Longitudinal differences in psychological outcomes for men with erectile dysfunction: results from ExCEED.
BACKGROUND
The direction of the relationship between psychological adjustment and erectile dysfunction (ED) is unclear and may differ for different men, and few studies have examined psychological outcomes for men receiving ED treatment.


OBJECTIVE
This study assessed the impact of ED therapy at baseline and 12-month follow-up, using standard psychological measures.


METHODS
Using an observational ED registry, we collected clinical and psychosocial data at baseline and 3, 6, and 12 months. Participants had (i) a patient-reported outcomes questionnaire at baseline and at least one follow-up; and (ii) data about ED treatments received during the study. Treated men were classified as responders based on improvements in International Index of Erectile Function scores from baseline to 12 months.


METHODS
The main outcome measures were changes in psychological outcomes in relation to treatment status and baseline ED severity.


RESULTS
Of 153 patients, 40 responded to treatment, 49 did not respond to treatment, and 64 did not receive treatment. Treatment responders reported significant improvements in 12-month sexual self-efficacy but only small improvements or no change across five other psychological domains, whereas nonresponders reported small decrements. There was a trend for differences in sexual self-efficacy to vary by baseline ED severity, as well as by treatment response.


CONCLUSIONS
Diagnosing and successfully treating ED significantly affects patient psychological adjustment, so providers should actively diagnose and treat ED.
Latini
David M
DM
Scott Department of Urology, Baylor College of Medicine, Houston, TX,; Houston Center for Quality of Care & Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX,. Electronic address: latini@bcm.tmc.edu.
Penson
David F
DF
Departments of Urology and Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Wallace
Katrine L
KL
School of Public Health, University of Illinois, Chicago, IL.
Lubeck
Deborah P
DP
Genentech, Inc., South San Francisco, CA.
Lue
Tom F
TF
Department of Urology, University of California, San Francisco, CA, USA.
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D007172:Erectile Dysfunction / Q000523:psychology* / Q000628:therapy*; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires