Endocrine Abstracts

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, which assesses, beside the organic (Scale1) and intra-psychic (Scale 3) domains, also the relation one (Scale 2). We previously established a pathological threshold for SIEDY Scale 1 and 3.

Aim: To identify a pathological threshold of SIEDY Scale 2.

Method: A non-selected, consecutive series of 2992 subject 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, MHQ) 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 2148 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.