Prevalence of psychiatric co-morbidity in individuals with erectile dysfunction – A cross sectional study

INTRODUCTION: Erectile Dysfunction (ED) is defined as the persistent inability to achieve or maintain an erection adequate for satisfactory sexual activity. The overall global prevalence is 13.1–71.2%. A study conducted in south India found prevalence of erectile dysfunction in 15.77%, with least in those aged 26-30 years(8.6%) and highest in those aged 51-60 years(27.6%). Emergence of erectile dysfunction may be attributed to organic or psychogenic factors, irrespective of which it often leads to psychological problems. Although ED is subjectively distressing, only a small proportion of males consider it a medical problem, and hence reported infrequently. This study tries to explore presence of co-morbid psychiatric diagnoses in patients with Erectile Dysfunction. SOURCE: 30 consecutive sexually active males attending the out-patient department of Urology, KIMS, Bangalore, diagnosed with erectile dysfunction were included in the study. ‘International Index of Erectile Function Questionnaire’ was used to assess severity and ‘The Mini International Neuropsychiatric Interview’ was used to assess the presence of co-morbid psychiatric disorders. RESULTS: 26 of the 30 study subjects had psychiatric co-morbidity, commonly anxiety spectrum disorder(46.15%), depressive spectrum disorder(38.46%) and substance use disorder(15.38%). 11 patients of the 26 had symptoms suggestive of psychiatric disorder before the onset of ED, though untreated. These were predominantly substance use disorder(4), generalized anxiety disorder(3), depressive disorder(3) and obsessive compulsive disorder(1) were seen. 15 patients developed psychological symptoms after the onset of ED, predominantly anxiety disorder(8) and depressive disorder(7). There was no association between psychiatry morbidity and socio-demographics of the patients. CONCLUSION: 57.6% of the study population developed psychiatric morbidity following the onset of erectile dysfunction, predominantly anxiety and depressive disorders. Since the occurrence of psychiatric morbidity is high in patients with erectile dysfunction, it is important to incorporate routine screening for the same at the outset.