title: Relationships between erectile dysfunction, depression, and anxiety in Japanese subjects.
abstract: OBJECTIVE
  This study aimed to elucidate the relationships between erectile dysfunction (ED) and depression or anxiety.
  
  
  METHODS
  Subjects were 1,419 Japanese men aged 40-64 years. ED was assessed by the International Index of Erectile Function 5 (IIEF-5) score (Japanese version), and depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS). In this study ED cases were defined as those whose IIEF-5 value was less than 12, and a score of 8 or higher was used to classify a subject as suffering from depression or anxiety, respectively. The prevalence odds ratio (OR) of ED was calculated with confidence interval (CI) estimated by the Woolf's method by five age groups (40-44, 45-49, 50-54, 55-59, 60-64 years). To control for age, body mass index, smoking, and alcohol drinking factors, we conducted the multivariate logistic regression analysis for calculating adjusted ORs and 99% CIs.
  
  
  RESULTS
  ED was significantly associated with depression in age groups 45-49 (OR 3.42, 99% CI 1.51-7.76) and 50-54 years (OR 2.43, 99% CI 1.11-5.35). After using multivariate analysis, adjusted OR also showed statistical significance. (OR 2.02, 99% CI 1.32-3.08). ED was significantly associated with anxiety in the 50-55-year-old age group (OR 2.48, 99% CI 1.12-5.47). After using multivariate analysis, adjusted OR also showed statistical significance (OR 1.77, 99% CI 1.15-2.72). The concomitant depression and anxiety group (A+D+) had significantly higher prevalence of ED than the control group (A-D-) in both the 45-49 and 50-54 age groups. (P < 0.01)
  
  
  CONCLUSIONS
  ED associated significantly with depression and anxiety status only in late 40s to early 50s (45-55 years) in male Japanese. Furthermore, comorbidities of depression and anxiety strengthen this association. Our results might be useful in furthering understanding of ED etiology and determining a target population for prevention in ED subjects.
authors.affiliation: Department of Preventive Medicine, St. Marianna University School of Medicine, Kawasaki, Japan. h.sugimor@marianna-u.ac.jp
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sugimori
authors.forename: Katsumi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Baba
authors.forename: Takayasu
authors.initials: T
authors.lastname: Nishida
authors.forename: Ryuto
authors.initials: R
authors.lastname: Nakazawa
authors.forename: Teruaki
authors.initials: T
authors.lastname: Iwamoto
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015992:Body Mass Index; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires