title: Dysregulation of emotions and premature ejaculation (PE): alexithymia in 100 outpatients.
abstract: BACKGROUND
  There is still a lack of agreement on etiology, definition, and mechanisms that underlie premature ejaculation (PE) as well as on the different role and interaction between psychological and biological factors. Alexithymia is a deficit in identifying and communicating emotions that is presumed to play an important role in psychosomatic diseases. The influences of alexithymic features on sexuality are still understudied.
  
  
  OBJECTIVE
  Following a previous report on the relationship between alexithymia and erectile dysfunction, the objective of this study was the investigation of alexithymic features in patients with lifelong PE compared with controls, and the relationship between alexithymia level and PE severity.
  
  
  METHODS
  We assessed 100 consecutive outpatients with lifelong PE (age range 20-60). A control group of 100 male volunteers was recruited for the control group. The two groups were comparable in age, marital status, and socioeconomic characteristics.
  
  
  METHODS
  The Toronto Alexithymia Scale (TAS-20) was employed for the assessment of alexithymia. The premature ejaculation severity index was used as self-report measure of PE severity on a multidimensional perspective.
  
  
  RESULTS
  Our data show significantly higher scores of alexithymia in patients with PE than in the control group (P < 0.001), and a positive correlation between alexithymia level and PE severity (P < 0.002). With regard to TAS-20 subfactors, an externally oriented cognitive style shows the highest correlation with PE severity (P < 0.001) and the most significant difference in the comparison between PE and control group (P < 0.001).
  
  
  CONCLUSIONS
  These findings suggest that alexithymic features, and in particular, an externally oriented cognitive style, can be seen as possible risk and/or maintenance factors for PE, and may contribute to a more serious manifestation of this condition. Alexithymia could represent an important variable for an integrated diagnosis and treatment of PE in a modern somatopsychic and holistic viewpoint.
authors.affiliation: Department of Urology, University of Rome La Sapienza, Rome, Italy. paolomaria.michetti@uniroma1.it
authors.forename: Paolo Maria
authors.initials: PM
authors.lastname: Michetti
authors.forename: Roberta
authors.initials: R
authors.lastname: Rossi
authors.forename: Daniele
authors.initials: D
authors.lastname: Bonanno
authors.forename: Carlo
authors.initials: C
authors.lastname: De Dominicis
authors.forename: Francesco
authors.initials: F
authors.lastname: Iori
authors.forename: Chiara
authors.initials: C
authors.lastname: Simonelli
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D004542:Ejaculation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires