psychological treatment of major depression: an analysis of the sexual desire

Objective: sexual dysfunction is frequently reported as a side effect of many antidepressant medications. as a result, for those depressed patients to whom sexual desire is important, psychological treatment may be a better intervention. thus, the present study aimed to determine the possible changes in sexual desire following psychological treatments in depression, when focus of therapy is not on sexual function. methods: this is a quasi-experimental study, which was conducted in tehran, iran. a total of 281 depressed patients in the remission phase underwent psychological treatments, either cognitive behavioral therapy (cbt, n=131) or mindfulness-based cognitive therapy (mbct, n=150). the therapy did not focus on any aspect of sexual function. using a single item measure before and after treatment, sexual desire of the patients was categorized into intact, mild, moderate, or severe decline. a total of 255 participants completed the study questionnaires and were randomly assigned to cbt (122) and mbct groups (133). before therapy, 128(50.2%) participants were categorized in intact sexual desire group, 73(28.6%) in mild sexual desire dysfunction group, 40(15.7%) in moderate sexual desire dysfunction group, and 14(5.5%) in severe sexual desire dysfunction group. logistic regression was used for analyzing the data by spss-16. results: low sexual desire in depression remission was predicted by age (p<0.001, or=0.21, ci=0.01–0.03), presence of comorbid anxiety disorder (p<0.04, or=-0.13, ci=-0.46–0.02), and global assessment of functioning (gaf) (p<0.001, or=-0.23, ci=-0.03–0.01). clinical improvement in sexual desire was predicted by the type of intervention (p=0.023, or=0.351, ci=0.142–0.869) and gaf (p=0.003, or=0.927, ci=0.881–0.975). conclusion: cbt might be superior to mbct in improving sexual desire in patients with depression. further studies using validated sexual function questionnaires are necessary.