Association between psychiatric symptoms and erectile dysfunction.
BACKGROUND
Erectile dysfunction (ED) is often associated with a wide array of psychiatric symptoms, although few studies systematically address their specific association with ED determinants.


OBJECTIVE
The aim of this study is to explore the relationship between ED (as assessed by SIEDY Structured Interview, a 13-item tool which identifies and quantifies the contribution of organic, relational, and intrapsychic domains of ED) and different psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire, a self-reported test for the screening of mental disorders in a nonpsychiatric setting).


METHODS
A consecutive series of 1,388 (mean age 51 +/- 13 years) male patients with ED was studied.


METHODS
Several hormonal and biochemical parameters were investigated, along with SIEDY Interview and the Middlesex Hospital Questionnaire.


RESULTS
Psychiatric symptoms resulted differentially associated with SIEDY domains. Depressive and phobic-anxiety symptoms were associated with the relational domain, somatization with the organic one, while free-floating anxiety, obsessive-compulsive, and phobic symptoms were significantly related with higher intrapsychic SIEDY scores. In addition, relevant depressive symptomatology was associated with hypogonadism, the presence of low frequency of intercourse, hypoactive sexual desire (HSD), and conflictual relationships within the couple and the family. Patients with high free-floating anxiety symptoms were younger, and complained of an unsatisfactory work and a conflictual relationship within family. Conversely, subjects with higher phobic anxious symptoms displayed a more robust relational functioning. Similar results were observed in subjects with obsessive-compulsive symptoms, who also reported a lower prevalence of HSD. Finally, subjects with somatization symptoms showed the worst erectile function.


CONCLUSIONS
The main value of this study is that it alters various clinicians' belief that many psychiatric symptoms can be found among ED patients. Systematic testing of patients with ED, through psychiatric questionnaires, is recommended to detect even slight or moderate psychopathological distresses, which specifically associate and exacerbate sexual disturbances.
Corona
Giovanni
G
Andrology Unit, Department of Clinical Physiopathology, University of Florence, Italy.
Ricca
Valdo
V
Bandini
Elisa
E
Mannucci
Edoardo
E
Petrone
Luisa
L
Fisher
Alessandra D
AD
Lotti
Francesco
F
Balercia
Giancarlo
G
Faravelli
Carlo
C
Forti
Gianni
G
Maggi
Mario
M
D000328:Adult; D000368:Aged; D015897:Comorbidity; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D054526:Men's Health; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D011788:Quality of Life; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires