Kosch S G, Curry R W, Kuritzky L
Department of Community Health and Family Medicine, University of Florida, Gainesville 32610.
Fam Pract Res J. 1988 Spring;7(3):162-74.
Twelve patient referrals for evaluation of impotence comprise the subjects of a pilot study examining psychogenic and biogenic factors of erectile dysfunction. A structured interview format (KCII) was developed which allowed the clinician to estimate the likelihood of the presence of three organic factors (hormonal, neurological, cardiovascular) and three psychogenic factors (intrapsychic, relational, and behavioral) as well as the presence of relevant lifestyle factors (alcohol, smoking, exercise patterns). The results demonstrated a good ability of the KCII to accurately identify impotent patients (on the basis of history) who would have positive or negative signs of hormonal factor or neurological factor confirmed by laboratory results or physical examination. The sample of patients who had significant vascular findings did not allow for adequate comparison with interview findings. The majority of patients had significant psychogenic components to their impotence and might have been incorrectly classified as "solely psychogenic" if they had not been simultaneously evaluated for organic factors. The most important finding was that impotence, in most cases, involved multifactorial etiological components and required a comprehensive evaluation and treatment program.
十二例因阳痿前来评估的患者构成了一项初步研究的对象，该研究旨在探讨勃起功能障碍的心理因素和生物因素。开发了一种结构化访谈形式（KCII），使临床医生能够评估三种器质性因素（激素、神经、心血管）、三种心理因素（内心、人际关系和行为）以及相关生活方式因素（酒精、吸烟、运动模式）存在的可能性。结果表明，KCII能够很好地准确识别（根据病史）那些经实验室检查结果或体格检查证实有激素因素或神经因素阳性或阴性体征的阳痿患者。有明显血管病变发现的患者样本无法与访谈结果进行充分比较。大多数患者的阳痿有明显的心理因素，如果没有同时评估器质性因素，他们可能会被错误地归类为“单纯心理性”。最重要的发现是，在大多数情况下，阳痿涉及多因素病因成分，需要全面的评估和治疗方案。
