Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Department of Andrology, Xi'an Daxing Hospital, Shaanxi University of Chinese Medicine, Xi'an, China.
Eur J Clin Invest. 2022 Sep;52(9):e13809. doi: 10.1111/eci.13809. Epub 2022 May 22.
A PHQ-9 score ≥ 15, represented as PHQ-9 , indicates major depressive disorder (MDD). On using PHQ-9, the psychological burden of several patients with lifelong premature ejaculation (LPE) gets aggravated, which may lead to LPE development. We aim to construct a nomogram for predicting the individual risk of PHQ-9 in patients with LPE and discerning those with low risks, who should avoid the PHQ-9.
The nomogram was constructed by analysing data of 802 patients from Xijing Hospital and Northwest Women's & Children's Hospital. The LASSO and multivariable logistic regressions were used to identify independent predictors of PHQ-9 , used for developing the nomogram. The discrimination, calibration and clinical usefulness of the nomogram were assessed in the derivation cohort and an independent validation cohort, which was composed of 505 prospectively enrolled patients from Daxing Hospital and Xijing Hospital.
The duration of PE, IELT, a history of PE exacerbation, IIEF-5 score, urinary frequency and physical pain score were identified as independent predictors. The nomogram showed excellent calibration, discrimination and clinical usefulness in the derivation and validation cohorts, with a predictive accuracy of 0.781 and 0.763, respectively. Based on this nomogram, patients were divided into not recommended, recommended and strongly recommended PHQ-9 filling groups, with PHQ-9 rates of 3.5%, 9.3% and 30.7%, respectively.
A nomogram to discern LPE patients with low risks of PHQ-9 was established. This tool can increase the positivity of MDD screening and may improve the therapeutic outcomes of those in the low-risk group.
PHQ-9 评分≥15 表示患有重度抑郁症（MDD）。PHQ-9 的使用使一些患有终身性早泄（LPE）的患者心理负担加重，可能导致 LPE 发展。我们旨在构建一个预测 LPE 患者 PHQ-9 个体风险的列线图，并识别低风险患者，避免 PHQ-9 的使用。
该列线图通过分析来自西京医院和西北妇女儿童医院的 802 名患者的数据构建。使用 LASSO 和多变量逻辑回归识别 PHQ-9 的独立预测因素，用于开发列线图。在推导队列和独立验证队列中评估列线图的判别、校准和临床实用性，该验证队列由来自大兴医院和西京医院的 505 名前瞻性入组患者组成。
PE 持续时间、IELT、PE 加重史、IIEF-5 评分、尿频和躯体疼痛评分被确定为独立预测因素。该列线图在推导和验证队列中均显示出良好的校准、判别和临床实用性，预测准确率分别为 0.781 和 0.763。基于该列线图，患者被分为不建议、建议和强烈建议进行 PHQ-9 填写的三个组别，PHQ-9 率分别为 3.5%、9.3%和 30.7%。
建立了一个用于识别低 PHQ-9 风险的 LPE 患者的列线图。该工具可以提高 MDD 筛查的阳性率，并可能改善低风险组患者的治疗效果。
