Hypersexual disorder, known more popularly as sex addiction, is normally defined as obsessive thoughts of sex, a loss of control, a compulsion to perform sexual acts, or sexual habits that are potentially harmful or risky. Comorbidity often occurs, however, between hypersexual disorder and other kinds of mental health issues, leading to controversy surrounding the diagnosis and symptoms. The causes of hypersexual disorder are murky as well, but researchers familiar with the neurobiological causes of mental illness are hoping to shed some light on them.

A new study by psychiatrist and researcher Jussi Jokinen and his team at Karolinska Institutet’s Department of Clinical Neuroscience examined a possible link between hypersexual disorder and stress. The scientists used a cortisone drug called dexamethasone in their experiment, which involved 67 men with hypersexual disorder and 39 healthy control participants. Dexamethasone is used to depress the nervous system (usually during anaphylactic shock or an organ transplant), but can also be used as a kind of chemical stress test.

The researchers gave subjects a low dose of dexamethasone the night before testing their levels of the stress hormones ACTH and cortisol. They found the subjects with hypersexual disorder had higher levels of both hormones than their healthy counterparts, even after they controlled for comorbid factors like depression and childhood trauma.

“Aberrant stress regulation has previously been observed in depressed and suicidal patients as well as in substance users,” Jokinen said in a statement. “In recent years, the focus has been on whether childhood trauma can lead to a dysregulation of the body’s stress systems via so-called epigenetic mechanisms.”

Basically, Jokinen said, researchers wanted to know if psychosocial environments, such as childhood trauma, can influence genes that control stress systems. The results of the study indicate that the same neurobiological system involved in coping with this kind of abuse could apply to people with hypersexual disorder. The researchers say the next step in their work would be to examine the effect of psychotherapy on the patients, to see if it helps normalize their physiological response to stress. They also plan to perform epigenetic analyses.

“This is the first study of neurobiological disease in this particular patient group,” Jokinen said. “It’s important to study stress systems in patients with different psychiatric diagnoses in order to understand if these biological changes are diagnosis-specific or related to different behaviors, and to take into account the impact that childhood trauma has on later mental health.”

Source: Chatzittofis A, Arver S, Oberg K, Hallberg J, Nordstrom P, Jokinen J. HPA axis dysregulation in men with hypersexual disorder. Psychoneuroendocrinology. 2015.