title: Are depression and poor sexual health neglected comorbidities? Evidence from a population sample.
abstract: OBJECTIVE
  To examine associations between sexual behaviour, sexual function and sexual health service use of individuals with depression in the British general population, to inform primary care and specialist services.
  
  
  METHODS
  British general population.
  
  
  METHODS
  15,162 men and women aged 16-74 years were interviewed for the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), undertaken in 2010-2012. Using age-adjusted ORs (aAOR), relative to a comparator group reporting no treatment or symptoms, we compared the sexual health of those reporting treatment for depression in the past year.
  
  
  METHODS
  Sexual risk behaviour, sexual function, sexual satisfaction and sexual health service use.
  
  
  RESULTS
  1331 participants reported treatment for depression (5.2% men; 11.8% women). Relative to the comparator group, treatment for depression was associated with reporting 2 or more sexual partners without condoms (men aAOR 2.07 (95% CI 1.38 to 3.10); women 2.22 (1.68 to 2.92)), and concurrent partnerships (men 1.80 (1.18 to 2.76); women 2.06 (1.48 to 2.88)), in the past year. Those reporting depression treatment were more likely to be dissatisfied with their sex lives (men 2.32 (1.74 to 3.11); women 2.30 (1.89 to 2.79)), and to score in the lowest quintile on the Natsal-sexual function measure. They were also more likely to report a recent chlamydia test (men 1.92 (1.15 to 3.20)); women (1.27 (1.01 to 1.60)), and to have sought help regarding their sex life from a healthcare professional (men 2.92 (1.98 to 4.30); women (2.36 (1.83 to 3.04)), most commonly from a family doctor. Women only were more likely to report attending a sexual health clinic (1.91 (1.42 to 2.58)) and use of emergency contraception (1.98 (1.23 to 3.19)). Associations were broadly similar for individuals with depressive symptoms but not reporting treatment.
  
  
  CONCLUSIONS
  Depression, measured by reported treatment, was strongly associated with sexual risk behaviours, reduced sexual function and increased use of sexual health services, with many people reporting help doing so from a family doctor. The sexual health of depressed people needs consideration in primary care, and mental health assessment might benefit people attending sexual health services.
authors.affiliation: Research Department of Infection and Population Health, UCL, London, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Field
authors.affiliation: Research Department of Infection and Population Health, UCL, London, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Prah
authors.affiliation: Research Department of Infection and Population Health, UCL, London, UK.
authors.forename: Catherine H
authors.initials: CH
authors.lastname: Mercer
authors.affiliation: Research Department of Primary Care and Population Health, UCL, London, UK.
authors.forename: Greta
authors.initials: G
authors.lastname: Rait
authors.affiliation: Division of Psychiatry (Faculty of Brain Sciences), UCL, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: King
authors.affiliation: Division of Primary Care and Public Health, University of Brighton, Brighton, UK.
authors.forename: Jackie A
authors.initials: JA
authors.lastname: Cassell
authors.affiliation: Research Department of Infection and Population Health, UCL, London, UK.
authors.forename: Clare
authors.identifier: http://orcid.org/0000-0002-4612-1858
authors.initials: C
authors.lastname: Tanton
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Heath
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Kirstin R
authors.initials: KR
authors.lastname: Mitchell
authors.affiliation: Research Department of Infection and Population Health, UCL, London, UK.
authors.forename: Soazig
authors.initials: S
authors.lastname: Clifton
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: Datta
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Kaye
authors.initials: K
authors.lastname: Wellings
authors.affiliation: Research Department of Infection and Population Health, UCL, London, UK.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Johnson
authors.affiliation: Research Department of Infection and Population Health, UCL, London, UK.
authors.forename: Pam
authors.initials: P
authors.lastname: Sonnenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D017280:Condoms; D003863:Depression / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011320:Primary Health Care / Q000458:organization & administration*; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D006113:United Kingdom; D055815:Young Adult
keywords: Depression; Sexual health; Sexual health services