ORIGINAL RESEARCH—PSYCHOLOGY: Relationships between Erectile Dysfunction, Depression, and Anxiety in Japanese Subjects


Hiroki Sugimori, MD, PhD, MMedSc, Department of Preventive Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, 2168511, Japan. Tel: +81 44 977 8111 x3416; Fax: +81 44 977 4350; E-mail: hsugimor@marianna-u.ac.jp


Aims.  This study aimed to elucidate the relationships between erectile dysfunction (ED) and depression or anxiety.

Methods.  Subjects were 1,419 Japanese men aged 40–64 years. ED was assessed by the International Index of Erectile Function 5 (IIEF-5) score (Japanese version), and depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS). In this study ED cases were defined as those whose IIEF-5 value was less than 12, and a score of 8 or higher was used to classify a subject as suffering from depression or anxiety, respectively. The prevalence odds ratio (OR) of ED was calculated with confidence interval (CI) estimated by the Woolf's method by five age groups (40–44, 45–49, 50–54, 55–59, 60–64 years). To control for age, body mass index, smoking, and alcohol drinking factors, we conducted the multivariate logistic regression analysis for calculating adjusted ORs and 99% CIs.

Results.  ED was significantly associated with depression in age groups 45–49 (OR 3.42, 99% CI 1.51–7.76) and 50–54 years (OR 2.43, 99% CI 1.11–5.35). After using multivariate analysis, adjusted OR also showed statistical significance. (OR 2.02, 99% CI 1.32–3.08). ED was significantly associated with anxiety in the 50–55-year-old age group (OR 2.48, 99% CI 1.12–5.47). After using multivariate analysis, adjusted OR also showed statistical significance (OR 1.77, 99% CI 1.15–2.72). The concomitant depression and anxiety group (A+D+) had significantly higher prevalence of ED than the control group (A–D–) in both the 45–49 and 50–54 age groups. (P < 0.01)

Conclusion.  ED associated significantly with depression and anxiety status only in late 40s to early 50s (45–55 years) in male Japanese. Furthermore, comorbidities of depression and anxiety strengthen this association. Our results might be useful in furthering understanding of ED etiology and determining a target population for prevention in ED subjects.