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Personality and psychiatric disorders in chronic pain male affected by erectile dysfunction: prospective and observational study

International Journal of Impotence Research volume 33, pages 339–347 (2021)Cite this article

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Abstract

The prevalence of personality disorders (PDs) and sexual dysfunction in chronic pain patients is higher than in general population. Our main objective was to analyse the influence of PD in patients with erectile dysfunction and chronic non-cancer pain and their response to andrological treatment. One-hundred one patients were included along 30 months. Pain intensity, quality of life, sexual life quality, anxiety and depression were analysed together with opioid dose. Erectile functioning was measured with the International Index of Erectile Function (IIEF) and PDs with Millon Clinical Multiaxial Inventory (MCMI-III). The mean age was 57 ± 12 years old, with moderate to severe pain, 70% were sexually active and presented moderate to severe ED. PDs were very frequent (31%, cut-off 85 and 84% cut-off 75 scores) mostly anxiety, compulsive, though disorder, somatoform and narcissistic. Self-defeating feature presence was significantly correlated (r = −0.4, 95% CI = −0.605 to −0.145, p = 0.002) with a more severe baseline ED and narcissistic, and a better response to andrological treatment (p = 0.010, d = 1.082). Patients with dysthymia features required significantly higher opioid doses vs. control (238 vs. 102 mg/day, respectively). These findings underline the importance of diagnosing PDs to rigorously treat patients with chronic pain and ED.

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Acknowledgements

We acknowledge the help received from Dr Olga Alda (pain clinical coordinator), Ms Raquel Martín (pain health care assistant), Ms Emi Martínez (biology fellow) and Mr Carlos García-Navas (pharmacy fellow).

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Author notes

  1. These authors contributed equally: Raquel Ajo, María-del-Mar Ind

Authors and Affiliations

  1. Pain Unit, Department of Health of Alicante-General Hospital, Alicante, Spain

    Raquel Ajo, María-del-Mar Inda, Pura Ballester, Javier Muriel, César Margarit & Ana M. Peiró

  2. Neuropharmacology on Pain (NED), Department of Health of Alicante-General Hospital, ISABIAL, Alicante, Spain

    Raquel Ajo, María-del-Mar Inda, Ana Segura, Pura Ballester, Javier Muriel, Guillermina Ferrández, César Margarit & Ana M. Peiró

  3. Andrology Unit, Department of Health of Alicante-General Hospital, Alicante, Spain

    Margarita Mateu

  4. Clinical Psychology Unit, Department of Health of Alicante-General Hospital, Alicante, Spain

    Ana Segura & Guillermina Ferrández

  5. Occupational Observatory, Miguel Hernández University of Elche, Alicante, Spain

    Rafael Sellers

  6. Clinical Pharmacology Unit, Department of Health of Alicante-General Hospital, Alicante, Spain

    Ana M. Peiró

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  1. Raquel Ajo
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Ajo, R., Inda, MdM., Mateu, M. et al. Personality and psychiatric disorders in chronic pain male affected by erectile dysfunction: prospective and observational study. Int J Impot Res 33, 339–347 (2021). https://doi.org/10.1038/s41443-020-0294-9

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