title: The association of anxiety with the subtypes of premature ejaculation: a chart review.
abstract: OBJECTIVE
  Premature ejaculation is one of the most common forms of male sexual dysfunction. Recent clinical and genetic evidence suggests that it can be classified into 4 subtypes, which may have distinct clinical profiles. Psychological factors, such as anxiety, may play a specific role in the acquired subtype. The objective of this study was to assess the association between psychological factors, particularly anxiety and marital disharmony, and the various subtypes of premature ejaculation.
  
  
  METHODS
  The case records of 28 men presenting with premature ejaculation to a clinic for psychosexual disorders in India between January 2012 and January 2013 were reviewed. The patients were classified into 4 subtypes (lifelong, acquired, natural variable, and premature-like ejaculatory dysfunction) and compared in terms of demographic and clinical profile.
  
  
  RESULTS
  Performance anxiety during intercourse was significantly associated with the acquired subtype of premature ejaculation (P = .011, Fisher exact test). Marital disharmony was equally common in the lifelong and acquired subtypes of premature ejaculation (P = not significant, Fisher exact test) and, in most cases, could be attributed to the distress caused by premature ejaculation itself.
  
  
  CONCLUSIONS
  Our results are consistent with existing literature that shows an association between anxiety and premature ejaculation, particularly the acquired subtype. Anxiety may play a causal or perpetuating role in these patients. If replicated, such a finding would have important therapeutic implications.
authors: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry (Dr Rajkumar); and Lakeshore Hospital, Ernakulam, Kerala (Dr Kumaran), India.
authors: Ravi Philip
authors: RP
authors: Rajkumar
authors: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry (Dr Rajkumar); and Lakeshore Hospital, Ernakulam, Kerala (Dr Kumaran), India.
authors: Arun Kumar
authors: AK
authors: Kumaran