Psycho-biological correlates of free-floating anxiety symptoms in male patients with sexual dysfunctions

Anxiety has a relevant impact on everyday life, including sexual life, and therefore is considered the final common pathway by which social, psychological, and biological stressors negatively affect sexual functioning. The aim of this study is to define the psycho-biological correlates of free-floating anxiety in a large sample of patients complaining of erectile dysfunction (ED)-based sexual problems. We studied a consecutive series of 882 ED patients using SIEDY (c), a 13-item structured interview, composed of 3 scales that identify and quantify organic, relational, and intrapsychic domains. MHQ-A scoring from Middlesex Hospital Questionnaire (MHQ) was used as a putative marker of free-floating anxiety symptoms (AS). Metabolic and hormonal parameters, nocturnal penile tumescence (NPT) test, and penile Doppler ultrasound (PDU) examination were also performed. MHQ-A score was significantly higher in patients complaining of difficulties in maintaining erection and in those reporting premature ejaculation (6.5 +/- 3.3 vs 5.8 +/- 3.3 and 6.6 +/- 3.3 vs 6.1 +/- 3.3, respectively; both P < .05). Moreover, ASs were significantly correlated to life stressors quantified by SIEDY (c) scale 2 (relational component) and scale 3 (intrapsychic component) scores, as dissatisfaction at work or within the family or couple relationships. Among physical, biochemical, or instrumental parameters tested, only end-diastolic velocity at PDU was significantly (P < .05) related to ASs. In conclusion, in patients with ED-based sexual problems, ASs are correlated to many relational and life stressors. Conversely, organic problems are not necessarily associated with MHQ-A score.