PDF(Pubmed)
Abstract：
BACKGROUND: Psychological inflexibility is a core concept of acceptance and commitment therapy (ACT), which is a comprehensive, transdiagnostic interpretation of mental health symptoms. Erectile dysfunction (ED) is a condition that affects male sexual performance, involving the inability to achieve and maintain a penile erection sufficient for satisfactory sexual activity. Psychosocial factors primarily influence ED in men younger than 40 years, whereas biological factors are more likely to be the underlying cause in older men.
OBJECTIVE: This web-based cross-sectional study examined differences in depression, anxiety, and psychological inflexibility among men with ED younger and older than 40 years in a Japanese population.
METHODS: We used a web-based survey to gather data from various community samples. ED was assessed by the International Index of Erectile Function-5 (IIEF-5) questionnaire, while depression, anxiety, and psychological inflexibility were evaluated by the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Acceptance and Action Questionnaire-II (AAQ-II), Cognitive Fusion Questionnaire (CFQ), and Valuing Questionnaire-Obstacle Subscale (VQ-OB) questionnaires. The chi-square test estimated the scores of PHQ-9 and GAD-7 among men with ED, comparing those younger than 40 years and those older than 40 years. Additionally, a two-way ANOVA was conducted with ED severity and age group as independent variables, assessing psychological inflexibility.
RESULTS: Valid responses from 643 individuals (mean age 36.19, SD 7.54 years) were obtained. Of these, 422 were younger than 40 years (mean age 31.76, SD 5.00 years), and 221 were older than 40 years (mean age 44.67, SD 2.88 years). There was a statistical difference in the prevalence of depression as judged by PHQ≥10 between men with ED younger and older than 40 years (P<.001). On the other hand, there was no difference in the prevalence of anxiety as judged by GAD≥10 (P=.12). The two-way ANOVA revealed that the interactions for CFQ (P=.04) and VQ-OB (P=.01) were significant. The simple main effect was that men with ED younger than 40 years had significantly higher CFQ (P=.01; d=0.62) and VQ-OB (P<.001; d=0.87) scores compared to those older than 40 years in moderate ED and severe ED. Additionally, it was found that men younger than 40 years with moderate to severe ED had significantly higher CFQ (P=.01; d=0.42) and VQ-OB (P=.02; d=0.38) scores compared to men younger than 40 years without ED. On the other hand, no interaction was found for AAQ-II (P=.16) scores.
CONCLUSIONS: To the best of our knowledge, this web-based cross-sectional study is the first to examine the relationship between psychological inflexibility and ED. We conclude that men with moderate and severe ED younger than 40 years have higher psychological inflexibility and might be eligible for ACT.
OBJECTIVE: This web-based cross-sectional study examined differences in depression, anxiety, and psychological inflexibility among men with ED younger and older than 40 years in a Japanese population.
METHODS: We used a web-based survey to gather data from various community samples. ED was assessed by the International Index of Erectile Function-5 (IIEF-5) questionnaire, while depression, anxiety, and psychological inflexibility were evaluated by the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Acceptance and Action Questionnaire-II (AAQ-II), Cognitive Fusion Questionnaire (CFQ), and Valuing Questionnaire-Obstacle Subscale (VQ-OB) questionnaires. The chi-square test estimated the scores of PHQ-9 and GAD-7 among men with ED, comparing those younger than 40 years and those older than 40 years. Additionally, a two-way ANOVA was conducted with ED severity and age group as independent variables, assessing psychological inflexibility.
RESULTS: Valid responses from 643 individuals (mean age 36.19, SD 7.54 years) were obtained. Of these, 422 were younger than 40 years (mean age 31.76, SD 5.00 years), and 221 were older than 40 years (mean age 44.67, SD 2.88 years). There was a statistical difference in the prevalence of depression as judged by PHQ≥10 between men with ED younger and older than 40 years (P<.001). On the other hand, there was no difference in the prevalence of anxiety as judged by GAD≥10 (P=.12). The two-way ANOVA revealed that the interactions for CFQ (P=.04) and VQ-OB (P=.01) were significant. The simple main effect was that men with ED younger than 40 years had significantly higher CFQ (P=.01; d=0.62) and VQ-OB (P<.001; d=0.87) scores compared to those older than 40 years in moderate ED and severe ED. Additionally, it was found that men younger than 40 years with moderate to severe ED had significantly higher CFQ (P=.01; d=0.42) and VQ-OB (P=.02; d=0.38) scores compared to men younger than 40 years without ED. On the other hand, no interaction was found for AAQ-II (P=.16) scores.
CONCLUSIONS: To the best of our knowledge, this web-based cross-sectional study is the first to examine the relationship between psychological inflexibility and ED. We conclude that men with moderate and severe ED younger than 40 years have higher psychological inflexibility and might be eligible for ACT.
摘要：
背景：心理僵化是接受和承诺疗法（ACT）的核心概念，这是一个全面的，精神健康症状的诊断解释。勃起功能障碍（ED）是一种影响男性性表现的疾病，涉及无法实现和维持足以令人满意的性活动的阴茎勃起。心理社会因素主要影响40岁以下男性的ED，而生物学因素更可能是老年男性的根本原因。
目的：这项基于网络的横断面研究检查了抑郁症的差异，焦虑,在日本人口中，年龄小于40岁的ED男性的心理缺乏灵活性。
方法：我们使用基于网络的调查从各种社区样本中收集数据。ED通过国际勃起功能指数-5(IIEF-5)问卷进行评估，而抑郁症,焦虑,通过患者健康问卷-9（PHQ-9）评估心理不灵活，一般焦虑症-7（GAD-7），接受和行动问卷-II(AAQ-II)，认知融合问卷(CFQ)，和评估问卷-障碍子量表(VQ-OB)问卷。卡方检验估计了ED男性的PHQ-9和GAD-7得分，比较40岁以下和40岁以上的人。此外,以ED严重程度和年龄组为自变量进行双向方差分析，评估心理上的僵化。
结果：获得了643名个体（平均年龄36.19，SD7.54岁）的有效反应。其中,422名年龄小于40岁（平均年龄31.76，SD5.00岁），221人年龄大于40岁（平均年龄44.67，SD2.88岁）。根据PHQ≥10判断，年龄小于40岁和年龄大于40岁的男性之间的抑郁症患病率存在统计学差异（P<0.001）。另一方面,GAD≥10判断焦虑患病率无差异(P=0.12).双向方差分析显示CFQ(P=.04)和VQ-OB(P=.01)的相互作用是显著的。简单的主要影响是，与40岁以上的男性相比，40岁以下的ED男性的CFQ（P=0.01；d=0.62）和VQ-OB（P<.001；d=0.87）得分明显高于40岁以上的中度ED和重度ED。此外,研究发现,与40岁以下无ED的男性相比,40岁以下有中度至重度ED的男性的CFQ(P=.01;d=0.42)和VQ-OB(P=.02;d=0.38)评分明显更高.另一方面,AAQ-II(P=.16)评分无交互作用.
结论：据我们所知，这项基于网络的横断面研究首次探讨了心理不灵活与ED之间的关系.我们得出的结论是，年龄在40岁以下的中度和重度ED男性具有更高的心理灵活性，可能有资格参加ACT。
目的：这项基于网络的横断面研究检查了抑郁症的差异，焦虑,在日本人口中，年龄小于40岁的ED男性的心理缺乏灵活性。
方法：我们使用基于网络的调查从各种社区样本中收集数据。ED通过国际勃起功能指数-5(IIEF-5)问卷进行评估，而抑郁症,焦虑,通过患者健康问卷-9（PHQ-9）评估心理不灵活，一般焦虑症-7（GAD-7），接受和行动问卷-II(AAQ-II)，认知融合问卷(CFQ)，和评估问卷-障碍子量表(VQ-OB)问卷。卡方检验估计了ED男性的PHQ-9和GAD-7得分，比较40岁以下和40岁以上的人。此外,以ED严重程度和年龄组为自变量进行双向方差分析，评估心理上的僵化。
结果：获得了643名个体（平均年龄36.19，SD7.54岁）的有效反应。其中,422名年龄小于40岁（平均年龄31.76，SD5.00岁），221人年龄大于40岁（平均年龄44.67，SD2.88岁）。根据PHQ≥10判断，年龄小于40岁和年龄大于40岁的男性之间的抑郁症患病率存在统计学差异（P<0.001）。另一方面,GAD≥10判断焦虑患病率无差异(P=0.12).双向方差分析显示CFQ(P=.04)和VQ-OB(P=.01)的相互作用是显著的。简单的主要影响是，与40岁以上的男性相比，40岁以下的ED男性的CFQ（P=0.01；d=0.62）和VQ-OB（P<.001；d=0.87）得分明显高于40岁以上的中度ED和重度ED。此外,研究发现,与40岁以下无ED的男性相比,40岁以下有中度至重度ED的男性的CFQ(P=.01;d=0.42)和VQ-OB(P=.02;d=0.38)评分明显更高.另一方面,AAQ-II(P=.16)评分无交互作用.
结论：据我们所知，这项基于网络的横断面研究首次探讨了心理不灵活与ED之间的关系.我们得出的结论是，年龄在40岁以下的中度和重度ED男性具有更高的心理灵活性，可能有资格参加ACT。
