INTRODUCTION: The relational domain of erectile dysfunction (ED) is difficult to investigate in a clinical setting.
We developed and validated SIEDY, a 13-item structured interview, that evaluates, besides the organic (Scale 1) and intra-psychic (Scale 3) domains, also the relational one (Scale 2). We previously established a pathological threshold for SIEDY Scale 1 and 3.
AIM: The aim of this study is to identify a pathological threshold of SIEDY Scale 2.
METHOD: A nonselected, consecutive series of 2,992 subjects with ED was retrospectively evaluated. In a first consecutive series of 844 patients (Sample A, studied without systematically applying a psychometric test: Middlesex Hospital Questionnaire), a pathological threshold of SIEDY Scale 2 score was identified through receiver operating characteristic, using, as surrogate marker of impaired couple relationship, at least a positive answer to two standard questions on conflict within the couple and on the presence of extramarital affairs.
MAIN OUTCOME MEASURE: Sensitivity and specificity, along with possible associations with biological and psychological correlates were verified in a further sample of 2,148 patients (Sample B).
RESULTS: In Sample A, a threshold of Scale 2 score ≥2 predicts couple impairment with a sensitivity of 53% and specificity of 66% and an overall accuracy of 62.0 ± 2.2% (P < 0.0001). When this threshold was verified in sample B, Scale 2 score ≥2 was associated with a higher risk of anxiety and depressive symptoms, higher prevalence of psychopathology, and higher Scale 3 scoring, even after adjusting for confounders. In the same sample, a Scale 2 score ≥2 was associated with a reduced intimacy during sexual intercourse and overall worse sexual functioning.
CONCLUSIONS: Until now, no instrument is available to quantify the marital domain of ED. The validation of a threshold of SIEDY Scale 2 score (≥2) represents an easy tool for the identification of ED patients with a relevant marital impairment.
Written by:
Boddi V, Corona G, Fisher AD, Mannucci E, Ricca V, Sforza A, Forti G, Maggi M. Are you the author?
Department of Physiopathology, Andrology Unit, Florence, Italy.
Reference: J Sex Med. 2012 Dec;9(12):3126-36.
doi: 10.1111/j.1743-6109.2012.02948.x
PubMed Abstract
PMID: 23036015
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