RELATIONSHIPS BETWEEN MAJOR DEPRESSIVE DISORDER , ANXIETY AND ERECTILE DYSFUNCTION

Dr Shubham Verma, Dr Amber Tiwari

Abstract


Aims - This study aimed to elucidate the relationships between erectile dysfunction (ED) and depression or anxiety.
Methods - Subjects were 242 Indian men aged 40–64 years. ED was assessed by the International Index of Erectile Function 5 (IIEF-5) score, and
depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS). In this study ED cases were defined as
those whose IIEF-5 value was less than 12, and a score of 8 or higher was used to classify a subject as suffering from depression or anxiety,
respectively. The prevalence odds ratio (OR) of ED was calculated with confidence interval (CI) estimated by the Woolf's method by five age
groups (40–44, 45–49, 50–54, 55–59, 60–64 years). To control for age, body mass index, smoking, and alcohol drinking factors, we conducted the
multivariate logistic regression analysis for calculating adjusted ORs and 99% CIs.
Results - ED was significantly associated with depression in age groups 45–49 (OR 3.42, 99% CI 1.51–7.76) and 50–54 years (OR 2.43, 99% CI
1.11–5.35). After using multivariate analysis, adjusted OR also showed statistical significance. (OR 2.02, 99% CI 1.32–3.08). ED was significantly
associated with anxiety in the 50–55-year-old age group (OR 2.48, 99% CI 1.12–5.47). After using multivariate analysis, adjusted OR also showed
statistical significance (OR 1.77, 99% CI 1.15–2.72). The concomitant depression and anxiety group (A+D+) had significantly higher prevalence
of ED than the control group (A–D-) in both the 45–49 and 50–54 age groups. (P < 0.01)
Conclusion - ED associated significantly with depression and anxiety status only in late 40s to early 50s (45–55 years) in males. Furthermore,
comorbidities of depression and anxiety strengthen this association. Our results might be useful in furthering understanding of ED etiology and
determining a target population for prevention in ED subjects


Keywords


Male Erectile Disorder; Male Psychological Assessment of Sexual Dysfunction; Male Risk Factors/Comorbidities; Male Epidemiology

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References


NIH Consensus Conference. Impotence. NIH Development Panel on Impotence. JAMA 1993; 270:83.

Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: Results of the Mas-sachusetts Male Aging Study. J Urol 1994;151: 54–61.

Braun M, Wassmer G, Klotz T, Reifenrath B, Mathers M, Engelmann U. Epidemiology of erec-tile dysfunction: Results of the “Cologne Male Survey.” Int J Impot Res 2000;12:305–11.

Roth A, Kalter-Leibovici O, Kerbis Y, Tenenbaum-Koren E, Chen J, Sobol T, Raz I. Prevalence and risk factors for erectile dysfunction in men with diabetes, hypertension, or both diseases: A commu-nity survey among 1,412 Israeli men. Clin Cardiol 2003;26:25–30.

Araujo AB, Durante R, Feldman HA, Goldstein I, McKinlay JB. The relationship between depressive symptoms and male erectile dysfunction: Cross-sectional results from the Massachusetts Male Aging Study. Psychosom Med 1998;60:458–65.

Shaeer KZ, Osegbe DN, Siddiqui SH, Razzaque A, Glasser DB, Jaguste V. Prevalence of erectile dysfunction and its correlates among men attending primary care clinics in three countries: Pakistan, Egypt, Nigeria. Int J Impot Res 2003;15(1 suppl): S8–14.

The Pfizer Global Study of Sexual Attitudes and Behaviors. 2002. http://www.pfizerglobalstudy.com/.

Nicolosi A, Moreira ED Jr, Shirai M, Bin Mohd Tambi MI, Glasser DB. Epidemiology of erectile dysfunction in four countries: Cross-national study of the prevalence and correlates of erectile dysfunction. Urology 2003;61:201–6.

Hale VE, Strassberg DS. The role of anxiety on sexual arousal. Arch Sex Behav 1990;19:569–81.

Hedon F. Anxiety and erectile dysfunction: A global approach to ED enhances results and quality of life. Int J Impot Res 2003;15(2 suppl):S16–9.

Marumo K, Nagatsuma K, Murai M. Effect of aging and diseases on male sexual function assessed by the International Index of Erectile Function. Nippon Hinyokika Gakkai Zasshi 1999;90:911–99

Naya Y, Soh J, Ochiai A. The erythrocyte aldosereductase is a useful modality for predicting erectile dysfunction in diabetic patients. Int J Impot Res 2002;14:213–6.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361– 70.

Rosen RC, Cappelleri JC. The sexual health inventory for men. Int J Impot Res 1999;11:319–26.

Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999;11:319– 26.

Melman A, Gingell JC. The epidemiology and pathophysiology of erectile dysfunction. J Urol 1999;161:5–11.

Armitage P, Berry G. Statistical methods in medical research. 2nd edition. London: Blackwell Scientific Publications; 1988.

Altman DG, Machin D, Bryant TN, Gardner MJ. Statistics with confidence. 2nd edition. London: BMJ publisher Group; 2000.

UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998;317:703–13.

SAS Institute Inc. SAS user’s guide statistics, Version 6, 1st edition. Cary, NC: SAS Institute Inc; 1993.

Panser LA, Rhodes T, Girman CJ, Guess HA, Chute CG, Oesterling JE, Lieber MM, Jacobsen SJ. Sexual function of men ages 40–79 years: The Olmsted County Study of Urinary Symptoms and Health Status Among Men. J Am Geriatr Soc 1995; 43:1107–11.

Shabsigh R, Klein LT, Seidman S, Kaplan SA, Lehrhoff BJ, Ritter JS. Increased incidence of depressive symptoms in men with erectile dysfunc-tion. Urology 1998;52:848–52.

Araujo AB, Johannes CB, Feldman HA, Derby CA, McKinlay JB. Relation between psychosocial risk factors and incident erectile dysfunction: Prospective results from the Massachusetts Male Aging Study. Am J Epidemiol 2000;152:533–41.

Sugimori H, Yoshida K, Tanaka T, Baba K, Nishida T, Iwamoto T. Age-related prevalence of erectile dysfunction in healthy men using multiple assessments based on the International Index of Erectile Function. Aging Male 2004;7:53.

D’Ath P, Katona P, Mullan E, Evans S, Katona C. Screening, detection and management of depression in elderly primary care attenders. I: The acceptabil-ity and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions. Fam Pract 1994;11:260–6.

Dorfman RA, Lubben JE, Mayer-Oakes A, Atchison K, Schweitzer SO, De Jong FJ, Matthias RE. Screening for depression among a well elderly population. Soc Work 1995;40:295–304.

Moore T, Strauss JL, Herman S, Donatucci CF. Erectile dysfunction in early, middle, and late adult-hood: Symptom patterns and psychosocial corre-lates. J Sex Marital Ther 2003;29:381–99.

Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Construction of a surro-gate variable for impotence in the Massachusetts Male Aging Study. J Clin Epidemiol 1994;47:457– 67.

Burchardt M, Burchardt T, Anastasiadis AG, Kiss AJ, Shabsigh A, de La Taille A, Pawar RV, Baer L, Shabsigh R. Erectile dysfunction is a marker for cardiovascular complications and psychological functioning in men with hypertension. Int J Impot Res 2001;13:276–81.

Goldstein I. Screening for erectile dysfunction: rationale. Int J Impot Res 2000;12(s4):s147–51.


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