INTRODUCTION

Depression might increase the risk of erectile dysfunction (ED), and ED might further exacerbate depression. The causal relationship between these two diseases remains controversial. In addition, limited evidence is available regarding the age-dependent and time-dependent effects on the association of depression and ED.

AIM

We investigated the hypothesis that ED increases the risk of depression by using a nationwide Taiwanese population-based claims database. In addition, we assessed the age-dependent and time-dependent effects on the association of depression and ED.

METHODS

A longitudinal cohort study was conducted to determine the association between patients with ED and depression development during a 5-year follow-up period, using claims data from the Taiwanese National Health Insurance Research Database.

MAIN OUTCOME MEASURES

The study cohort comprised patients who were diagnosed with ED during 1997 to 2005 (N = 2,527). For a comparison cohort, 5 age- and sex-matched patients for every patient in the study cohort were selected using random sampling (N = 12,635). All of the patients were followed-up for 5 years from the date of cohort entry to identify the development of depression.

RESULTS

The main finding of this study was that patients with ED are at an increased risk of developing depression. The adjusted hazard ratio (AHR) for depression was 2.24-fold higher in the patients with ED than in the comparison cohort (95% confidence interval [CI]: 1.83-2.74; P < 0.001). Regarding the time-dependent effect, the incidence of depression was highest during the first year of follow-up (AHR: 3.03, 95% CI = 2.08-4.40; P < 0.001).

CONCLUSIONS

This study demonstrates that patients with ED are at a higher longitudinal risk of developing depression in Asian men, particularly within the first year after the diagnosis of ED.