Age of sexual initiation and depression in adolescents: Data from the 1993 Pelotas (Brazil) Birth Cohort

Identifying causal associations between early sexual intercourse or number of sexual partners and major depressive disorders: A bidirectional two-sample Mendelian randomization analysis

BACKGROUND

Early sexual intercourse and a greater number of sexual partners have been proved associated with depression. However, the causality of these associations is not clear.

METHODS

To unveil the causal associations between sexual factors and major depression disorder (MDD). The bidirectional, two-sample Mendelian randomization (MR) study was conducted, which used genetic variants associated with two sexual factors (age first had sexual intercourse, n = 406,457; lifetime number of sexual partners, n = 378,882) and MDD (n = 500,199) from the largest genome-wide association studies (GWASs) conducted by the UK biobank and the Psychiatric Genomics Consortium. The two-step MR analysis was applied to assess mediation. The Genetic predictors for five risky behaviors were also obtained from the most up-to-date GWAS conducted by the UK Biobank (ever self-harmed: 117,733; ever attempted suicide: 4933; psychoactive substance abuse, alcohol use, and tobacco use: 463,010).

RESULTS

MR analysis indicated a risky causal effect of age first had sexual intercourse (OR = 0.720, 95 % CI: 0.661-0.784, P = 2.45 × 10^-14) and lifetime number of sexual partners (OR = 1.656, 95 % CI: 1.356-2.022, P = 7.46 × 10^-7) on MDD. Mediation analysis showed the effects were mediated by tobacco use, with a proportion of 34.20 % on age first had sexual intercourse and 22.94 % on lifetime number of sexual partners separately.

LIMITATIONS

The overlap of participants in different traits and unclear gender.

CONCLUSIONS

Robust genetic evidence indicated that premature sexual intercourse and more sexual partners were risks for MDD. Risky behaviors, especially the tobacco use, mediated this effect.

Women's reproductive traits and major depressive disorder: A two-sample Mendelian randomization study

BACKGROUND

Evidence suggested strong associations between women's reproductive factors and major depressive disorder (MDD), but their causalities are unclear.

METHODS

Using female-specific SNPs as genetic instruments obtained from large-scale genome-wide association studies for women's reproductive traits, we designed two-sample univariable and multivariable Mendelian randomization (MR) analysis to evaluate the causal effects of women's reproductive traits on MDD. For both univariable MR (UVMR) and multivariable MR (MVMR), the inverse variance weighting estimates were reported as main results. MR-Egger, weighted median, and generalized summary-data-based MR (GSMR) methods for UVMR, and MVMR-Egger and MVMR-robust methods for MVMR were used as sensitivity analyses. Negative control analyses, MVMR of age at first birth (AFB) and age at first sexual intercourse (AFS) on MDD, and sex-combined genetic variants for AFB and AFS were performed to enhance the robustness of our study.

RESULTS

There was substantial evidence for associations of genetically predicted later age at menarche (AAM) (odds ratio (OR) = 0.97, 95 % confidence interval (CI) = 0.94-0.99, P = 0.007), AFB (OR = 0.91, 95 % CI = 0.86-0.97, P = 0.002) and AFS (OR = 0.70, 95 % CI = 0.60-0.80, P < 0.001) with lower MDD risk in UVMR. After adjustment of BMI and educational attainment using MVMR, we found consistently significant causal effects of AAM (OR = 0.95, 95 % CI = 0.92-0.99, P = 0.006), AFB (OR = 0.88, 95 % CI = 0.84-0.91, P < 0.001) and AFS (OR = 0.71, 95 % CI = 0.64-0.79, P < 0.001) on MDD.

CONCLUSIONS

Our results provide compelling evidence that early AAM, AFB, and AFS are risk factors for MDD. Promoting the cognition of reproductive health care for women may reduce the risk of MDD.

Risk Factors for Early Sexual Intercourse in Adolescence: A Systematic Review of Cohort Studies

This systematic review provides a comprehensive assessment of risk factors related to early sexual intercourse (ESI) among adolescents. We used PRISMA guidelines to identify eligible cohort studies published between January 1999 and December 2020. We searched on three databases: PubMed, Embase and LILACS. Studies were screened for quality and eligibility. Of 2787 identified studies, seven met our inclusion criteria. The studies examined a range of factors, which were organized into four dimensions - individual, family, social and environmental, and sociodemographic. Risk factors with strong associations for ESI were: adolescent and parental substance use, aggression and conduct disorders, family attachment, school achievement, family living situation, and maternal education. Three studies were birth cohorts. This review demonstrates the important roles of substance use, family attachment and academic factors in shaping adolescents' sexual behavior. A strength of this review is its focus on longitudinal studies, enabling exploration of exposures collected before initiation of sexual intercourse.

Influence of Selected Sociodemographic and Cultural Factors on the Age of Sexual Initiation of Students from Polish Universities

Sexuality is the one of the most important parts of human life. The aim of our study was to identify the factors influencing the onset and age of sexual initiation in students and drawing attention to the need to improve access to sexual education in Polish schools at a sufficiently high level. An original questionnaire with 31 questions was used for the study. Data were collected using the Google Forms tool. A total of 7528 students participated in the study and 5824 underwent sexual initiation. The mean age at sexual initiation was 18.1 years. Logistic regression analysis was performed to show factors influencing the onset of sexual activity, while linear regression analysis was used for factors influencing the age of sexual initiation. Religion, drug use, smoking, alcohol consumption, type of housing, and conversations with parents about contraception or sex affect the onset of sexual activity. The age of sexual initiation is affected by religion, the age of the first viewing of pornography, quality of life, the size of the city of residence, smoking and drug use.

Regional and Sex Differences in the Prevalence and Correlates of Early Sexual Initiation Among Adolescents Aged 12-15 Years in 50 Countries

PURPOSE

This study aimed to investigate the regional and sex differences in the prevalence of early sexual initiation and its correlates among school-going adolescents in 50 countries.

METHODS

We used data from the Global School-based Health Survey from 50 countries in 2009-2015 for 124,091 adolescents (53.5% girls) aged 12-15 years. Using meta-analysis with random effects, we estimated the prevalence of early sexual initiation (i.e., having first sexual intercourse at ≤14 years) by sex, region, and country income classification. Multilevel mixed-effect logistic regressions including a random intercept for countries were used to investigate the correlates of early sexual initiation.

RESULTS

Overall, 14.2% (95% confidence interval: 12.1-16.2) of adolescents aged 12-15 years had early sexual initiation, with boys reporting much higher than girls (19.7%, 16.9-22.5 vs. 8.9%, 7.6-10.3). The prevalence of early sexual initiation was the highest in the region of the Americas (18.4%, 15.2-21.5) and the lowest in the South-east Asia region (5.3%, 2.6-8.0). Adolescents from high-income and lower middle-income countries had the highest (19.5%, 13.5-25.5) and the lowest (7.3%, 5.5-9.0) prevalence, respectively. Older age, anxiety, loneliness, suicidal ideation, being bullied, physical fight, school truancy, smoking, drinking alcohol, illicit drug use, physical activity, and being overweight were associated with higher odds of early sexual initiation, whereas female sex, parental monitoring, and peer support were protective. There was little or no evidence of heterogeneity by sex and across regions for these associations.

CONCLUSIONS

Substantial differences in the prevalence are observed by sex and across regions for early sexual initiation among adolescents, whereas its correlates remain relatively similar when examined separately by these characteristics.

Prevalence and correlates of early sexual initiation among Brazilian adolescents

Background

Early adolescence is a critical stage in adolescents. This is the phase at which many young people start their sexual life early, increasing the risk of sexually transmitted infections and unintended pregnancy. Few studies have analyzed the factors associated with early sexual initiation in very young adolescents in low- and middle-income countries. Therefore, this study assessed the early sexual initiation stratified by sex and its correlates in a sample of Brazilian adolescents.

Methods

The study sample included Brazilian adolescents aged 12–14 who participated in The Study of Cardiovascular Risk in Adolescents (ERICA), a multicenter, school-based, country-wide, cross-sectional study. Early sexual initiation was defined as the first sexual intercourse at or before 14 years old. Multivariate logistic regression was used to identify independent factors associated with early sexual initiation.

Results

The prevalence of early sexual initiation was 7% among girls and 18% in boys. In a multivariate analysis, the adolescent’s age, mother’s schooling, smoking, alcohol consumption, and Tanner Stages were associated with early sexual initiation for both boys and girls. For girls, living with both parents, common mental disorders, and age at menarche were predictors of early sexual initiation, while race and type of school were correlated to early sexual initiation only for boys.

Conclusions

The early sexual initiation was associated with sociodemographic, lifestyle risk factors and secondary sexual characteristics in both sexes, while there were differences between the predictors of early sexual initiation among girls and boys. It emphasizes the importance of sex education and promotes healthy lifestyles in environments through families and schools in early adolescence.

Emotional Outcomes of Casual Sexual Relationships and Experiences: A Systematic Review

Casual sexual relationships and experiences (CSREs) are common and emotionally significant occurrences. Given the uncommitted, often emotionally complicated nature of CSREs, researchers have asked whether these experiences may have positive and/or negative emotional consequences. We reviewed 71 quantitative articles examining emotional outcomes of CSREs, including subjective emotional reactions (e.g., excitement, regret) and emotional health (e.g., depression, self-esteem). Overall, people evaluated their CSREs more positively than negatively. In contrast, CSREs were associated with short-term declines in emotional health in most studies examining changes in emotional health within a year of CSRE involvement. Emotional outcomes of CSREs differed across people and situations. Women and individuals with less permissive attitudes toward CSREs experienced worse emotional outcomes of CSREs. Alcohol use prior to CSREs, not being sexually satisfied, and not knowing a partner well were also associated with worse emotional outcomes. These findings suggest directions for prevention/intervention related to CSREs. For example, skill-building related to sexual decision-making may help individuals decide whether, and under what circumstances, CSREs are likely to result in positive or negative emotional outcomes. In addition, the limitations of extant research suggest directions for future inquiry (e.g., examining whether verbal and nonverbal consent practices predict emotional outcomes of CSREs).

Suicidal behavior among school-going adolescents in Bangladesh: findings of the global school-based student health survey

PURPOSE

Suicidal behavior, defined as non-fatal suicidal thoughts and behaviors that include having suicide ideation, plan, and attempts, is a leading cause of injury and death among adolescents globally. This study aimed to explore the prevalence of and the factors associated with suicidal behavior among school-going adolescents in Bangladesh.

METHODS

This study utilized data from the 2014 Global School-based Student Health Survey (GSHS), Bangladesh. A sample of (n = 2989) school-going adolescents aged 11-18 years was selected for this study. Risk factors of suicidal behavior were identified using a generalized estimating equation-modified Poison regression approach.

RESULTS

The age-adjusted prevalence of suicidal behavior among adolescents in Bangladesh was 11.7%. The result indicated that individual psychosocial factors such as loneliness [adjusted risk ratio (ARR) 1.36; 95% confidence interval (CI) 1.02-1.81], anxiety (ARR 2.01; 95% CI 1.43-2.81), being bullied (ARR 1.88; 95% CI 1.51-2.33), and having no close friends (ARR 2.30; 95% CI 1.77-2.97) were associated with increased likelihood of suicidal behavior. Health-risk behaviors such as ever having sexual intercourse, alcohol and drug abuse, and social-environmental factors, such as rare parental homework check, and lack of peer support were found to be positively associated with adolescents' suicidal behavior. Additionally, a dose-response relationship is observed between the experience of multiple adverse psychosocial factors and suicidal behavior.

CONCLUSION

Suicidal behavior is prevalent among school-going adolescents in Bangladesh. This study underscores the importance of early screening and interventions targeted to adolescents at risk, which might reduce the suicide rate among this population in Bangladesh.

The Impact of Sexual Initiation Timing and Sexual Experience on Depressive Symptoms in South Korean Adolescents: Gender Differences in a Nationwide Cross-Sectional Study

PURPOSE

This study utilized data from the Korea Youth Risk Behavior Survey to examine gender differences in the impact of sexual initiation, and age at sexual initiation, on depressive symptoms among Korean adolescents.

DESIGN AND METHODS

This study performed a secondary analysis of cross-sectional data from the 14th Korea Youth Risk Behavior Survey (2018). Data from 60,040 adolescents aged 12-18 were included in this study. The relationship between sexual experience, age at initiation, and depressive symptoms was analyzed with complex sample multiple logistic regression.

RESULTS

Overall, 5.7% of participants declared having had sexual experience. Sexual initiation tended to occur from grade 7 and above. In addition, 33.6% of girls and 21.1% of boys reported having depressive symptoms. Depressive symptoms were associated with sexual initiation experience, but depression symptoms were not associated with the timing of sexual initiation.

CONCLUSIONS

This study provides preliminary evidence of a relationship between sexual experience and depressive symptoms among adolescents; however, this relationship appeared independent of the timing of sexual initiation. These findings suggest that sexually active adolescents should be screened for depressive symptoms, regardless of gender.

PRACTICE IMPLICATIONS

This is the first study to examine the impact of sexual initiation and its timing on depressive symptoms among Korean adolescents. Sexual behaviors of Korean adolescents should be accounted for during the development of mental health policies aimed at young people. In addition, sexually active adolescents should be screened and monitored for depressive symptoms.

Association between Sexual Satisfaction and Depression and Anxiety in Adolescents and Young Adults

The role of sexual satisfaction in adolescents and young adults’ mental health has not been thoroughly investigated. The aim of this work is to study differences in sexual satisfaction and mental health (anxiety and depression) based on romantic relationship status (having a partner vs. not having one) and gender. Likewise, the association between sexual satisfaction and mental health and the moderating effect of romantic relationship status and gender was addressed in this research. A total of 1682 Spanish adolescents (14–17) and young adults (18–29) agreed to participate in this cross-sectional investigation. Two-factor ANOVA and MANOVA, and hierarchical regression models were utilized in this study. In general, results showed more difficulties in sexual satisfaction and mental health for those not in a current relationship and for women. Additionally, higher levels of sexual satisfaction was associated with lower levels of anxiety for adolescents and lower levels of depression for young adults. These associations were stronger for those in a current relationship. This study highlights the importance of sexual satisfaction as a modifying factor against mental health problems, especially in the context of a current romantic relationship.

A Person-Centered Approach to the Study of Black Adolescent Religiosity, Racial Identity, and Sexual Initiation

Decreasing the number of adolescents who have never had sexual intercourse is one way to address sexual health disparities. We used intersectionality to explore the joint effects of religiosity and racial identity on Black adolescent sexual initiation. Data originated from the National Survey of American Life-Adolescent (n = 1,170), a nationally representative study of Black adolescents. Latent profile analysis and survival analysis were used to evaluate study hypotheses. Results showed four distinct profiles of religiosity and racial identity. These profiles explained 19% of the variability in sexual initiation. Additional analyses revealed sociodemographic differences in profile membership. Findings contribute to understanding ethnic heterogeneity among Black adolescents and racial identity and religiosity as sociocultural factors that influence sexual initiation; and support reconceptualizing Black adolescent religiosity.

Prevalence and factors associated with Premenstrual Dysphoric Disorder: A community sample of young adult women

Premenstrual Dysphoric Disorder (PMDD) was recently included in DSM-5 as a full diagnostic category. Few studies have investigated PMDD in a community sample of young adults, especially in Brazil. Thus, the objective of this study was to evaluate the prevalence and the factors associated with PMDD in a community sample of 727 young adult women between the 18 and 24 years of age in southern Brazil. This was a cross-sectional population-based study. The data were collected from 2012 to 2014. PMDD was assessed using the Mini International Neuropsychiatry Interview (M.I.N.I. - Plus). The prevalence of PMDD was 17.6%. PMDD was significantly higher among older women, and in women from lower socio-economic status. A trend towards significance was found for women without a current occupation (study or work). The comorbidities significantly associated with PMDD were current major depression disorder, agoraphobia, bipolar disorder, current suicide risk, generalized anxiety disorder, social phobia, and specific phobia. The high prevalence found in the present study should be interpreted considering a retrospective report. However, our data showed that clinicians should be alert for PMDD symptoms, especially among young adult women.