Anxiety and depression among Greek men with primary erectile dysfunction and premature ejaculation

Annals of General Psychiatry, Oct 2015

Background Erectile dysfunction (ED) and premature ejaculation (PE) are the two most prevalent sexual disorders among males associated with significant distress and impairment in quality of life. The aim of this study was to investigate the prevalence of anxiety and depression symptoms among patients with primary ED and PE. Methods A sample of 57 men (ED = 31; PE = 26) were compared to 25 male outpatients with anxiety disorder (AD) and 25 healthy controls. Principal assessment measures included the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI). Results Greater levels of STAI state anxiety were reported among the ED, PE, and AD groups as compared to healthy controls. In contrast ED and AD groups scored higher than controls on the STAI trait anxiety and BDI, but PE scores were not different from healthy controls in both measures. Conclusions The study findings suggest that both primary ED and PE are conditions associated with significant state anxiety; however, PE appears to be less associated with trait anxiety and depression compared to ED, a finding that corroborates the recent acknowledgement of PE as a more biologically based condition. Limitations and potential clinical implications are also discussed.

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Anxiety and depression among Greek men with primary erectile dysfunction and premature ejaculation

Mourikis et al. Ann Gen Psychiatry Anxiety and depression among Greek men with primary erectile dysfunction and premature ejaculation Iraklis Mourikis 0 1 Marianthi Antoniou 1 Efi Matsouka 1 Eleni Vousoura 1 Chara Tzavara 1 Chrysa Ekizoglou 1 George N. Papadimitriou 1 Nikos Vaidakis 1 Iannis M. Zervas 1 0 Sexual Disorders Clinic, First Department of Psychiatry, Eginition Hospital , 74 Vas. Sofias Ave, 11528 Athens , Greece 1 Department of Psychiatry, Eginition Hospital, Athens University Medical School , 72-74 Vas. Sophias Ave., 11528 Athens , Greece Background: Erectile dysfunction (ED) and premature ejaculation (PE) are the two most prevalent sexual disorders among males associated with significant distress and impairment in quality of life. The aim of this study was to investigate the prevalence of anxiety and depression symptoms among patients with primary ED and PE. Methods: A sample of 57 men (ED = 31; PE = 26) were compared to 25 male outpatients with anxiety disorder (AD) and 25 healthy controls. Principal assessment measures included the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI). Results: Greater levels of STAI state anxiety were reported among the ED, PE, and AD groups as compared to healthy controls. In contrast ED and AD groups scored higher than controls on the STAI trait anxiety and BDI, but PE scores were not different from healthy controls in both measures. Conclusions: The study findings suggest that both primary ED and PE are conditions associated with significant state anxiety; however, PE appears to be less associated with trait anxiety and depression compared to ED, a finding that corroborates the recent acknowledgement of PE as a more biologically based condition. Limitations and potential clinical implications are also discussed. Sexual dysfunction; Erectile dysfunction; Premature ejaculation; STAI; Anxiety; Depression - Background Sexual dysfunction is characterized by disturbances during any stage of the sexual response cycle. It is a common, yet debilitating, condition affecting both men and women at some point in their lives and preventing them from experiencing satisfaction from the sexual activity [1]. Among men, the two most prevalent sexual complaints are erectile dysfunction (ED) and premature ejaculation (PE) [2]. ED is defined as persistent inability to achieve and maintain an erection sufficient for satisfactory sexual performance [3]. It is estimated to affect up to 52 % of men globally, of whom 5–20 % experience moderate to severe ED symptoms [4–6]. PE is defined as persistent ejaculation with minimal sexual stimulation before or soon after penetration, in which the individual has minimal voluntary control over [7]. It is a highly common condition, with prevalence rates reported in epidemiological studies as high as of 30  % [6, 8–12]. Both disorders can be profoundly disabling, causing long-lasting adverse effects on self-image, significant interpersonal and intimacy difficulties [3, 13–15], and mental health problems [13–15]. It has long been thought that sexual disorders, including ED and PE, are primarily due to psychological factors. Anxiety and depression in specific are considered to play a major role in the development and maintenance of problems related to sexual functioning [16, 17]. Several studies have identified an association between anxiety and ED [18–21], as well as anxiety and PE [22, 23], © 2015 Mourikis et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. although some studies have found that anxiety may in fact facilitate sexual arousal [17, 24]. A strong association exists between depression and ED and the strength of that relationship increases with the severity of depression [25, 26]. Depression has also been linked to PE [9, 27], with recent findings showing that this relationship increases with the duration of PE [28]. Recent studies have pointed out that ED and PE may be differentially affected by anxiety and depression symptoms. For instance, genetic rather than psychological factors are increasingly recognized as important contributors to the development of PE [29], while performance and free-floating anxiety appear to play a crucial role on the development and sustenance of ED [18]. To our knowledge, there are no studies that directly compare patients with ED and PE on anxiety and depression symptoms. In addition, very few studies have investigated sexual disorders among Greek ma (...truncated)


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Iraklis Mourikis, Marianthi Antoniou, Efi Matsouka, Eleni Vousoura, Chara Tzavara, Chrysa Ekizoglou, George Papadimitriou, Nikos Vaidakis, Iannis Zervas. Anxiety and depression among Greek men with primary erectile dysfunction and premature ejaculation, Annals of General Psychiatry, 2015, pp. 34, 14, DOI: 10.1186/s12991-015-0074-y