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Study: Young Men with ED Have Higher Rates of Depression, Anxiety

— Screen for psych problems in workup, researchers urge

MedpageToday

Mental health disorders were diagnosed nearly twice as often in young men who had erectile dysfunction (ED), a researcher reported.

Approximately 15% of young men with ED were given a new diagnosis of anxiety or depression 3 years after their ED diagnosis, compared with 8% of patients in a control group, said Tad Manalo, a 4th-year medical student at Emory Medicine in Atlanta.

"Mental health disorders such as depression and anxiety are known risk factors for ED in young men," Manalo said in a presentation at the Sexual Medicine Society of North America 2020 virtual meeting. "Screening for mental health disorders should be included in the workup of ED," and referring patients to a mental health professional or sexual therapist should be considered.

"The key clinical implication of this research would be not to just focus on a young man's ED," Bobby Najari, MD, MSc, of NYU Langone Health in New York City, who was not involved with the research, told 51˶. "We should consider the fact that they could also have anxiety or depression."

"Erectile dysfunction in younger men is understudied and underrecognized in the medical field," Najari continued. He said the study represents an opportunity for urologists not only to address sexual issues among young men, but also to take a more interdisciplinary, holistic approach to managing mental health concerns.

Najari noted that some treatments for mental health disorders, such as selective serotonin reuptake inhibitors, are known to affect sexual function, and future studies should focus on whether it is the mental health disorder itself or the medication that is associated with ED.

Manalo said that although ED is most common in older men, the prevalence in younger men could be as high as 30%. Mental health disorders are a risk factor for ED, and the conditions are associated with a self-perpetuating cycle that may result in poor self-image, psychological distress, and sexual failure.

For the study, the researchers used commercial claims data from 2009 to 2018 to identify young men with ED. The group was matched 1:1 with controls, and the team tracked anxiety and depression diagnoses in both groups. Cases were matched with controls based on age, comorbidities, history of hypertension, geographic location and year of ED presentation, and the prevalence of mental health disorders were compared in the 12-month period prior to the diagnosis of ED and up to 3 years later.

The investigators matched a total of 264,187 young men with ED to controls; the majority of patients had no comorbidities or history of hypertension.

In the year before receiving a diagnosis of ED, about 11% of young men had been diagnosed with a mental health disorder compared with 6% of those in the control group. Three years later, 15% and 8%, respectively, were given a new diagnosis of anxiety or depression.

  • Amanda D'Ambrosio is a reporter on 51˶’s enterprise & investigative team. She covers obstetrics-gynecology and other clinical news, and writes features about the U.S. healthcare system.

Disclosures

Manalo and co-authors did not report any disclosures.

Primary Source

Sexual Medicine Society of North America

Manalo T, et al "Frequency of anxiety and depression in young men with erectile dysfunction" SMSNA 2020; Abstract 005.