Ponizovsky Alexander M
Mental Health Services, Ministry of Health, Jerusalem, Israel.
J Sex Med. 2008 Oct;5(10):2347-58. doi: 10.1111/j.1743-6109.2008.00882.x. Epub 2008 Jun 17.
Men with alcohol dependence (AD) commonly suffer from alcohol-induced sexual (erectile) dysfunction (ED) and have poor quality of life (Qol). Knowledge about the factors associated with Qol in such patients is lacking.
To identify in men who sought medical help for both AD and ED the variables that best predicted feelings of satisfaction with life and with specific life domains.
The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Secondary study measures were the International Index of Erectile Function (IIEF), Beck Depression Inventory (BDI-13), General Health Questionnaire (GHQ-12), Rosenberg's General Self-Esteem Scale (RGSES), and the Multidimensional Scale of Perceived Social Support (MSPSS).
Within an open-label sildenafil trial, 101 men aged 18-50 years with an International Classification of Diseases, Tenth Edition diagnosis of AD and concomitant ED were interviewed and completed the questionnaires. Multivariate analyses were applied to establish predictors of life satisfaction and factors mediating the relation between ED and life satisfaction.
ED and self-rated depressive symptoms, emotional distress, self-esteem, and perceived social support were found to be significantly associated with Qol and its component domains. Altogether they explained 18-38% of the variance in the Qol ratings. Depressive symptomatology, distress, and self-esteem, individually, demonstrated a mediating effect on the relation between ED and Qol. Finally, self-esteem was shown to be the primary mediator in this relationship.
The results of the study show that self-esteem is the primary factor, and depressive symptoms and severe emotional distress are secondary factors mediating the effects of ED on Qol in male patients seeking medical help for both AD and ED. An integrated pharmacopsychosocial approach targeting the underlying ED as well as the mediating emotional conditions could improve Qol of these patients and thus help them to stop using alcohol.
酒精依赖（AD）男性通常患有酒精所致性（勃起）功能障碍（ED），且生活质量（Qol）较差。目前缺乏关于此类患者生活质量相关因素的了解。
在因AD和ED寻求医疗帮助的男性中，确定最能预测生活满意度及特定生活领域满意度的变量。
生活质量享受与满意度问卷（Q-LES-Q）。次要研究指标包括国际勃起功能指数（IIEF）、贝克抑郁量表（BDI-13）、一般健康问卷（GHQ-12）、罗森伯格一般自尊量表（RGSES）以及多维感知社会支持量表（MSPSS）。
在一项开放标签的西地那非试验中，对101名年龄在18至50岁、国际疾病分类第十版诊断为AD且伴有ED的男性进行访谈并完成问卷。采用多变量分析来确定生活满意度的预测因素以及介导ED与生活满意度之间关系的因素。
发现ED、自评抑郁症状、情绪困扰、自尊和感知社会支持与生活质量及其组成领域显著相关。它们共同解释了生活质量评分中18%至38%的变异。抑郁症状、困扰和自尊各自对ED与生活质量之间的关系具有中介作用。最后，自尊被证明是这种关系中的主要中介因素。
研究结果表明，自尊是主要因素，抑郁症状和严重情绪困扰是介导ED对同时因AD和ED寻求医疗帮助的男性生活质量影响的次要因素。针对潜在的ED以及介导情绪状况的综合药物心理社会方法可以改善这些患者的生活质量，从而帮助他们戒酒。
