Evaluating mental health risk and psychiatric care access in 18-40 year old men with erectile dysfunction.

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.