ANXIETY AND DEPRESSION IN ERECTILE DYSFUNCTION AND PREMATURE EJACULATION CASES IN A TERTIARY HEALTH CENTRE: A CROSS-SECTIONAL STUDY
Main Article Content
Keywords
Anxiety, Depression, Erectile dysfunction, Premature ejaculation, Sexual dysfunction, HAM-A, HDRS
Abstract
Erectile dysfunction (ED) and premature ejaculation (PME) significantly impact quality of life and are closely associated with anxiety and depression. The psychological aspects of these conditions often remain underexplored, particularly in the Indian population.
Objectives: To assess the prevalence and severity of anxiety and depression in individuals with ED and PME, and to explore the relationship between the severity of sexual dysfunction and psychiatric symptoms.
Methods: This hospital-based cross-sectional study included 91 male patients presenting with ED and/or PME to the Psychiatry outpatient department of Rajshree Medical Research Institute, Bareilly. Patients were assessed using the International Index of Erectile Function (IIEF), Premature Ejaculation Diagnostic Tool (PEDT), Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HDRS). Descriptive statistics, correlation analysis, and regression analysis were performed using R statistical software.
Results: Of 91 patients (mean age: 35.4 ± 9.2 years), ED only was present in 53.8%, PME only in 5.5%, and both conditions in 40.7%. Anxiety was detected in 90.1% of patients while depression was found in 86.8%. Severe anxiety was present in 63.7% and severe/very severe depression in 80.3% of patients. Significant negative correlations were observed between IIEF scores and HAM-A scores (r = -0.698, p < 0.001) and HDRS scores (r = -0.640, p < 0.001). Multiple regression analysis revealed that IIEF score was a significant predictor of both anxiety (p = 0.034) and depression (p = 0.004).
Conclusion: This study demonstrates a very high prevalence of anxiety (90.1%) and depression (86.8%) among patients with erectile dysfunction and premature ejaculation. The significant inverse correlation between ED severity and psychiatric symptoms underscores the importance of routine psychiatric screening and integrated treatment approaches for these patients.
References
2. Rosen RC. Prevalence and risk factors of sexual dysfunction in men and women. Curr Psychiatry Rep. 2000;2(3):189-195.
3. Hatzimouratidis K, Amar E, Eardley I, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. 2010;57(5):804-814.
4. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993;270(1):83-90.
5. Ayta IA, McKinlay JB, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999;84(1):50-56.
6. Xiao Y, Xie T, Peng J, et al. Factors associated with anxiety and depression in patients with erectile dysfunction: a cross-sectional study. BMC Psychol. 2023;11(1):36.
7. Yang Y, Wang J, Zhang Y, et al. Associations between erectile dysfunction and psychological disorders (depression and anxiety): A cross-sectional study in a Chinese population. Andrologia. 2019;51(10):e13395.
8. McMahon CG, Althof SE, Waldinger MD, et al. An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine. J Sex Med. 2008;5(7):1590-1606.
9. Serefoglu EC, McMahon CG, Waldinger MD, et al. An evidence-based unified definition of lifelong and acquired premature ejaculation. J Sex Med. 2014;11(6):1423-1441.
10. Atlantis E, Sullivan T. Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. J Sex Med. 2012;9(6):1497-1507.
11. Liu Q, Zhang Y, Wang J, et al. Erectile dysfunction and depression: a systematic review and meta-analysis. J Sex Med. 2018;15(8):1073-1082.
12. Tripathi A, Kumar D, Ksar SK, et al. Sociodemographic and clinical profile of patients presenting with erectile dysfunction: experience from a tertiary care centre of North India. J Psychosexual Health. 2021;3(3):242-249.
13. Das J, Yadav S. Comorbidities of male patients with sexual dysfunction in a psychiatry clinic: a study on industrial employees. Ind Psychiatry J. 2022;31(1):81-88.
14. Barlow DH. Causes of sexual dysfunction: the role of anxiety and cognitive interference. J Consult Clin Psychol. 1986;54(2):140-148.
15. Reisman Y, Porst H, Lowenstein L, et al. A psychosocial approach to erectile dysfunction: position statements from the European Society of Sexual Medicine (ESSM). J Sex Med. 2022;19(1):25-41.
16. Chepure AH, Ungratwar AK. Study of comorbid psychiatric diagnoses in premature ejaculation and erectile dysfunction. J Clin Diagn Res. 2018;12(2):VC01-VC03.
17. Osasona SO, Ehimigbai M. Sexual dysfunction: prevalence and associated factors in patients with mental illness receiving psychotropic medication in Nigeria. Afr Health Sci. 2019;19(4):2973-2984.
18. Adesola AO, Oladeji B. Prevalence and correlates of sexual dysfunction among patients with mental disorders in a tertiary hospital in Southwest Nigeria. S Afr J Psychiatr. 2021;27:1575.
19. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32(1):50-55.
20. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56-62.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Karan Tomar
Junior Resident, Department of Psychiatry, Rajshree Medical Research Institute, Bareilly, [email protected]
Dr. Rakesh Yaduvanshi
Professor and Head of Department, Department of Psychiatry, Rajshree Medical Research Institute, Bareilly
