Relationship between premature ejaculation and depression: A PRISMA-compliant systematic review and meta-analysis

BACKGROUND: Premature ejaculation (PE) is the most prevalent male sexual dysfunction. Epidemiologic findings are inconsistent concerning the risk for depression associated with PE. OBJECTIVE: The aim of this study was to investigate the potential association between between depression and risk of PE. DATA SOURCES: We conducted a literature search of PubMed, Embase, and the Cochrane Library from these databases’ inception through June 2014 for observational epidemiological studies examining the association between depression on risk of PE. Study eligibility criteria: Studies were selected if they reported the risk estimates for PE associated with depression. PARTICIPANTS: patients>18 years of age suffering from PE. INTERVENTIONS: a history of depressive disorder. STUDY APPRAISAL AND SYNTHESIS METHODS: These odds ratios (ORs) were pooled using a random or fixed effects model and were tested for heterogeneity. Subgroup analysis was employed to explore heterogeneity. RESULTS: Eight trials involving 18,035 patients were included in the meta-analysis. Depression were statistically significantly associated with the risk of PE (OR = 1.63, 95% CI:1.42–1.87). There was no evidence of between-study heterogeneity (P = 0.623, I(2) = 0.0%). The association was similar when stratified by mean age, geographical area, study design, sample size, publication year, and controlling key confounders. LIMITATIONS: The severity of depression and PE could not be identified due to unavailable data of trials. No evidence of publication bias was observed. CONCLUSIONS: These findings provide evidence that depression is associated with a significantly increased risk of PE. In addition, more prospective studies are necessary to evaluate the association and identify the ideal treatment. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42016041272