Numerous studies have linked a greater prevalence of high-risk sexual behaviors to teens with mental health disorders.
Now, new research reveals that certain psychiatric disorders are associated with an additional risk in this population.
Findings pointed to the manic phase of bipolar disorder as a catalyst to a more active sexual lifestyle and more irresponsible sexual behavior — such as unprotected sex. Marked by dramatic mood swings from euphoria and elation to irritability, people with the disorder were found to have more sexual partners and a greater likelihood of having contracted a sexually transmitted infection (STI) than those without the illness.
Other externalized disorders such as attention deficit hyperactivity disorder and conduct disorders were also linked to riskier sexual behavior in teens. This population was found to be more sexually active than their peers without the disorder, putting them at higher risk for HIV and other STIs.
Research found that this fact remained true for teens who also had a co-occurring internalizing disorder, such as anxiety, depression and post-traumatic stress disorder.
“Increased sexual risk taking may be linked to these disorders because they’re often associated with impulsive or reckless behaviors, which could include multiple sexual partners or not using condoms regularly,” said lead author Larry K. Brown, MD, of the Bradley Hasbro Children’s Research Center.
“Because of their increased vulnerability to HIV and other sexually transmitted infections, the sexual risk behavior of teens with these diagnoses should be carefully and routinely screened as part of their mental health treatment.”
Participants in the study included 840 teens and their parents from the cities of Providence, Atlanta and Chicago, who were part of Project STYLE (Strengthening Today’s Youth Life Experience), the first multi-site HIV prevention program designed specifically for parents and youths with significant mental health disorders.
Participants were asked to complete a computer-assisted survey that determined psychiatric symptoms and sexual risk behaviors. Urine screens were also taken to determine the presence of an STI.
More than half of all participants were both female and African-American, and the average age was 15.
The mental health breakout of the study included 153 teens with a diagnosis of mania, 48 with internalizing disorders, 282 with externalizing disorders, 252 with more than one diagnosis and 105 in mental health treatment who did not meet the criteria for any of the assessed psychiatric diagnoses.
More than half of participants reported a history of vaginal or anal intercourse. Among those who were sexually active, 29% did not use a condom the last time they had sexual intercourse.
Approximately 31% reported sexual activity within the previous 90 days, with an average of two partners each, while 15 percent reporting having four or more partners. Fourteen percent of teens tested positive for a STI.
“This is interesting because there’s very little information on adolescents with mania,” said Brown, who is also a professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University.” We know that adults with mania are more likely to engage in risky sexual behavior, but we haven’t had data like this before for teens.”
It is estimated that 25% of teens in the United States will contract a sexually transmitted disease, according to the Centers for Disease Control and Prevention. Statistics also suggest that adolescents with mental health disorders or a history of psychiatric hospitalizations have intercourse at an earlier age, have more unintended pregnancies and have more sexual partners than their peers.