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
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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],
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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)