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Przydacz M, Russo GI, Osman NI, Gomez Rivas J, Rajwa P, Werneburg GT, Anis O, De Cillis S, Guillot-Tantay C, Tutolo M, Geretto P, Capogrosso P, Falcone M, Manfredi C, Morgado A, Chlosta P. Severity of erectile dysfunction and premature ejaculation positively correlate with aggression levels in men: insights from a large population-representative study. Int J Impot Res 2025:10.1038/s41443-025-01065-y. [PMID: 40234544 DOI: 10.1038/s41443-025-01065-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2024] [Revised: 03/15/2025] [Accepted: 04/03/2025] [Indexed: 04/17/2025]
Abstract
The effects of erectile dysfunction (ED) and premature ejaculation (PE) on men's mental health are well-studied, but their link to aggression has been less explored. Thus, we measured associations between ED, PE, and aggression of men in a large representative cohort with well-balanced demographic characteristics. Participants completed computer-assisted web interviews with reliable questionnaires to assess ED, PE, and aggression. These included the five-item International Index of Erectile Function (IIEF-5), the Premature Ejaculation Diagnostic Tool (PEDT), and the Aggression Module of the Hospital Anxiety and Depression Scale-Modified Version (A-HADS-M). A representative sample of adult men was generated based on the most recent census data, incorporating age and place of residence as quota controls, along with sample size calculations. We interviewed 3001 men, with a mean IIEF-5 score of 18.92 ± 5.04, a mean PEDT score of 7.15 ± 4.26, and a mean A-HADS-M score of 2.71 ± 1.64. We found that aggression was more prevalent in those with ED or PE (p < 0.001). The greater the severity of ED and PE, the greater was the intensity of aggression (Spearman's rank correlation coefficients of -0.207, p < 0.001 and 0.19, p < 0.001 for ED and PE, respectively). Univariate regression models showed significant links between aggression and both ED and PE across age groups. Multivariate models confirmed that these associations were significant and independent of age, sociodemographic factors, comorbidities, and lifestyle habits (regression coefficients: -0.041, p < 0.001 for ED and 0.028, p < 0.001 for PE). Our findings convincingly demonstrated a consistent association between aggression, ED, and PE, warranting further investigation into the underlying mechanisms of these relationships.
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Affiliation(s)
- Mikolaj Przydacz
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland.
| | - Giorgio I Russo
- Urology Section, Department of Surgery, University of Catania, Catania, Italy
| | - Nadir I Osman
- Department of Urology, Royal Hallamshire Hospital, Sheffield, UK
| | - Juan Gomez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Pawel Rajwa
- Second Department of Urology, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Glenn T Werneburg
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Omer Anis
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sabrina De Cillis
- Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | | | - Manuela Tutolo
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Paolo Geretto
- Division of Neuro-Urology, Department of Surgical Sciences, CTO Hospital, Citta della Salute e della Scienza University Hospital, Turin, Italy
| | - Paolo Capogrosso
- Department of Urology, Circolo and Fondazione Macchi Hospital - ASST Sette Laghi, Varese, Italy
| | - Marco Falcone
- Department of Urology, Molinette Hospital, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Torino, Italy
| | - Celeste Manfredi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Afonso Morgado
- Department of Urology, Unidade Local de Saúde São João, Porto, Portugal
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University Medical College, Krakow, Poland
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Quang N, Van Truong L, Chung E, Van Quang B, Long LQ, Ngoc NT, Minh NT, Anh DM, Thanh ND, Nam NT. Predicting Anxiety and Depression Among Erectile Dysfunction Patients: A Cross-Sectional Study. Am J Mens Health 2024; 18:15579883231223502. [PMID: 38288597 PMCID: PMC10826397 DOI: 10.1177/15579883231223502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024] Open
Abstract
In Vietnam, erectile dysfunction (ED) is prevalent and recognized to be associated with mental disorders; however, societal taboos impede a comprehensive understanding of this connection. Our study aims to investigate the factors related to higher levels of anxiety and/or depression (HAD) in individuals with ED. Between November 2022 and March 2023, a face-to-face survey was conducted at the Center for Andrology of Viet Duc University Hospital, involving 390 patients diagnosed with ED. The survey included 51 questions covering general patient information, the International Index of Erectile Function-15 (IIEF-15), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). The stepwise Akaike Information Criterion (AIC) method was used to identify factors associated with HAD. The study revealed an average age of 37.63 (11.84) years among participants, with a HAD prevalence of 17.69%. Several factors were associated with a higher likelihood of belonging to the HAD group in ED patients. These factors included non-office workers (OR: 1.11; 95% CI: [1.01, 1.21], p = .025), medium and high levels of work-related stress (OR: 1.23; [1.06, 1.44], p = .008; OR: 1.22; [1.04, 1.45], p = .018), multiple shameful experiences related to ED (OR: 1.16; [1.08, 1.25], p < .001), moderate and severe ED (OR: 1.17; [1.03, 1.32], p = .013; OR: 1.31; [1.14, 1.51], p < .001), and dissatisfaction with intercourse skills (OR: 1.09; [1.01, 1.17], p = .028). Our findings suggest a 16% higher likelihood of HAD status in individuals with multiple shameful experiences related to ED, while moderate and severe ED are associated with respective increases of 17% and 31% in the likelihood. These findings emphasize the importance of considering mental health in the care of individuals with ED.
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Affiliation(s)
- Nguyen Quang
- Center for Andrology, Viet Duc University Hospital, Hanoi, Vietnam
- University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Le Van Truong
- Traditional Medicine Hospital, Ministry of Public Security, Hanoi, Vietnam
| | - Eric Chung
- Department of Urology, University of Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Bui Van Quang
- Center for Andrology, Viet Duc University Hospital, Hanoi, Vietnam
- University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Luu Quang Long
- Center for Andrology, Viet Duc University Hospital, Hanoi, Vietnam
| | | | | | - Do Mai Anh
- Vietnam University of Traditional Medicine, Hanoi, Vietnam
| | | | - Nguyen Truong Nam
- Faculty of Traditional Medicine at Phenikaa University, Hanoi, Vietnam
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