INCREASED INCIDENCE OF DEPRESSIVE SYMPTOMS IN MEN WITH ERECTILE DYSFUNCTION

Objectives. To investigate the hypothesis that men with erectile dysfu nction (ED) have a higher incidence of depressive symptoms compared wi th age-matched control subjects. We also hypothesized that depressive symptoms impact on the level of libido and on the success of treatment of ED. Methods. One hundred twenty men with ED or benign prostatic hy perplasia (BPH) were divided into three groups. Group 1 had ED only, g roup 2 had BPH only, and group 3 had both ED and BPH. Patients were sc reened for depressive symptoms using the Primary Care Evaluation of Me ntal Disorders and the Beck Depression Inventory. They were also surve yed for comorbidity, marital status, severity of ED, level of libido, prior ED treatment choice (if any), success of treatment, and others. Results. One hundred patients completed the questionnaires. Depressive symptoms were reported by 26 (54%) of 48 men with ED alone, 10 (56%) of 18 men with ED and BPH, and 7 (21%) of 34 men with BPH alone. Patie nts with ED were 2.6 times more likely to report depressive symptoms t han men with BPH alone (P < 0.005). Patients with depressive symptoms reported lower libido than other patients (P < 0.0001). Severity of co morbidities did not differ among the three groups. A total of 33 patie nts with ED had prior treatment for ED using penile injections or vacu um devices. AII 15 (100%) patients with ED only continued treatment an d were satisfied with its outcome, whereas only 7 (38.9%) of 18 patien ts with ED and depressive symptoms continued treatment (P < 0.00021). Conclusions. ED is associated with high incidence of depressive sympto ms, regardless of age, marital status, or comorbidities. Patients with ED have a decreased libido compared with control subjects. In additio n, patients with depressive symptoms have a lower libido than patients without depressive symptoms. Patients with ED and depressive symptoms are more likely to discontinue treatment for ED than other patients w ith ED. These data emphasize the importance of a multidisciplinary app roach to the treatment of erectile dysfunction. (C) 1998, Elsevier Sci ence Inc. All rights reserved.