMJ Ment Health. 2024 May 22;27(1):e300998. doi: 10.1136/bmjment-2024-300998.
Hypersexuality (HS) accompanying neurological conditions remains poorly characterized despite profound psychosocial impacts. We aimed to systematically review the literature on HS in patients with neurological disorders. We conducted a systematic review to identify studies that reported HS in neurological disorders. HS was defined as a condition characterized by excessive and persistent preoccupation with sexual thoughts, urges, and behaviors that cause significant distress or impairment in personal, social, or occupational functioning. Data on demographics, assessment techniques, associated elements, phenotypic manifestations, and management strategies were also extracted. The final analysis included 79 studies on HS, encompassing 32 662 patients across 81 cohorts with neurological disorders. Parkinson's disease was the most frequently studied condition (55.6%), followed by various types of dementia (12.7%). Questionnaires were the most common assessment approach for evaluating HS, although the techniques varied substantially. Alterations in the dopaminergic pathways have emerged as contributing mechanisms based on the effects of medication cessation. However, standardized treatment protocols still need to be improved, with significant heterogeneity in documented approaches. Critical deficiencies include risks of selection bias in participant sampling, uncontrolled residual confounding factors, and lack of blinded evaluations of reported outcomes. Despite growth in the last decade, research on HS remains limited across neurological conditions, with lingering quality and methodological standardization deficits. Key priorities include advancing assessment tools, elucidating the underlying neurobiology, and formulating management guidelines.
CRD42017036478.
尽管对神经疾病患者的性欲亢进（HS）有深刻的社会心理影响，但对其的描述仍不完善。我们旨在对神经疾病患者的 HS 相关文献进行系统综述。我们进行了一项系统综述，以确定报告神经疾病中 HS 的研究。HS 被定义为一种以过度和持续的性思维、冲动和行为为特征的疾病，这些会导致个人、社会或职业功能的显著痛苦或损伤。还提取了人口统计学、评估技术、相关因素、表型表现和管理策略的数据。最终分析包括 79 项关于 HS 的研究，涵盖了 81 个神经疾病队列中的 32662 名患者。帕金森病是最常研究的疾病（55.6%），其次是各种类型的痴呆症（12.7%）。问卷是评估 HS 的最常见评估方法，尽管技术有很大差异。基于药物停药的影响，多巴胺能途径的改变已被认为是一种促成机制。然而，标准化治疗方案仍需改进，所记录的方法存在很大的异质性。关键缺陷包括参与者抽样的选择偏差风险、未控制的残余混杂因素以及报告结果的缺乏盲法评估。尽管在过去十年中有所增长，但神经疾病中 HS 的研究仍然有限，存在质量和方法学标准化的持续缺陷。主要重点包括推进评估工具、阐明潜在的神经生物学以及制定管理指南。
PROSPERO 注册号：CRD42017036478。
