Clinical and psychosocial factors associated with quality of life in alcohol-dependent men with erectile dysfunction.
BACKGROUND
Men with alcohol dependence (AD) commonly suffer from alcohol-induced sexual (erectile) dysfunction (ED) and have poor quality of life (Qol). Knowledge about the factors associated with Qol in such patients is lacking.


OBJECTIVE
To identify in men who sought medical help for both AD and ED the variables that best predicted feelings of satisfaction with life and with specific life domains.


METHODS
The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Secondary study measures were the International Index of Erectile Function (IIEF), Beck Depression Inventory (BDI-13), General Health Questionnaire (GHQ-12), Rosenberg's General Self-Esteem Scale (RGSES), and the Multidimensional Scale of Perceived Social Support (MSPSS).


METHODS
Within an open-label sildenafil trial, 101 men aged 18-50 years with an International Classification of Diseases, Tenth Edition diagnosis of AD and concomitant ED were interviewed and completed the questionnaires. Multivariate analyses were applied to establish predictors of life satisfaction and factors mediating the relation between ED and life satisfaction.


RESULTS
ED and self-rated depressive symptoms, emotional distress, self-esteem, and perceived social support were found to be significantly associated with Qol and its component domains. Altogether they explained 18-38% of the variance in the Qol ratings. Depressive symptomatology, distress, and self-esteem, individually, demonstrated a mediating effect on the relation between ED and Qol. Finally, self-esteem was shown to be the primary mediator in this relationship.


CONCLUSIONS
The results of the study show that self-esteem is the primary factor, and depressive symptoms and severe emotional distress are secondary factors mediating the effects of ED on Qol in male patients seeking medical help for both AD and ED. An integrated pharmacopsychosocial approach targeting the underlying ED as well as the mediating emotional conditions could improve Qol of these patients and thus help them to stop using alcohol.
Mental Health Services, Ministry of Health, Jerusalem, Israel. ponizovsky@moh.health.gov.il
Alexander M
AM
Ponizovsky
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D007172:Erectile Dysfunction / Q000150:complications* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D011594:Psychometrics; D011788:Quality of Life; D012307:Risk Factors; D012649:Self Concept; D012737:Sex Factors; D012944:Social Support; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult