Erektil disfonsiyon ve depresyon

Year 2015, Volume: 10 Issue: 1, 55 - 59, 01.01.2015

Serdar Toksöz² Taha Numan Yıkılmaz

Abstract

Erektil disfonksiyon ED hasta ve cinsel partnerinin yaşam kalitesini etkileyen yaygın bir şikayettir. Erektil disfonksiyon ile ilgili değişkenler yaş ve eşlik eden medikal hastalıklardır. Erektil disfonksiyon ED nedenleri fizyolojik ve psikolojik olarak ikiye ayrılır. Psikojenik ve organik nedenler çoğu kez iç içe olabilmekte ve ayırıcı tanıda zorluklar yaratabilmektedir. Depresyon psikiyatrik nedenler arasında en sık görülen etken iken özellikle cinsel ilgi ve istek kaybına neden olmaktadır. Epidemiyolojik ve klinik çalışmalarda depresyonun, tedavi edilmeyen hastalarda cinsel işlev ve doyum bozukluğu ile ilişkili olduğu gösterilmiştir. Depresyon sık görülen, uzun süreli atakları olan, tekrarlama gösteren, ciddi fiziksel ve psikososyal yeti kaybına neden olan son derece yıkıcı bir bozukluktur. Tüm erişkin erkek popülasyonun %10-20’sinde görülmektedir, 40-70 yaşları arasındaki erkeklerde %52 oranında görülmektedir. Cinsel işlev bozukluğu ve depresyon arasındaki ilişki karmaşık, çift yönlü ve nedensel olmakla birlikte belirsizdir. Cinsel işlev bozukluğu ve psikososyal stres depresyona eşlik edebilirken depresyon da cinsel fonksiyon bozukluğuna sebep olabilir. Depresyon ve ED’nun patofizyolojik ilişkileri ile ilgili öne sürülen tezler olmasının yanı sıra klinik olarak birbiri ile olan bağlantıları açıktır. Psikolojik kaynaklı ED’nun ürolog ve psikiyatr tarafından multidisipliner bir şekilde araştırılması tanı ve tedavi basamaklarında hastaya daha fazla fayda sağlayacaktır. Bu yazının amacı depresyon ile cinsel işlev bozukluğu arasındaki ilişkiyi gözden geçirmek ve güncel durumun tartışılmasıdır

Keywords

Cinsellik , cinsel işlev bozukluğu , depresyon , antidepresanlar

Erectile dysfunction and depression

Abstract

Erectile dysfunction ED is a common complaint that affects the quality of life in both patient and sexual partner. Variables related to ED include age and comorbid medical illnesses. The causes of erectile dysfunction ED are divided into physical and psychological. Psychogenic and organic causes may be often intertwined and in the differential diagnosis may lead to difficulties. While depression is the most frequent reason for psychiatric causes, especially among the causes loss of sexual interest and desire. Epidemiological and clinical studies show that depression is associated with impairments of sexual function and satisfaction, even in untreated patients. Depression is frequent episodes of long-term, repeating, indicating a serious physical and psychiatric disabilities have a devastating disorder. It is seen in 10-20% of the all male population and seen in %52 of 40-70 years. The relationship between Sexual dysfunction and depression is the complex, bi-directional and uncertain, but the causal. sexual dysfunction and psychosocial stress can also accompanied by depression and it causes sexual dysfunction. Depression and ED as well as arguments put forward regarding pathophysiologic relationships with each other, which is clinically obvious connections. Psychological ED induced by a urologist and psychiatrist in multidisciplinary research will more benefit the patient diagnosis and treatment stages. The aim of this paper was to review the relationship between depression and sexual dysfunction and discussed the current status

Keywords

Sexuality , sexual dysfunctions , depression , antidepressants

References

• Gürbüz N, Karabağ S, Aras B, Aktaş F, Kalfazade N, Taş- çı Aİ. Parkinson hastalarında cinsel işlev bozukluğu. Türk Üroloji Dergisi 2007;33:36-9.
• NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence.; JAMA 1993;270:83-90.
• Porto R. Depressive symptoms and sexuality. Presse Med 2014;14:354-6.
• Laumann EO, West S, Glasser D et al. Prevalence and cor- relates of erectile dysfunction by race and ethnicity among men aged 40 or older in the United States: from the Male Attitudes Regarding Sexual Health survey. J Sex Med 2007;4:57–65.
• Tuncel A, Güzel Ö, Atan A. Erektil disfonksiyonda rol oynayan risk faktörlerini belirleme. Androloji Bülteni 2013;54:158-63.
• Fazio L, Brock G. Erectile dysfunction: management upda- te. CMAJ 2004;170:1429-37.
• Akkuş E. Erektil disfonksiyon epidemiyoloji, fizyopatoloji ve tanı. Klinik Gelişim Üroloji özel sayısı 2008;21:161-170
• Tükel AG. Erektil disfonksiyon. Türkiye Klinikleri J Psychi- atry- Special Topics 2009;2:28-33.
• Jackson G. Erectile dysfunction and the heart–what’s new?. J Mens Health Gend 2006;3: 337–41.
• Montorsi P, Ravagnani PM, Galli S et al. Association bet- ween erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of co- ronary vessels involvement: the COBRA trial. Eur Heart J 2006;27:2632–9.
• Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol 1994;151:54-61.
• Akkus E, Kadioglu A, Esen A, et al. Prevalence and corre- lates of erectile dysfunction in Turkey: a population-based study. Eur Urol 2002;41: 298-304.
• Kayıkçı MA. Erektil disfonksiyona genel bir bakış: epide- miyoloji ve etyoloji. Türkiye Klinikleri J Urology- Special Topics 2013;6:7-11.
• Wang W. Psychological factors involved in erectile dysfunction, Zhonghua Nan Ke Xue 2011;17:1146-51.
• Suija K, Kerkela M, Rajala U et al. The association between erectile dysfunction, depressive symptoms and testostero- ne levels among middle-aged men. Scand J Public Health 2014. pii:140349814545103.
• Racagni G, Brunello N. Physiology to functionality: the brain and neurotransmitter activity. Int Clin Psychophar- macol 1999;14:3-7.
• Atlantis E, Sullivan T. Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. J Sex Med 2012;9:1497-507 doi,10.1111 /j.1743-6109.2012.02709.
• Dording CM, LaRocca RA, Hails KA et al. The effect of sildenafil on quality of life. Ann Clin Psychiatry 2013;25:3- 10.
• Rosen RC, Fisher WA, Eardley I et al. Men’s Attitudes to Life Events and Sexuality (MALES) Study. The multinatio- nal Men’s Attitudes to Life Events and Sexuality (MALES) study: I. Prevalence of erectile dysfunction and related health concerns in the general population. Curr Med Res Opin 2004;20:607–17.
• Seftel AD, Sun P, Swindle R. The prevalence of hyperten- sion, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J Urol 2004;171: 2341–5.
• Shabsigh R, Klein LT, Seidman S, Kaplan SA, Lehrhoff BJ, Ritter JS. Increased incidence of depressive symptoms in men with erectile dysfunction. Urology 1998;52:848–52.
• Seidman SN, Roose SP, Menza MA, Shabsigh R, Rosen RC. Treatment of erectile dysfunction in men with depressive symptoms: results of a placebo-controlled trial with silde- nafil citrate. Am J Psychiatry 2001;158:1623–30.
• Rosen R, Shabsigh R, Berber M et al. Vardenafil Study Site Investigators. Efficacy and tolerability of vardenafil in men with mild depression and erectile dysfunction: the depres- sion-related improvement with vardenafil for erectile res- ponse study. Am J Psychiatry 2006;163:79–87.
• Shiri R, Koskimaki J, Tammela TL, Hakkinen J, Auvinen A, Hakama M. Bidirectional relationship between depression and erectile dysfunction. J Urol 2007;177:669-73.
• Çoban G, Gürer E, Altay B. Spor ve erektil disfonksiyon. Androloji Bülteni 2011;44:1-3.
• Solak Y, Atalay H, Kan S et al. Effects of sildenafil and var- denafil treatments on sleep quality and depression in he- modialysis patients with erectile dysfunction. Int J Impot Res 2011;23:27–31.
• Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of sexual dysfunction associated with an- tidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. J Clin Psychi- atry 2001;62:10–21.
• Bishop JR, Moline J, Ellingrod VL, Schultz SK, Clayton AH. Serotonin 2A-1438 G/A and G-protein Beta3 subu- nit C825T polymorphisms in patients with depression and SSRIassociated sexual side-effects. Neuropsychopharma- cology 2006;31:2281–8.
• McMahon FJ, Buervenich S, Charney D et al. Variation in the gene encoding the serotonin 2A receptor is associated with outcome of antidepressant treatment. Am J Hum Ge- net 2006;78: 804–14.
• Paddock S, Laje G, Charney D et al. Association of GRIK4 with outcome of antidepressant treatment in the STAR*D cohort. Am J Psychiatry 2007;164: 1181–8.
• Hull EM, Dominguez JM. Getting his act together: roles of glutamate, nitric oxide, and dopamine in the medial pre- optic area. Brain Res 2006;1126:66–75.
• El-Shafey H, Atteya A, el-Magd SA, Hassanein A, Fathy A, Shamloul R. Tianeptine can be effective in men with dep- ression and erectile dysfunction. J Sex Med 2006;3:910–7.