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Prevalence of sexual dysfunctions and other sexual disorders in adults with attention-deficit/hyperactivity disorder compared to the general population

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is characterized by symptoms of inattention and/or hyperactivity and impulsivity that lead to dysfunctioning in daily life. One of the affected areas of life that has so far not been studied in ADHD is sexual functioning. The goal of this study was to assess prevalence of sexual dysfunctions and other sexual disorders among adults with ADHD. A total of n = 136 adult patients treated in a Dutch outpatient ADHD clinic filled out two questionnaires to screen for sexual dysfunctions and other sexual disorders. We compared the prevalence of sexual dysfunctions and other sexual disorders in our ADHD patient population to results from two large surveys among the general Dutch population. We found that 39% of the male and 43% of the female ADHD patients had symptoms of a sexual dysfunction, and 17% of the male and 5% of the female ADHD patients had symptoms of any other sexual disorder. Only one male patient had received a diagnosis of a sexual disorder at this clinic prior to study participation. In conclusion, sexual dysfunctions and other sexual disorders are highly prevalent in adults with ADHD. Screening for sexual disorders should be therefore standard procedure during diagnostic assessment.

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References

  1. APA (2000) Diagnostic and statistical manual of mental disorders, 4th edition, Text Revision (DSM-IV-TR). American Psychiatric Association, Washington DC

    Google Scholar 

  2. Bakker F, Vanwesenbeeck I (2006) Seksuele gezondheid in Nederland 2006. [Sexual health in The Netherlands 2006]. Eburon, Delft

    Google Scholar 

  3. Bakker F, de Graaf H, de Haas S, Kedde H, Kruijer H, Wijsen C (2009) Seksuele gezondheid in Nederland 2009. [Sexual health in The Netherlands 2009]. Rutgers Nisso Groep, Utrecht

    Google Scholar 

  4. Barkley RA, Biederman J (1997) Toward a broader definition of the age-of-onset criterion for attention- deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 36(9):1204–1210

    CAS  Article  PubMed  Google Scholar 

  5. Barkley RA, Fischer M, Smallish L, Fletcher K (2006) Young adult outcome of hyperactive children: adaptive functioning in major life activities. J Am Acad Child Adolesc Psychiatry 45(2):192–202

    Article  PubMed  Google Scholar 

  6. Blocher D, Henkel K, Retz W, Retz-Junginger P, Thome J, Rosler M (2001) Symptome aus dem Spektrum des hyperkinetischen Syndroms bei Sexualdeliquenten [Symptoms from the spectrum of attention-deficit/hyperactivity disorder (ADHD) in sexual delinquents]. Fortschr Neurol Psychiatr 69(10):453–459

    CAS  Article  PubMed  Google Scholar 

  7. Briscoe-Smith AM, Hinshaw SP (2006) Linkages between child abuse and attention-deficit/hyperactivity disorder in girls: behavioral and social correlates. Child Abuse Negl 30(11):1239–1255. doi:10.1016/j.chiabu.2006.04.008

    Article  PubMed  PubMed Central  Google Scholar 

  8. Brown LK, Hadley W, Stewart A, Lescano C, Whiteley L, Donenberg G, DiClemente R (2010) Psychiatric disorders and sexual risk among adolescents in mental health treatment. J Consult Clin Psychol 78(4):590–597

    Article  PubMed  PubMed Central  Google Scholar 

  9. Canu WH, Carlson CL (2003) Differences in heterosocial behavior and outcomes of ADHD-symptomatic subtypes in a college sample. J Atten Disord 6(3):123–133

    CAS  Article  PubMed  Google Scholar 

  10. Donahue KL, Lichtenstein P, Lundstrom S, Anckarsater H, Gumpert CH, Langstrom N, D’Onofrio BM (2013) Childhood behavior problems and adolescent sexual risk behavior: familial confounding in the child and adolescent twin study in Sweden (CATSS). J Adolesc Health 52(5):606–612. doi:10.1016/j.jadohealth.2012.11.001

    Article  PubMed  PubMed Central  Google Scholar 

  11. Faraone SV, Sergeant J, Gillberg C, Biederman J (2003) The worldwide prevalence of ADHD: is it an American condition? World Psychiatry 2(2):104–113

    PubMed  PubMed Central  Google Scholar 

  12. Fava M, Rush AJ, Thase ME, Clayton A, Stahl SM, Pradko JF, Johnston JA (2005) 15 years of clinical experience with bupropion HCl: from bupropion to bupropion SR to bupropion XL. Prim Care Companion J Clin Psychiatry 7(3):106–113

    Article  PubMed  PubMed Central  Google Scholar 

  13. Fayyad J, de Graaf R, Kessler R, Alonso J, Angermeyer M, Demyttenaere K et al (2007) Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry 190:402–429. doi:10.1192/bjp.bp.106.034389

    CAS  Article  PubMed  Google Scholar 

  14. Flory K, Molina BS, Pelham WE, Gnagy E, Smith B (2006) Childhood ADHD predicts risky sexual behavior in young adulthood. J Clin Child Adolesc Psychol 35(4):571–577

    Article  PubMed  Google Scholar 

  15. Fuller-Thomson E, Lewis DA, Agbeyaka SK (2016) Attention-deficit/hyperactivity disorder casts a long shadow: findings from a population-based study of adult women with self-reported ADHD. Child Care Health Dev 42(6):918–927. doi:10.1111/cch.12380

    CAS  Article  PubMed  Google Scholar 

  16. Guay DR (2009) Drug treatment of paraphilic and nonparaphilic sexual disorders. Clin Ther 31(1):1–31. doi:10.1016/j.clinthera.2009.01.009

    CAS  Article  PubMed  Google Scholar 

  17. Guendelman MD, Ahmad S, Meza JI, Owens EB, Hinshaw SP (2016) Childhood attention-deficit/hyperactivity disorder predicts intimate partner victimization in young women. J Abnorm Child Psychol 44(1):155–166. doi:10.1007/s10802-015-9984-z

    Article  PubMed  PubMed Central  Google Scholar 

  18. Halley AC, Boretsky M, Puts DA, Shriver M (2016) Self-reported sexual behavioral interests and polymorphisms in the dopamine receptor D4 (DRD4) exon III VNTR in heterosexual young adults. Arch Sex Behav 45(8):2091–2100. doi:10.1007/s10508-015-0646-6

    Article  PubMed  Google Scholar 

  19. Hechtman L, Swanson JM, Sibley MH, Stehli A, Owens EB, Mitchell JT et al (2016) Functional adult outcomes 16 years after childhood diagnosis of attention-deficit/hyperactivity disorder: MTA results. J Am Acad Child Adolesc Psychiatry 55(11): 945–952 e942. doi: 10.1016/j.jaac.2016.07.774

  20. Homma Y, Wang N, Saewyc E, Kishor N (2012) The relationship between sexual abuse and risky sexual behavior among adolescent boys: a meta-analysis. J Adolesc Health 51(1):18–24. doi:10.1016/j.jadohealth.2011.12.032

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kafka MP (2012) Axis I psychiatric disorders, paraphilic sexual offending and implications for pharmacological treatment. Isr J Psychiatry Relat Sci 49(4):255–261

    PubMed  Google Scholar 

  22. Kafka MP, Prentky RA (1998) Attention-deficit/hyperactivity disorder in males with paraphilias and paraphilia-related disorders: a comorbidity study. J Clin Psychiatry 59(7):388–396

    CAS  Article  PubMed  Google Scholar 

  23. Kessler RC, Adler LA, Barkley R, Biederman J, Conners CK, Faraone SV et al (2005) Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood: results from the national comorbidity survey replication. Biol Psychiat 57(11):1442–1451

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kooij JJ (2013) Adult ADHD: diagnostic assessment and treatment, 3rd edn. Springer, London

    Book  Google Scholar 

  25. Kooij JJ, Francken MH (2010) Diagnostisch interview voor ADHD bij volwassenen versie 2.0 (DIVA 2.0) [Diagnostic interview for ADHD in adults]. DIVA Foundation, The Hague. Available online at: www.divacenter.eu

  26. Kooij JJ, Buitelaar JK, van den Oord EJ, Furer JW, Rijnders CA, Hodiamont PP (2005) Internal and external validity of attention-deficit hyperactivity disorder in a population-based sample of adults. Psychol Med 35(6):817–827. doi:10.1017/S003329170400337X

    Article  PubMed  Google Scholar 

  27. Lacelle C, Hebert M, Lavoie F, Vitaro F, Tremblay RE (2012) Child sexual abuse and women’s sexual health: the contribution of CSA severity and exposure to multiple forms of childhood victimization. J Child Sex Abus 21(5):571–592. doi:10.1080/10538712.2012.688932

    Article  PubMed  Google Scholar 

  28. Marsh LE, Norvilitis JM, Ingersoll TS, Li B (2012) ADHD symptomatology, fear of intimacy, and sexual anxiety and behavior among college students in China and the United States. J Atten Disord. doi:10.1177/1087054712453483

    PubMed  Google Scholar 

  29. Miner MH, Romine RS, Raymond N, Janssen E, MacDonald A 3rd, Coleman E (2016) Understanding the personality and behavioral mechanisms defining hypersexuality in men who have sex with men. J Sex Med 13(9):1323–1331. doi:10.1016/j.jsxm.2016.06.015

    Article  PubMed  PubMed Central  Google Scholar 

  30. Ouyang L, Fang X, Mercy J, Perou R, Grosse SD (2008) Attention-deficit/hyperactivity disorder symptoms and child maltreatment: a population-based study. J Pediatr 153(6):851–856. doi:10.1016/j.jpeds.2008.06.002

    Article  PubMed  Google Scholar 

  31. Pineiro-Dieguez B, Balanza-Martinez V, Garcia-Garcia P, Soler-Lopez B (2014) Psychiatric comorbidity at the time of diagnosis in adults with ADHD: the CAT study. J Atten Disord. doi:10.1177/1087054713518240

    PubMed  Google Scholar 

  32. Reid RC, Carpenter BN, Gilliland R, Karim R (2011) Problems of self-concept in a patient sample of hypersexual men with attention-deficit disorder. J Addict Med 5(2):134–140. doi:10.1097/ADM.0b013e3181e6ad32

    Article  PubMed  Google Scholar 

  33. Rucklidge JJ, Brown DL, Crawford S, Kaplan BJ (2006) Retrospective reports of childhood trauma in adults with ADHD. J Atten Disord 9(4):631–641. doi:10.1177/1087054705283892

    Article  PubMed  Google Scholar 

  34. Sarver DE, McCart MR, Sheidow AJ, Letourneau EJ (2014) ADHD and risky sexual behavior in adolescents: conduct problems and substance use as mediators of risk. J Child Psychol Psychiatry 55(12):1345–1353. doi:10.1111/jcpp.12249

    Article  PubMed  PubMed Central  Google Scholar 

  35. Simon V, Czobor P, Balint S, Meszaros A, Bitter I (2009) Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry 194:204–211. doi:10.1192/bjp.bp.107.048827

    Article  PubMed  Google Scholar 

  36. Snyder JA (2015) The link between ADHD and the risk of sexual victimization among college women: expanding the lifestyles/routine activities framework. Violence Against Women 21(11):1364–1384. doi:10.1177/1077801215593647

    Article  PubMed  Google Scholar 

  37. Soendergaard HM, Thomsen PH, Pedersen P, Pedersen E, Poulsen AE, Nielsen JM et al (2015) Education, occupation and risk-taking behaviour among adults with attention-deficit/hyperactivity disorder. Dan Med J 62(3):A5032

    PubMed  Google Scholar 

  38. Strang JF, Kenworthy L, Dominska A, Sokoloff J, Kenealy LE, Berl M et al (2014) Increased gender variance in autism spectrum disorders and attention deficit hyperactivity disorder. Arch Sex Behav 43(8):1525–1533. doi:10.1007/s10508-014-0285-3

    Article  PubMed  Google Scholar 

  39. Swanson JM, Sunohara GA, Kennedy JL, Regino R, Fineberg E, Wigal T et al (1998) Association of the dopamine receptor D4 (DRD4) gene with a refined phenotype of attention deficit hyperactivity disorder (ADHD): a family-based approach. Molecular Psychiatry 3(1):38–41

    CAS  Article  PubMed  Google Scholar 

  40. van Veen MM, Kooij JJ, Boonstra AM, Gordijn MC, van Someren EJ (2010) Delayed circadian rhythm in adults with attention-deficit/hyperactivity disorder and chronic sleep-onset insomnia. Biol Psychiatry 67(11): 1091–1096. doi: S0006-3223(10)00007-7 [pii] 10.1016/j.biopsych.2009.12.032 [doi]

  41. Voermans JM, Van HL, Peen J, Hengeveld MW (2012) Het bespreken van seksuele problemen door psychiaters en aiossen. [Is there adequate discussion between psychiatrists and their patients regarding patients’ sexual problems?]. Tijdschrift voor Psychiatrie 54(1): 9–16

  42. Vroege JA (1994) Vragenlijst voor het signaleren van Seksuele Dysfuncties (VSD, 5de versie) [Questionnaire for screening Sexual Dysfunctions (QSD, 5th version)]. Academisch Ziekenhuis Utrecht, Afdeling Medische Seksuologie/Nederlands Instituut voor Sociaal Sexuologisch Onderzoek, Utrecht

    Google Scholar 

  43. Vroege JA (1996) Vragenlijst voor het signaleren van seksuele dysfuncties (VSD). 4de versie: Validatiestudies. [Questionnaire for screening Sexual Dysfunctions (QSD). 4th version: validation studies]. Rijks Universiteit Leiden/Utrecht AZU, Leiden

    Google Scholar 

  44. Vroege JA (2003) De Vragenlijst voor het signaleren van Seksuele Dysfuncties (VSD). Bruikbaarheid in de klinische praktijk. [The Questionnaire for screening Sexual Dysfunctions (QSD). Usefulness in clinical practice]. Eburon, Delft

    Google Scholar 

  45. Yoon SYR, Jain U, Shapiro C (2012) Sleep in attention-deficit/hyperactivity disorder in children and adults: past, present, and future. Sleep Med Rev 16(4):371–388. doi:10.1016/j.smrv.2011.07.001

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank all of the study participants and the staff of the PsyQ Program Adult ADHD for inclusion of study participants. We thank Marieke Michielsen, Jessica Ontijd, and Henrieke Wesstein for their help with data-entry.

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Correspondence to D. Bijlenga.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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In loving memory of A.J.M. Stammen, MD, who passed away December 30, 2016.

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Bijlenga, D., Vroege, J.A., Stammen, A.J.M. et al. Prevalence of sexual dysfunctions and other sexual disorders in adults with attention-deficit/hyperactivity disorder compared to the general population. ADHD Atten Def Hyp Disord 10, 87–96 (2018). https://doi.org/10.1007/s12402-017-0237-6

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Keywords

  • Sexual dysfunction
  • Paraphilia
  • Hypersexuality
  • Gender identity disorder