Association Between Alexithymia, Sexual Dysfunctions, and Dyadic Adjustment in Obsessive–Compulsive Disorder

<i>Background and Objectives</i>: Chronic mental disorders may negatively affect sexual functioning and dyadic adjustment. This study aimed to investigate the associations between alexithymia, sexual dysfunctions, and dyadic adjustment in patients with obsessive-compulsive disorder (OCD) and to compare these variables with those of healthy controls. <i>Materials and Methods</i>: This case-control study included 72 patients with OCD and 82 sociodemographically matched healthy controls. All participants completed the Toronto Alexithymia Scale (TAS-20), Arizona Sexual Experiences Scale (ASEX), Yale-Brown Obsessive Compulsive Scale (YBOCS), and Dyadic Adjustment Scale (DAS). Group comparisons were conducted using independent <i>t</i>-tests, Mann-Whitney U tests, and chi-square tests, while correlations were examined using Pearson's analysis. <i>Results</i>: Patients with OCD had significantly higher TAS-20 scores (60.97 ± 11.15 vs. 43.18 ± 8.86, <i>p</i> < 0.001) and ASEX total scores (18.33 ± 4.93 vs. 13.76 ± 3.55, <i>p</i> < 0.001), alongside lower DAS scores (total and all subscales, <i>p</i> < 0.001) than controls. Within the OCD group, TAS-20 scores correlated positively with the total ASEX score (r = 0.366, <i>p</i> = 0.002) and negatively with the total DAS score (r = -0.339, <i>p</i> = 0.004) and subscales (all <i>p</i> < 0.05). <i>Conclusions</i>: Patients with OCD exhibit elevated alexithymia, greater sexual dysfunction, and reduced dyadic adjustment compared with healthy controls. Furthermore, alexithymia in patients with OCD is associated with impaired sexual functioning and dyadic adjustment. Assessing alexithymic traits and addressing them in treatment may improve social and familial functioning in this population.