Is problematic sexuality a marker for the onset of mental disorders? A cross-sectional study on psychotic-like experiences and sexual behaviour in a non-clinical sample

Impairments in sexual functioning or behaviour may increase the risk of developing mental disorders, including in young people with early psychosis. The aim of this crosssectional study was to examine the relationship between psychotic-like experiences (PLEs) and sexual functioning and dysfunctional sexual behaviour. We collected a convenience sample of 582 subjects. Of them, 197 experienced clinically relevant PLEs (having a cut-off score of ≥ 6 in the Prodromal Questionnaire 16-item). In addition, they completed a specific self-reported psychometric protocol assessing sexual function, hypersexual behaviour, problematic pornography use, depression and PLEs. The PQ-16 Absence/Presence score correlated significantly with hypersexuality, problematic pornography use, and difficulties in reaching orgasm. The PQ-16 Intensity score correlated significantly with hypersexuality, problematic pornography use, difficulties in reaching orgasm, orgasm dissatisfaction, and achieving and/or maintaining an erection or lubrication. When comparing subjects experiencing significant PLEs with control subjects while covarying age and depression, the former exhibited more hypersexuality and problematic pornography use, and poorer sexual function related to difficulties in orgasm attainment. The difference in hypersexuality was maintained when the analysis was limited to the female subgroups or the male subgroups, while the difference in problematic pornography use was confirmed only in the female subgroups. Both dysfunctional sexual behaviour and sexual dysfunction are associated with the severity of PLEs. Sexological aspects related to behaviour differentiate more individuals with relevant PLEs from the control group, compared to functional aspects. Screening for sexual health problems could be valuable among individuals with PLEs.