Prevalence and Clinical Correlates of Sexual Dysfunction in Drug-Naïve Male Patients with First-Episode Depression

Abstract Sexual dysfunction is increasingly recognised as intrinsic to depression rather than solely a treatment effect, but most research has examined antidepressant-induced dysfunction, with few studies in drug-naïve, first-episode patients. This cross-sectional study determined the prevalence, domain-wise pattern, and clinical correlates of sexual dysfunction in 94 drug-naïve men aged 18–60 years with first-episode depressive disorder (ICD-11) at a tertiary care hospital in North India. Severity was assessed using the Hamilton Rating Scale for Depression (HAM-D) and sexual functioning using the 14-item Changes in Sexual Functioning Questionnaire–Male version (CSFQ-14); associations with age, illness duration, and severity were examined using Spearman's correlation. Sexual dysfunction was present in 54 participants (57.45%); desire/frequency, desire/interest, arousal/excitement, and orgasm domains were each impaired in 66/94 (70.21%), and pleasure in 62/94 (65.96%). Illness duration correlated strongly with overall sexual function (ρ = -0.79, P < 0.001) and all domains (ρ = -0.70 to -0.82, P < 0.001); severity showed a moderate negative correlation (ρ = -0.48, P < 0.001). Age was not significantly associated, except for weak correlations with pleasure and orgasm. Sexual dysfunction is highly prevalent before antidepressant exposure in first-episode depression, driven predominantly by illness duration and severity rather than age, supporting routine baseline sexual health assessment before treatment initiation.