A new study has revealed that teens who experience the manic phase of bipolar disorder - which is marked by dramatic mood swings from euphoria and elation to irritability - are more sexually active with more sexual partners and are more likely to have a sexually transmitted infection.
Researchers from the Bradley Hasbro Children's Research Centre also found that teens with externalising disorders (which includes attention deficit hyperactivity disorder, conduct disorders and angry, defiant or hostile behaviors like stealing) are more likely to be sexually active than their peers, putting them at higher risk for HIV and other STIs.
This was true even for teens that also had a co-occurring internalising disorder, such as anxiety, depression or post-traumatic stress disorder.
"Increased sexual risk taking may be linked to these disorders because they're often associated with impulsive or reckless behaviours, which could include multiple sexual partners or not using condoms regularly," said lead author Larry K Brown of the Bradley Hasbro Children's Research Centre.
"Because of their increased vulnerability to HIV and other sexually transmitted infections, the sexual risk behaviour of teens with these diagnoses should be carefully and routinely screened as part of their mental health treatment," said Brown.
The study included 840 teens and their parents from Providence, Atlanta and Chicago participating in Project STYLE (Strengthening Today's Youth Life Experience) - the first multi-site HIV prevention program designed specifically for parents and youths with significant mental health disorders.
All participants completed computer-assisted surveys to gather information about psychiatric symptoms and sexual risk behaviours.
Teens also completed urine screens to determine the presence of an STI. More than half of all participants were both female and African-American. The average age was 15.
Overall, the study included 153 teens with a diagnosis of mania, 48 with internalising disorders, 282 with externalising disorders, 252 with more than one diagnosis and 105 in mental health treatment who did not meet the criteria for any of the assessed psychiatric diagnoses.
More than half of all participants reported a history of vaginal or anal intercourse. Among those who were sexually active, 29% did not use a condom the last time they had sexual intercourse.
Approximately 31% had been sexually active within the previous 90 days, with an average of two partners each, while 15% reporting having four or more partners. Fourteen percent of teens tested positive for a STI.
The study revealed that while teens with an externalising disorder - even if they have a co-occurring internalising disorder - do tend to engage in risky sexual behaviour, adolescents with mania are at an even higher risk for HIV and STI.
These teens had significantly more sexual partners and were four times as likely to have an STI compared to the other groups.
The findings were published in the Journal of Consulting and Clinical Psychology.
