Adolescents, Young Adults With Bipolar Disorder More Likely to Contract STIs

Blood samples with HIV and syphilis positive
Psychiatrists can help adolescent and young adult patients with bipolar disorder address risky sexual behavior and can provide regular medication intervention to reduce the risk for STIs.

Adolescents and young adults with bipolar disorder (BD) have an increased risk for contracting sexually transmitted infections (STIs) compared with those without BD, according to research published in the Journal of Clinical Psychiatry. Previous studies have shown an association between BD and risky sexual behaviors that leads to the potential for STIs.

Researchers assessed data from 26,028 adolescents and young adults with BD and 104,112 age- and sex-matched control participants without BD from the Taiwan National Health Insurance Research Database. Patients who contracted any type of STI during follow-up were identified and data were assessed using a Cox regression analysis adjusted for demographic data, psychiatric comorbidities, and BD medications.

The analysis revealed that BD is an independent risk factor for contracting an STI (hazard ratio [HR]=4.11; 95% CI, 3.62-4.66). In addition, patients with BD and substance use disorders (HR=1.94; 95% CI, 1.71-2.20) and alcohol use disorders HR=1.27; 95% CI, 1.08-1.49) had the highest risk for contracting an STI. However, participants with long-term use of mood stabilizers and atypical antipsychotic medications had a reduced risk for STI occurrence.

The study was limited by a potential underestimation of STI incidence because the data were gathered from those who had sought medical help. In addition, researchers could not identify health-related risky behaviors or BD symptom severity that could have led to an increased risk for STIs.

Given that adolescents and young adults with BD are more likely to contract STIs, researchers stated that “it appears that this should be a topic of frequent discussion in treatment with adolescents and young adults with [BD], and risky sexual behaviors should be regularly assessed and addressed as a focus of treatment with this population, especially when the patient is also abusing alcohol or other substances.”


Chen MH, Wei HT, Bai YM, et al. Sexually transmitted infection among adolescents and young adults with bipolar disorder: a nationwide longitudinal study. J Clin Psychiatry. 2019;80(2):18m12199.

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This article originally appeared on Psychiatry Advisor