The George Washington University School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Sciences, Washington, DC 20037, USA.
Gen Hosp Psychiatry. 2013 Jan-Feb;35(1):33-8. doi: 10.1016/j.genhosppsych.2012.08.008. Epub 2012 Oct 6.
Erectile dysfunction (ED), defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, is the most common sexual problem in men. ED arises when there is disruption of the complex interplay between vascular, neurologic, hormonal and psychologic factors necessary for normal erectile function. It may have a significant effect on quality of life and portend undetected cardiovascular disease. Risk factors for development of ED include advancing age, tobacco use, a history of pelvic irradiation or surgery and antipsychotic use (Table 1) [1]. Treatment guidelines continue to evolve for optimal management of ED. In this article, we review diagnostic and treatment strategies for ED relevant to psychiatrists.
We present an integrative approach to the treatment of ED based on a review of the urologic and psychiatric literature.
ED is multifactorial in origin and responsive to a variety of therapeutic interventions, including psychopharmacology and psychotherapy in which cognitive underpinnings of poor sexual performance, including diminished self-esteem, lack of confidence and perceived failures in the male role, are examined.
Psychiatrists can readily perform a basic workup for ED as they integrate both a medical and therapeutic model when confronted with such patients.
勃起功能障碍（ED）定义为无法获得或维持足以满足满意的性表现的勃起，是男性最常见的性问题。当血管、神经、激素和心理因素之间复杂的相互作用受到干扰，导致正常勃起功能受到影响时，就会出现 ED。它可能对生活质量产生重大影响，并预示着未被发现的心血管疾病。ED 的发展风险因素包括年龄增长、吸烟、盆腔放疗或手术史和抗精神病药物的使用（表 1）[1]。ED 的治疗指南继续发展，以实现最佳管理。在本文中，我们回顾了与精神科医生相关的 ED 的诊断和治疗策略。
我们根据泌尿科和精神病学文献的回顾，提出了一种治疗 ED 的综合方法。
ED 的病因是多因素的，对各种治疗干预措施有反应，包括精神药理学和心理治疗，其中包括对性表现不佳的认知基础进行检查，包括自尊心下降、缺乏信心和对男性角色的失败感。
当精神科医生面对这样的患者时，他们可以将医学和治疗模式结合起来，轻松为 ED 进行基本的检查。
