Latini DM et al. (2006) Clinical and psychosocial characteristics of men with erectile dysfunction: baseline data from ExCEED™. J Sex Med 3: 1059–1067

Erectile dysfunction (ED) is associated with psychological dysfunction, but this finding is based on comparisons of men with and without ED. Latini and colleagues, therefore, explored the relationship between ED and psychosocial impairment; they found that as the severity of ED worsens, psychological dysfunction also worsens.

The authors assessed baseline clinical data and responses to a questionnaire from 162 men with ED who participated in the Exploratory and Comprehensive Evaluation of ED study. The cohort was predominantly white (86%), well-educated (48% had a college degree) and married (74%); many (44%) were employed full-time. In total, 27 men had mild ED, 41 had moderate ED and 94 had severe ED. The questionnaire assessed multiple, validated, ED-specific measures of health-related quality of life, and measures of psychological functioning. Interestingly, patients' and physicians' assessments of ED severity differed; Latini et al. suggest that patients might (perhaps unconsciously) over-represent the severity of their ED, or that their assessment of its severity might be influenced by the amount of psychological distress suffered.

Men with severe ED reported the most depression, anxiety and loneliness, although these impairments were generally insufficient to require psychotherapy. Low sexual self-efficacy scores correlated closely with severe ED; Latini et al. infer that patients' confidence in their sexual abilities is strongly linked to the amount of ED-related psychological distress they experience. These authors call for a multidisciplinary approach to treatment for men with severe ED, and recommend increased use of psychosocial interventions.