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Objectives This study aims to examine sexual functioning in adolescents with depression. Methods Between 09/2010 and 03/2014, 235 participants who were between 15 and 20 years old and were unmedicated or within one month of beginning antidepressant treatment completed the Beck Depression (BDI) and Anxiety Inventories (BAI) and the Changes in Sexual Functioning Questionnaire (CSFQ). They were also assessed to establish the presence of a major depressive episode (MDE), following the DSM-IV-TR. The Student’s t test and chi-square test were used to compare continuous and categorical variables, respectively, across participants with vs. without MDE. Multivariable linear regression analysis examined the association between depression and sexual functioning. Results After controlling for age, female sex, antidepressant use, and the presence of generalized anxiety disorder, the presence of MDE was associated with a lower score on the CSFQ overall as well as on its desire, arousal, and orgasm subscales. Antidepressants were not associated with sexual functioning neither in the sample overall nor in those with MDE. BDI items related to affective symptoms, rather than those tapping into neurovegetative or cognitive functioning, accounted for the association between depression and lower sexual functioning. Furthermore, with higher BDI scores, males exhibited a steeper decline than females in both the CSFQ total score as well as in the desire subscale. Anxiety was not significantly associated with sexual functioning. Conclusions MDE in older adolescents is associated with lower sexual functioning, particularly in males. This appears most related to affective symptoms. The potential impact of such impairment on future sexual functioning deserves further examination.

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