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Impotence and depression

Impotence and depression

In another study from the Massachusetts Male Aging Study (age 40-70, 71% high school graduates, 78% employed, 75% married) of 1,709 men were studied from 1986 to 1989. The incidence of impotence (erectile dysfunction) was 25% for the 40-44 age bracket and 47% for those >65. After controlling for an enormous number of confounding factors (age; diabetes treated and untreated; coronary artery disease treated and untreated; hypertension; ulcer; arthritis; cancer; medications; levels of testosterone, dehydroepiandrosterone sulfate, cortisol and prolactin; emotional support; recent marital change; current intake of alcohol; smoking incidence; education; frequency of sexual thoughts; desire; life satisfaction and future expectation), the odds ratio for erectile dysfunction was 1.82 (95% Cl 1.21-2.73) in the presence of depression v. the absence of depression.

The head bone is connected to the body bone. The mind-brain-body continuum means that psychological issues, conditions or "diseases" (the latter comes with codes so physicians can get paid) deserve to be noted, addressed and ameliorated. And the approach need not be pharmacological. Persuade a depressed person to enter a regular aerobic exercise program and 35% of the time the depression will improve or disappear. So how does one persuade? A recent study (Bittner MJ, Veterans' Med. Center, Omaha. American Federation for Medical Research Meeting, 2000. Fam Pract News 2000 Apr 1; 30(7):63) found in a survey of 97 hospital inpatients, the strongest factor creating patient satisfaction and perception of high quality care (American Board of Internal Medicine Patient Satisfaction Questionnaire) was the humanistic quality of their doctor, rather than the time spent with patients and their families, their medical knowledge or their training examination scores. So persuasion is a function of communication, and the quality of humanistic relationship developed between patient and practitioner.

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