Background: The connection between sexual dysfunction and depressive disorders has been noted for centuries; Freud, for example, wrote that “melancholia consists in mourning over loss of libido.” More recently, the acceptance of decreased libido as a symptom of major depressive disorder (MDD) is reflected in various standardized depression rating forms that contain an item assessing loss of sexual interest. However, there has been little empirical research that evaluates the prevalence, clinical subtypes, and natural course of sexual changes in medication-free patients with depressive disorders. The goals of this article are to review research on the prevalence of sexual dysfunction in people with depressive disorders and to make recommendations for future research.

Aim: Depression occurs in 10% to 25% of all women after childbirth, and women with a history of MDD or bipolar disorder are at a significantly increased risk for recurrence of depression during this time. Decreased libido is a common complaint in nondepressed postpartum women, and to our knowledge, no study has compared sexual dysfunction in women with and without depression during the postpartum period.

Material and Methods: Investigate physical symptoms in 132 patients with depressive disorders and reported that 72% of patients with unipolar depression and 77% of patients with bipolar depression acknowledged loss of libido, compared with 5% of age-matched controls. Two similar studies including only patients with unipolar depression found a greater prevalence of decreased libido in patients with depression compared with age-matched controls.

Conclusion: The reported evidence suggests a relatively high prevalence of sexual dysfunction in patients with MDD before treatment with medication or psychotherapy compared with nondepressed patients or community sample controls. To date, reduced libido appears to be the most common problem, occurring frequently in both men and women with depression.

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