Mental Disorders in Peyronie's Disease: A Swedish Cohort Study of 3.5 Million Men.

Studies have shown that men with Peyronie's disease often suffer from psychological problems, but the psychiatric burden of this disorder remains largely unknown. We assessed risks of a range of psychiatric outcomes in a population-based, Swedish cohort comprising 3. 5 million men.

We conducted a longitudinal cohort study based on Swedish national registers. A total of 8,105 men diagnosed with Peyronie's disease and 3.5 million comparison subjects from the general Swedish population were selected, and followed-up for diagnosed psychiatric outcomes, including substance use disorder, alcohol misuse, anxiety disorder, depression, and self-injurious behaviors. Risks of psychiatric outcomes were estimated with Cox regressions, and additionally adjusted for birth year.

Men with Peyronie's disease had increased risks of being diagnosed with substance use disorder; hazard ratio (HR) 1.4, 95% confidence interval (CI) 1.1-1.9, no excess risk of alcohol misuse; HR 0.9, CI 0.8-1.1, but elevated risks of anxiety disorder; HR 1.9, CI 1.6-2.2, depression; HR 1.7, CI 1.5-2.0, self-injurious behaviors; HR 2.0, 95% CI 1.7-2.3, as well as any psychiatric outcomes; HR 1.4, 95% CI 1.2-1.5. The risk estimates were slightly decreased when adjusted for birth year. A limitation of the study was that we had no information about Peyronie's disease diagnoses assigned before year 1997.

Men with Peyronie's disease are at increased risk of being diagnosed with adverse psychiatric outcomes. Health care providers should ensure that men with Peyronie's disease have a documented mental health status assessment.

The Journal of urology. 2020 Oct 20 [Epub ahead of print]

Ralf Kuja-Halkola, Lars Henningsohn, Brian M D'Onofrio, Jesse Mills, Annsofie Adolfsson, Henrik Larsson, Martin Cederlöf

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden., Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden., Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, California., School of Health Sciences, Örebro University, Örebro, Sweden., School of Medical Sciences, Örebro University, Örebro, Sweden.