Rajkumar Ravi Philip, Kumaran Arun Kumar
Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry (Dr Rajkumar); and Lakeshore Hospital, Ernakulam, Kerala (Dr Kumaran), India.
Prim Care Companion CNS Disord. 2014 Jul 31;16(4). doi: 10.4088/PCC.14m01630. eCollection 2014.
Premature ejaculation is one of the most common forms of male sexual dysfunction. Recent clinical and genetic evidence suggests that it can be classified into 4 subtypes, which may have distinct clinical profiles. Psychological factors, such as anxiety, may play a specific role in the acquired subtype. The objective of this study was to assess the association between psychological factors, particularly anxiety and marital disharmony, and the various subtypes of premature ejaculation.
The case records of 28 men presenting with premature ejaculation to a clinic for psychosexual disorders in India between January 2012 and January 2013 were reviewed. The patients were classified into 4 subtypes (lifelong, acquired, natural variable, and premature-like ejaculatory dysfunction) and compared in terms of demographic and clinical profile.
Performance anxiety during intercourse was significantly associated with the acquired subtype of premature ejaculation (P = .011, Fisher exact test). Marital disharmony was equally common in the lifelong and acquired subtypes of premature ejaculation (P = not significant, Fisher exact test) and, in most cases, could be attributed to the distress caused by premature ejaculation itself.
Our results are consistent with existing literature that shows an association between anxiety and premature ejaculation, particularly the acquired subtype. Anxiety may play a causal or perpetuating role in these patients. If replicated, such a finding would have important therapeutic implications.
早泄是男性性功能障碍最常见的形式之一。近期的临床和遗传学证据表明，早泄可分为4种亚型，各亚型可能具有不同的临床特征。焦虑等心理因素可能在获得性亚型中起特定作用。本研究的目的是评估心理因素，尤其是焦虑和婚姻不和谐与早泄各亚型之间的关联。
回顾了2012年1月至2013年1月期间在印度一家性心理障碍诊所就诊的28例早泄男性患者的病例记录。将患者分为4种亚型（终身性、获得性、自然变异性和早泄样射精功能障碍），并比较其人口统计学和临床特征。
性交时的表现焦虑与早泄的获得性亚型显著相关（P = .011，Fisher精确检验）。婚姻不和谐在早泄的终身性和获得性亚型中同样常见（P = 无显著性差异，Fisher精确检验），且在大多数情况下，可归因于早泄本身所导致的痛苦。
我们的结果与现有文献一致，表明焦虑与早泄之间存在关联，尤其是获得性亚型。焦虑可能在这些患者中起因果或持续作用。如果该发现得到重复验证，将具有重要的治疗意义。
