Rajkumar Ravi Philip, Kumaran Arun Kumar
Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantari Nagar, Pondicherry, 605 006, India.
Lakeshore Hospital, Ernakulam, Kerala, India.
Compr Psychiatry. 2015 Jul;60:114-8. doi: 10.1016/j.comppsych.2015.03.001. Epub 2015 Mar 19.
Comorbid anxiety disorders and depression are commonly seen in men with sexual disorders such as erectile dysfunction (ED) and premature ejaculation (PE). However, they are often undiagnosed and untreated, and their relationship to sexual dysfunction is complex. This study examines the frequency and correlates of comorbid anxiety and depression in men with ED or PE.
The case records of 64 men with ED or PE attending a clinic for psychosexual disorders in a general hospital psychiatry unit during the period 2010-14 were reviewed. Information on comorbid anxiety disorders and depression was extracted from these records, and their clinical and demographic associations were analyzed.
Eight (12.5%) men had comorbid depressive disorders, and fifteen (23.4%) had anxiety disorders. These disorders predated the onset of sexual dysfunction in the majority of patients. Generalized anxiety disorder was the commonest anxiety disorder. Men with comorbid depression had significantly elevated rates of suicidal ideation or behavior related to their sexual dysfunction, and were more likely to report a lack of libido. Men with pre-existing anxiety disorders were more likely to experience performance anxiety related to sex, and to have PE without comorbid ED.
Depression and anxiety affect a substantial minority of men with sexual dysfunction. Men presenting for the evaluation of ED and PE should be carefully screened for these disorders. The links between anxiety disorders and sexual performance anxiety merit further investigation in this patient group.
共病焦虑症和抑郁症在患有勃起功能障碍(ED)和早泄(PE)等性功能障碍的男性中很常见。然而,它们往往未被诊断和治疗,且它们与性功能障碍的关系很复杂。本研究调查了患有ED或PE的男性中共病焦虑和抑郁的频率及其相关因素。
回顾了2010年至2014年期间在一家综合医院精神科性心理障碍门诊就诊的64例患有ED或PE的男性的病例记录。从这些记录中提取有关共病焦虑症和抑郁症的信息,并分析其临床和人口统计学关联。
8例(12.5%)男性患有共病抑郁症,15例(23.4%)患有焦虑症。这些疾病在大多数患者的性功能障碍发病之前就已存在。广泛性焦虑症是最常见的焦虑症。患有共病抑郁症的男性因性功能障碍出现自杀意念或行为的比率显著升高,且更有可能报告性欲缺乏。既往患有焦虑症的男性更有可能经历与性相关的表现焦虑,且患有PE但无共病ED。
抑郁症和焦虑症影响了相当一部分患有性功能障碍的男性。前来评估ED和PE的男性应仔细筛查这些疾病。焦虑症与性表现焦虑之间的联系值得在该患者群体中进一步研究。