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Sexual response in obsessive–compulsive disorder: the role of obsessive beliefs

Published online by Cambridge University Press:  15 July 2020

Andrea Pozza
Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
Donatella Marazziti*
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Federico Mucci
Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
Nicole L. Angelo
School of Psychology, University of Florence, Florence, Italy
Davide Prestia
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Infant-Maternal Science, Section of Psychiatry, University of Genoa, Genoa, Italy IRCCS Ospedale Policlinico San Martino, Genoa, Italy
Davide Dèttore
Department of Health Sciences, University of Florence, Florence, Italy
Author for correspondence: Donatella Marazziti Email:



Sexual response in obsessive–compulsive disorder (OCD) research and practice is overlooked. According to the Dual Control Model, satisfactory sexual response is based upon a balance of sexual excitation and inhibition. The assessment of sexual response in OCD may have clinical implications, such as the integration of sex therapy in psychotherapeutic intervention. The present study was aimed at comparing sexual excitation and inhibition levels between OCD patients and matched control subjects, and investigating whether obsessive beliefs might predict sexual excitation/inhibition.


Seventy-two OCD patients (mean age ± standard deviation [SD]: 34.50 ± 10.39 years) and 72 matched control subjects (mean age ± SD: 34.25 ± 10.18) were included (62.50% men and 37.50% women in both groups). The Obsessive Compulsive Inventory-Revised (OCI-R), the Obsessive Beliefs Questionnaire-46 (OBQ-46), and the Sexual Inhibition/Sexual Excitation Scales (SIS/SES) were administered.


Patients with OCD showed significantly higher levels of sexual excitation, inhibition due to threat of performance failure, and inhibition due to threat of performance consequences than the controls. In addition, the patients with more severe symptoms showed lower excitation than those with less severe symptoms, and those with higher perfectionism had stronger inhibition due to threat of performance failure than those with lower perfectionism.


This is the first study exploring sexual response in OCD according to the Dual Control Model. Sexual response is an impaired quality of life outcome in OCD that should be assessed in routine clinical practice. These findings support the importance of addressing specific obsessive beliefs to improve sexuality in OCD patients.

Original Research
© The Author(s), 2020. Published by Cambridge University Press

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