Severe depressive symptoms in ED associated with higher incidence of major cardiovascular events
20 july 2010-- Depressive symptoms in men with erectile dysfunction (ED) constitute an independent risk factor for the incidence of a major cardiovascular event (MACE), according to a study published online July 13 in the Journal of Sexual Medicine.
Elisa Bandini, M.D., of the University of Florence in Italy, and colleagues interviewed 2,303 male patients at a clinic for sexual dysfunction using a Structured Interview on Erectile Dysfunction with three scales to explore the organic, relational, and intra-psychic factors of the condition. The researchers assessed depression in the cohort using the Middlesex Hospital Questionnaire for depressive symptoms (MHQ-D) and correlated it to the incidence of MACE, as recorded by the City of Florence Registry Office, in a subset of 1,687 subjects followed for a mean 4.3 years in a longitudinal study.
The researchers identified a positive relationship between MHQ-D score in the ED patients and increasing difficulty achieving an erection sufficient for penetration. Among the subjects in the longitudinal study, there were 139 MACE incidents (15 fatal), with the unadjusted incidence of MACE significantly associated with baseline depressive symptoms. Also, having severe depressive symptoms was independently associated with a higher MACE incidence in a regression model that also included arteriogenic ED, the partner's reduced sexual desire, age, chronic diseases, and an index of psychopathology.
"In particular, our study demonstrates that depressive symptomatology constitutes an independent risk factor for cardiac morbidity and mortality in men with ED. The need for a regular screening for cardiac morbidity in men with ED is even greater in those patients showing depressive symptoms associated with ED," the authors write.
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