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Boström ADE, Andersson P, Chatzittofis A, Savard J, Rask-Andersen M, Öberg KG, Arver S, Jokinen J. HPA-axis dysregulation is not associated with accelerated epigenetic aging in patients with hypersexual disorder. Psychoneuroendocrinology 2022; 141:105765. [PMID: 35452872 DOI: 10.1016/j.psyneuen.2022.105765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/15/2022] [Accepted: 04/10/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Hypersexual disorder (HD) - a nonparaphilic sexual desire disorder with impulsivity component - was evaluated for inclusion as a diagnosis in the DSM-5 and the diagnosis compulsive sexual behavior disorder is included as an impulse control disorder in the ICD-11. Hypothalamic-pituitary-adrenal (HPA)-axis hyperactivity is believed to affect cellular senescence and has been implicated in HD. No previous study investigated HD or HPA-axis dysregulation in relation to measures of epigenetic age (EA) acceleration. METHODS This study reports on a case-control study set-up from a well-characterized cohort, contrasting EA predictors in relation to 60 HD patients and 33 healthy volunteers (HV) and 19 mixed HD/HV exhibiting dexamethasone suppression test (DST) non-suppression to 73 mixed HD/HV DST controls. The genome-wide methylation pattern was measured in whole blood from 94 subjects using the Illumina Infinium Methylation EPIC BeadChip and preprocessed according to specialized protocols suitable for epigenetic age estimation. The online DNAm Age Calculator (https://dnamage. GENETICS ucla.edu/) was implemented to retrieve various EA predictors, which were compared between the in-silico generated subgroups. RESULTS Quality control analyses indicated strong correlations between the EA measure DNA methylation GrimAge (DNAm GrimAge - the EA clock most reliably associated with mortality risk) and chronological age in all sub-groups. The study was adequately powered to detect differences of 2.5 and 3.0 years in DNAm GrimAge minus age in relation to both HD and HPA-axis dysregulation, respectively. Baseline DNAm GrimAge exceeded chronological age by 2.8 years on average across all samples. No EA acceleration marker was associated with HD or DST suppression status (p > 0.05). CONCLUSION EA acceleration markers shown to be strongly predictive of physiological dysregulation and mortality-risk, are not related to HD or DST non-suppression status (measured after 0.5 mg dexamethasone). The independency of HPA-axis dysregulation to EA acceleration does not support the biological relevance of this dosage-regimen when applied to patients with HD. These findings do not support the notion of accelerated cellular senescence in HD. Studies stratifying DST non-suppressors according to established dosage-regimens in somatic settings are needed to fully elucidate the putative contribution of HPA-axis dysregulation to EA.
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Affiliation(s)
- Adrian Desai E Boström
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden; Department of Women's and Children's Health/Neuropediatrics, Karolinska Institutet, Stockholm, Sweden.
| | - Peter Andersson
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
| | - Andreas Chatzittofis
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden; Medical School, University of Cyprus, Nicosia, Cyprus
| | - Josephine Savard
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
| | - Mathias Rask-Andersen
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Katarina G Öberg
- Anova, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Arver
- Anova, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jussi Jokinen
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Dutta E, Naphade NM. Hypersexuality - a cause of concern: A case report highlighting the need for psychodermatology liaison. Indian J Sex Transm Dis AIDS 2018; 38:180-182. [PMID: 30148274 PMCID: PMC6085926 DOI: 10.4103/ijstd.ijstd_27_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Sexual addictions are behavioral addictions. Hypersexuality is used to describe non-paraphilic “excesses” of sexual behavior. Hypersexual disorder (HSD) can be accompanied by clinically significant social, personal distress, and medical morbidity. Common medical comorbidities seen with HSD are the sexually transmitted diseases (STDs). We present one such case with management. A psychodermatology liaison clinic would be the ideal one-stop for screening patients with STDs for HSD.
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Affiliation(s)
- Era Dutta
- Department of Mental and Behavioural Sciences, Fortis Group of Hospitals, Mumbai, Maharashtra, India
| | - Nilesh M Naphade
- Department of Psychiatry, Bharati Hospital, Bharati Vidyapeeth Medical College, Deemed University, Pune, Maharashtra, India
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Jokinen J, Boström AE, Chatzittofis A, Ciuculete DM, Öberg KG, Flanagan JN, Arver S, Schiöth HB. Methylation of HPA axis related genes in men with hypersexual disorder. Psychoneuroendocrinology 2017; 80:67-73. [PMID: 28319850 DOI: 10.1016/j.psyneuen.2017.03.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 01/26/2017] [Accepted: 03/03/2017] [Indexed: 12/21/2022]
Abstract
Hypersexual Disorder (HD) defined as non-paraphilic sexual desire disorder with components of compulsivity, impulsivity and behavioral addiction, and proposed as a diagnosis in the DSM 5, shares some overlapping features with substance use disorder including common neurotransmitter systems and dysregulated hypothalamic-pituitary-adrenal (HPA) axis function. In this study, comprising 67 HD male patients and 39 male healthy volunteers, we aimed to identify HPA-axis coupled CpG-sites, in which modifications of the epigenetic profile are associated with hypersexuality. The genome-wide methylation pattern was measured in whole blood using the Illumina Infinium Methylation EPIC BeadChip, measuring the methylation state of over 850K CpG sites. Prior to analysis, the global DNA methylation pattern was pre-processed according to standard protocols and adjusted for white blood cell type heterogeneity. We included CpG sites located within 2000bp of the transcriptional start site of the following HPA-axis coupled genes: Corticotropin releasing hormone (CRH), corticotropin releasing hormone binding protein (CRHBP), corticotropin releasing hormone receptor 1 (CRHR1), corticotropin releasing hormone receptor 2 (CRHR2), FKBP5 and the glucocorticoid receptor (NR3C1). We performed multiple linear regression models of methylation M-values to a categorical variable of hypersexuality, adjusting for depression, dexamethasone non-suppression status, Childhood Trauma Questionnaire total score and plasma levels of TNF-alpha and IL-6. Of 76 tested individual CpG sites, four were nominally significant (p<0.05), associated with the genes CRH, CRHR2 and NR3C1. Cg23409074-located 48bp upstream of the transcription start site of the CRH gene - was significantly hypomethylated in hypersexual patients after corrections for multiple testing using the FDR-method. Methylation levels of cg23409074 were positively correlated with gene expression of the CRH gene in an independent cohort of 11 healthy male subjects. The methylation levels at the identified CRH site, cg23409074, were significantly correlated between blood and four different brain regions. CRH is an important integrator of neuroendocrine stress responses in the brain, with a key role in the addiction processes. Our results show epigenetic changes in the CRH gene related to hypersexual disorder in men.
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Affiliation(s)
- Jussi Jokinen
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden.
| | | | - Andreas Chatzittofis
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden; Medical School, University of Cyprus, Nicosia, Cyprus
| | | | | | - John N Flanagan
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Arver
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helgi B Schiöth
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
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Abstract
Hypersexual disorder has phenomenological resemblance with impulsive-compulsive spectrum disorders. Inhibitory repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area (SMA) has been found to be effective in the management of impulsive-compulsive behaviors. Inhibitory rTMS over SMA may be helpful in hypersexual disorder. We highlight here a case of hypersexual disorder (excessive sexual drive) who failed to respond adequately to the conventional pharmacological treatment and responded with rTMS augmentation.
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Affiliation(s)
- Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Amit Singh
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Harpreet Singh
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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Short MB, Wetterneck CT, Bistricky SL, Shutter T, Chase TE. Clinicians' Beliefs, Observations, and Treatment Effectiveness Regarding Clients' Sexual Addiction and Internet Pornography Use. Community Ment Health J 2016; 52:1070-81. [PMID: 27345497 DOI: 10.1007/s10597-016-0034-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 06/07/2016] [Indexed: 10/21/2022]
Abstract
This study addressed how sex addiction and problematic IP use present to mental health professionals (MHPs), and how MHPs conceptualize and treat these issues. MHPs (N = 183) reported on beliefs about, experiences with, and treatment of problematic sexual behaviors (PBS). Most MHPs saw clients with PBS, but most do not feel competent to treat PBS. Specialized MHPs endorsed seeing more clients with PBS and feeling more effective than nonspecialists. Sexual addiction and problematic IP use share similarities, but differ in etiology and co-occurring problems. Diagnostic ambiguity, insufficient knowledge, and limited dissemination may hinder MHPs ability to assess and treat PBSs.
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Scanavino MDT, Ventuneac A, Rendina HJ, Abdo CHN, Tavares H, Amaral MLSD, Messina B, Reis SCD, Martins JPLB, Gordon MC, Vieira JC, Parsons JT. Sexual Compulsivity Scale, Compulsive Sexual Behavior Inventory, and Hypersexual Disorder Screening Inventory: Translation, Adaptation, and Validation for Use in Brazil. Arch Sex Behav 2016; 45:207-17. [PMID: 25348356 DOI: 10.1007/s10508-014-0356-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 02/19/2014] [Accepted: 03/10/2014] [Indexed: 05/25/2023]
Abstract
Epidemiological, behavioral, and clinical data on sexual compulsivity in Brazil are very limited. This study sought to adapt and validate the Sexual Compulsivity Scale (SCS), the 22-item version of the Compulsive Sexual Behavior Inventory (CSBI-22), and the Hypersexual Disorder Screening Inventory (HDSI) for use in Brazil. A total of 153 participants underwent psychiatric assessment and completed self-reported measures. The adaptation process of the instruments from English to Portuguese followed the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. The reliability and validity of the HDSI criteria were evaluated and the construct validity of all measures was examined. For the SCS and HDSI, factor analysis revealed one factor for each measure. For the CSBI-22, four factors were retained although we only calculated the scores of two factors (control and violence). All scores had good internal consistency (alpha >.75), presented high temporal stability (>.76), discriminated between patients and controls, and presented strong (ρ > .81) correlations with the Sexual Addiction Screening Test (except for the violence domain = .40) and moderate correlations with the Impulsive Sensation Seeking domain of the Zuckerman Kuhlman Personality Questionnaire (ρ between .43 and .55). The sensitivity of the HDSI was 71.93 % and the specificity was 100 %. All measures showed very good psychometric properties. The SCS, the HDSI, and the control domain of the CSBI-22 seemed to measure theoretically similar constructs, as they were highly correlated (ρ > .85). The findings support the conceptualization of hypersexuality as a cluster of problematic symptoms that are highly consistent across a variety of measures.
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Affiliation(s)
- Marco de T Scanavino
- Department and Institute of Psychiatry (IPq), Clínicas' Hospital (HC), University of São Paulo Medical School (FMUSP), Sao Paulo, Brazil.
- , Rua Mato Grosso, 306, conj. 614, Sao Paulo, SP, 01239-040, Brazil.
| | - Ana Ventuneac
- Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA
| | - H Jonathon Rendina
- Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA
- Basic and Applied Social Psychology Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Carmita H N Abdo
- Department of Psychiatry, University of São Paulo Medical School (FMUSP), Sao Paulo, Brazil
| | - Hermano Tavares
- Department of Psychiatry, University of São Paulo Medical School (FMUSP), Sao Paulo, Brazil
| | - Maria L S do Amaral
- Department and Institute of Psychiatry (IPq), Clínicas' Hospital (HC), University of São Paulo Medical School (FMUSP), Sao Paulo, Brazil
| | - Bruna Messina
- Department and Institute of Psychiatry (IPq), Clínicas' Hospital (HC), University of São Paulo Medical School (FMUSP), Sao Paulo, Brazil
| | - Sirlene C dos Reis
- Department and Institute of Psychiatry (IPq), Clínicas' Hospital (HC), University of São Paulo Medical School (FMUSP), Sao Paulo, Brazil
| | - João P L B Martins
- Department and Institute of Psychiatry (IPq), Clínicas' Hospital (HC), University of São Paulo Medical School (FMUSP), Sao Paulo, Brazil
| | - Marina C Gordon
- Department and Institute of Psychiatry (IPq), Clínicas' Hospital (HC), University of São Paulo Medical School (FMUSP), Sao Paulo, Brazil
| | - Julie C Vieira
- Department and Institute of Psychiatry (IPq), Clínicas' Hospital (HC), University of São Paulo Medical School (FMUSP), Sao Paulo, Brazil
| | - Jeffrey T Parsons
- Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA
- Basic and Applied Social Psychology Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
- Department of Psychology, Hunter College and the Graduate Center of the City University of New York (CUNY), New York, NY, USA
- Health Psychology Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
- The CUNY School of Public Health at Hunter College, New York, NY, USA
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Scanavino MDT, Ventuneac A, Abdo CHN, Tavares H, do Amaral MLS, Messina B, dos Reis SC, Martins JPLB, Parsons JT. Compulsive sexual behavior and psychopathology among treatment-seeking men in São Paulo, Brazil. Psychiatry Res 2013; 209:518-24. [PMID: 23415890 DOI: 10.1016/j.psychres.2013.01.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 12/17/2012] [Accepted: 01/14/2013] [Indexed: 11/25/2022]
Abstract
This study examined compulsive sexual behavior (CSB) and psychopathology in a treatment-seeking sample of men in São Paulo, Brazil. Eighty-six men (26% gay, 17% bisexual, 57% heterosexual) who met diagnostic criteria for excessive sexual drive and sexual addiction completed assessments consisting of the Mini International Neuropsychiatric Interview, a structured clinical interview for DSM-IV Axis I Disorders-Clinical Version (segment for Impulse Control Disorder), Sexual Compulsivity Scale (SCS), and questions about problematic CSB. The average SCS score for our sample was above the cut-off score reported in other studies, and 72% of the sample presented at least one Axis I psychiatric diagnosis. There were no differences among gay, bisexual, and heterosexual men on SCS scores and psychiatric conditions, but gay and bisexual men were more likely than heterosexual men to report casual sex and sex with multiple casual partners as problematic behaviors. SCS scores were associated with psychiatric co-morbidities, mood disorder, and suicide risk, but diagnosis of a mood disorder predicted higher SCS scores in a regression analysis. The study provides important data on the mental health needs of men with CSB in São Paulo, Brazil.
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Affiliation(s)
- Marco de Tubino Scanavino
- Department and Institute of Psychiatry, Clínicas' Hospital (HC), University of São Paulo Medical School (FMUSP), Brazil.
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