The journal of sexual medicine · 2026
Evaluating mental health risk and psychiatric care access in 18-40 year old men with erectile dysfunction.
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Morcos Maya, Shoeib Ahmed, Golrokhian-Sani Amir-Ali, Breau Rodney H, Witherspoon Luke
Аннотация
BACKGROUND: Mental health conditions (MHCs) are established risk factors for the development and severity of erectile dysfunction (ED), yet it is unclear whether patients are accessing psychiatric care.
AIM: The objectives of this study are to assess the proportion of young men with a MHC within 5 years before or after their ED diagnosis, determine their comorbidities, and characterize their interactions with psychiatric and psychological subspecialists before and after their ED diagnosis.
METHODS: A retrospective review was performed using The Ottawa Hospital's patient data from June 1, 2019, to June 1, 2025. Male patients aged 18-40 years at the index date of their ED diagnosis were included. MHCs were defined with the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition and MHC-related terms.
OUTCOMES: Demographics, prevalence of MHCs, and referrals and appointments with psychiatric and psychological services were assessed.
RESULTS: Overall, 535 patients met the inclusion criteria, with a median age at ED diagnosis of 32.4 (n = 535), body mass index of 27 (n = 172), 5.3% (n = 19/355) with uncomplicated diabetes, and 0.8% (n = 3/355) with complicated diabetes. Of these, 15.1% (n = 81/535) were diagnosed with an MHC within 5 years before or after their ED index date. Of those with an MHC, 28.4% (n = 23/81) received a psychiatry referral; 14.8% (n = 12/81) before and 13.6% (n = 11/81) after their ED diagnosis. Only 6.2% (n = 5/81) of those with an MHC had a psychiatry appointment, all of which were prior to their ED diagnosis. Regarding psychology referrals, 13.6% (n = 11/81) of those with an MHC received them, specifically 8.6% (n = 7/81) before and 4.9% (n = 4/81) after their ED diagnosis. Conversely, 22.2% (n = 18/81) of those with an MHC had a psychology appointment, of which 14.8% (n = 12/81) occurred before, and 7.4% (n = 6/81) occurred after their ED diagnosis.
CLINICAL IMPLICATIONS: These findings highlight a potential gap in mental health care access, emphasizing the need to integrate psychiatric support into ED management for young men.
STRENGTHS AND LIMITATIONS: To our knowledge, this is one of the largest studies examining MHCs and access to psychiatric care among young patients with ED. Temporal conclusions were limited by the implementation of a new electronic medical record system in 2019.
CONCLUSIONS: Patients with ED scarcely interacted with mental health specialists, suggesting a lack of MHC access or interest in this population.
AIM: The objectives of this study are to assess the proportion of young men with a MHC within 5 years before or after their ED diagnosis, determine their comorbidities, and characterize their interactions with psychiatric and psychological subspecialists before and after their ED diagnosis.
METHODS: A retrospective review was performed using The Ottawa Hospital's patient data from June 1, 2019, to June 1, 2025. Male patients aged 18-40 years at the index date of their ED diagnosis were included. MHCs were defined with the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition and MHC-related terms.
OUTCOMES: Demographics, prevalence of MHCs, and referrals and appointments with psychiatric and psychological services were assessed.
RESULTS: Overall, 535 patients met the inclusion criteria, with a median age at ED diagnosis of 32.4 (n = 535), body mass index of 27 (n = 172), 5.3% (n = 19/355) with uncomplicated diabetes, and 0.8% (n = 3/355) with complicated diabetes. Of these, 15.1% (n = 81/535) were diagnosed with an MHC within 5 years before or after their ED index date. Of those with an MHC, 28.4% (n = 23/81) received a psychiatry referral; 14.8% (n = 12/81) before and 13.6% (n = 11/81) after their ED diagnosis. Only 6.2% (n = 5/81) of those with an MHC had a psychiatry appointment, all of which were prior to their ED diagnosis. Regarding psychology referrals, 13.6% (n = 11/81) of those with an MHC received them, specifically 8.6% (n = 7/81) before and 4.9% (n = 4/81) after their ED diagnosis. Conversely, 22.2% (n = 18/81) of those with an MHC had a psychology appointment, of which 14.8% (n = 12/81) occurred before, and 7.4% (n = 6/81) occurred after their ED diagnosis.
CLINICAL IMPLICATIONS: These findings highlight a potential gap in mental health care access, emphasizing the need to integrate psychiatric support into ED management for young men.
STRENGTHS AND LIMITATIONS: To our knowledge, this is one of the largest studies examining MHCs and access to psychiatric care among young patients with ED. Temporal conclusions were limited by the implementation of a new electronic medical record system in 2019.
CONCLUSIONS: Patients with ED scarcely interacted with mental health specialists, suggesting a lack of MHC access or interest in this population.