Obsessive-Compulsive Disorder, Sexual Obsessions and Sexual (Dys) Function: A Narrative Review

Abstract

Introduction: obsessions are common symptoms of Obsessive-Compulsive Disorder (OCD) that can cause great distress and can focus on various sexual themes: unwanted sexual thoughts, thoughts of violent sexual behaviour, obsessions about the fear of engaging in homosexual activity or sex with animals. Our aim is to discuss the findings from previous studies about sexual obsessions and sexual dysfunction in OCD, analyse compulsive sexual behaviour disorder and the sexual dysfunction associated with the pharmacological treatment of OCD. Material and Methods: A literature research was conducted using the “PubMed” database and the search equation was built using the terms: Obsessive Compulsive Disorder; Sexual Obsessions; “Compulsive Behaviour” and Sexual Function; 18 articles were selected for the discussion of this narrative review. Results and Discussion: Several studies have been conducted on sexual function in individuals with OCD. obsessions comprise intrusive, recurrent and persistent thoughts, images or concerns about sexual matters that do not usually prompt sexual behaviour. orientation obsessions and the related distress may be misunderstood as being the result of a sexual identity conflicts. obsessions and obsessive thoughts about self-impurity play a role in sexual dysfunction in OCD as well as relationship difficulties and pharmacological management of the disease. Some studies suggest an association between OCD and compulsive sexual behaviour disorder, however, repetitive sexual thoughts in compulsive sexual behaviour are egosyntonic, whereas the obsessions in OCD are egodystonic. Conclusions: The occurrence of sexual obsessions in OCD should be recognised and understood as an ordinary and non-threatening OCD symptom. The more specific neurobiological characteristics of OCD and its treatment seem to influence sexual function in unique ways. A better understanding of sexual function in OCD may help clinicians to choose treatments more suited to the specific needs of these patients.