(819) Sexuality, Gender Identity and Relationships in 18-59-Year-Old Individuals with and Without Newly Diagnosed Bipolar Disorder in Denmark

Introduction Mental disorders are associated with sex-life challenges, yet these remain scarcely studied in bipolar disorder (BD). Objective To investigate sexual function, behaviours, experiences and orientations as well as gender identity and relationship characteristics in Danes with and without newly diagnosed BD. Methods This cross-sectional questionnaire study included 232 individuals with newly diagnosed BD and a general population sample of 11,175 individuals without BD from a large prospective Danish cohort study, all aged 18-59 years. Outcomes included selected items from the prospective cohort study’s questionnaire covering same- and opposite-sex sexual experiences and behaviours, sexual orienta-tion, gender identity, sexual needs, satisfaction with sex life and relationships, and lifetime history of sexually transmitted infections. Sexual function was measured using the 6-item Female Sexual Function Index (FSFI-6) for women and the 5-item International Index of Erectile Function (IIEF-5) for men. Sex-specific logistic regression analyses compared study outcomes between the two groups, using individuals without BD as reference. Odds ratios adjusted for potential confounders (aORs) with 95% confidence intervals (CIs) served as measures of relative risk. Results Among men, strongest associations with BD were observed for bisexual (aOR 3.31 [95% CI: 1.42–7.73]) or other minority sexual orientations (aOR 4.07 [95% CI: 1.72–9.62]), non-cisgender identity (aOR 8.12 [95% CI: 2.39–27.60]), 1-4 same-sex partners (aOR 3.32 [95% CI: 1.85–5.95]), and compul-sive sexual behavior (aOR 6.32 [95% CI: 3.04–13.16]). Among women, strongest associations with BD were seen for other minority sexual orientations (aOR 6.02 [95% CI: 3.71–9.80]), lifetime histo-ries of ≥5 same-sex (aOR 9.13 [95% CI: 5.03–16.59]) and ≥50 opposite-sex partners (aOR 6.24 [95% CI: 3.07–12.69]), compulsive sexual behavior (aOR 4.15 [95% CI: 1.54–11.15]), and infidelity in cur-rent relationship (aOR 4.18 [95% CI: 1.89-9.23]). Individuals with BD rated their sex lives and current relationships less favorably than those without BD, and they reported lower sexual desire, more cases of chlamydia, and, among women, more sexual dysfunction as measured by the FSFI-6. No statistically significant differences in erectile dysfunction, as assessed by the IIEF-5, were observed among men. Conclusions This study revealed major differences in sexuality, gender identity, and relationship characteristics between individuals with and without newly diagnosed BD, with potential impacts on sexual well-being, psychosocial functioning and the clinical course of BD. Routine assessment and management of sexual health should therefore be an integrated part of comprehensive care in individuals with BD. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Lundbeck Pharma A/S Viatris, Eroxon Innovation/Futura Medical, Freya Pharmaceutical, Gedeon Richter, and Besins Healthcare, Teva, Eli Lilly and Johnson & Johnson, Janssen/Cilag.