Peyronie's disease and risk of depression. A nationwide 25-year cohort study.

BACKGROUND

Peyronie's disease leads to penile deformities and can cause physical symptoms, for example, penile pain, and erectile dysfunction, along with psychological issues, such as depressive symptoms.

AIM

The aim of this study was to investigate whether men with Peyronie's disease have an increased risk of depression.

METHODS

This nationwide cohort study included men with Peyronie's disease (ICD-10 code: N486) from 1997 to 2021 and age-matched (1:10) men without Peyronie's disease. We obtained complete medical history before the Peyronie's disease diagnosis/index date. We followed both cohorts for depression. We computed the cumulative incidence of depression at 5 and 10 years of follow-up and estimated hazard ratios for depression comparing the 2 cohorts while adjusting for selected chronic diseases using Cox regression.

OUTCOME

The primary outcome, depression, was defined by ICD-10 code: F32, F33 recorded in the Danish National Patient Registry or the Psychiatric Central Research Registry and/or redemption of at least 2 prescriptions for an antidepressant (ATC-code: N06A).

RESULTS

We included 10 053 men with Peyronie's disease and 100 530 without (median age 55.6 years). At the index date, 19.6% men with Peyronie's disease had depression versus 14.0% men without. At baseline, men with Peyronie's disease had a 5-year risk of depression of 7.0% versus 4.4% in men without, while the 10-year risks were 12.5% and 8.7%, respectively. The adjusted hazard ratio was 1.42 (95% CI, 1.32, 1.52).Men with Peyronie's disease had a 10-year all-cause mortality of 5.9%, while it was 9.1% in men without.

CLINICAL IMPLICATIONS

Health professionals should ensure that men with Peyronie's disease are examined for depression.

STRENGTHS AND LIMITATIONS

A limitation of our study is the potential underdiagnosis of men with Peyronie's disease, which may lead to an incorrect estimation of depression among Peyronie's disease patients. It is a strength that we include a nationwide cohort of men with Peyronie's disease and age-matched controls. Other strengths are that we included information from several Danish medical databases and depression was defined as a clinic diagnosis and/or redemption of at least 2 prescriptions for an antidepressant.

CONCLUSIONS

Men with Peyronie's disease had a higher prevalence of depression at the time of diagnosis and a higher risk of depression following diagnosis compared with men without.