Predicting Anxiety and Depression Among Erectile Dysfunction Patients: A Cross-Sectional Study

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.

Keywords: anxiety; depression; erectile dysfunction; multiple logistic regression.

Figure 1.

Relationship Between GAD-7 Scores and IIEF-15 Scores by HAD and LAD Groups Note. Figure 1A represents the density distribution of IIEF-15 scores by HAD and LAD groups; Figure 1B is a scatter plot of IIEF-15 and GAD-7 with the size of each point related to age and separate regression lines for the HAD and LAD groups; Figure 1C is the density distribution plot for GAD-7 scores for HAD and LAD groups. GAD-7 = Generalized Anxiety Disorder-7; IIEF-15 = International Index of Erectile Function-15; HAD = high anxiety and/or depression; LAD = low anxiety and depression.

Figure 2.

Relationship Between PHQ-9 Scores and IIEF-15 Scores by HAD and LAD Groups Note. Figure 2A represents the density distribution of IIEF-15 scores by HAD and LAD groups; Figure 2B is a scatter plot of IIEF-15 and PHQ-9 with the size of each point related to age and separate regression lines for the HAD and LAD groups; Figure 2C is the density distribution plot for PHQ-9 scores for HAD and LAD groups. PHQ-9 = Patient Health Questionnaire-9; IIEF-15 = International Index of Erectile Function-15; HAD = high anxiety and/or depression; LAD = low anxiety and depression.