title: Bidirectional relationship between depression and erectile dysfunction.
abstract: OBJECTIVE
  We specified the interrelationship between depressive mood and erectile dysfunction.
  
  
  METHODS
  The target population consisted of men who were 50, 60 or 70 years old and residing in the study area in Finland in 1994. Questionnaires were mailed to 3,143 men in 1994 and to 2,837 men 5 years later. The followup sample consisted of 1,683 men who responded to the baseline and followup questionnaires.
  
  
  RESULTS
  Erectile dysfunction was strongly associated with untreated and treated depressive symptoms. The prevalence OR adjusted for potential confounders was 2.6 (95% CI 1.8-3.8) for untreated and 3.3 (95% CI 1.6-7.1) for treated depressive symptoms at the beginning of followup. The incidence of erectile dysfunction was 59/1,000 person-years (95% CI 39-90) in men with depressive mood and 37/1,000 person-years (95% CI 32-43) in those free of the disorder. Compared with men free of depressive symptoms who did not use medication for psychological disorders at study entry the adjusted incidence density ratio of erectile dysfunction was 4.5 (95% CI 2.2-9.2) in men with treated depressive symptoms and 1.2 (0.7-2.1) in those with untreated depressive symptoms. The incidence of depressive mood was 20/1,000 person-years in men with erectile dysfunction and 11/1,000 person-years in those free of erectile dysfunction. The adjusted incidence density ratio of depressive mood was 1.9 (95% CI 1.1-3.3) in men with erectile dysfunction compared with those free of it at entry.
  
  
  CONCLUSIONS
  Moderate or severe depressive mood or antidepressant medication use may cause erectile dysfunction and erectile dysfunction independently may cause or exacerbate depressive mood.
authors.affiliation: Tampere School of Public Health, University of Tampere, Tampere, Finland. r_shiri@yahoo.com
authors.forename: Rahman
authors.initials: R
authors.lastname: Shiri
authors.forename: Juha
authors.initials: J
authors.lastname: Koskimäki
authors.forename: Teuvo L J
authors.initials: TL
authors.lastname: Tammela
authors.forename: Jukka
authors.initials: J
authors.lastname: Häkkinen
authors.forename: Anssi
authors.initials: A
authors.lastname: Auvinen
authors.forename: Matti
authors.initials: M
authors.lastname: Hakama
mesh_terms: D000368:Aged; D003863:Depression / Q000150:complications* / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000150:complications* / Q000453:epidemiology; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors