Bidirectional association between depression and sexual dysfunction: A systematic review and meta-analysis
Abstract
INTRODUCTION: Depression is frequently associated with sexual dysfunction in both men and women. AIM: To examine whether depression predicts sexual dysfunction and, conversely, whether sexual dysfunction predicts depression. METHOD: A systematic review and meta-analysis was conducted. PubMed and EMBASE biomedical answers electronic databases were searched for relevant studies up to November 2011. Reference lists of relevant articles were hand-searched and expert opinions were sought. Studies identified for inclusion had to be prospective cohort studies in adult populations that reported an association between depression and sexual dysfunction variables. MAIN OUTCOME MEASURES: Odds ratios (ORs), prioritized where available, or relative risks (RRs) were pooled across studies using random-effects meta-analysis models. RESULTS: Eight citations included for review yielded six studies on depression and risk of sexual dysfunction in 3,285 participants followed for 2-9 years, and six studies on sexual dysfunction and risk of depression in 11,171 participants followed for 1-10 years. Depression increased the risk of sexual dysfunction in pooled unadjusted (RR/OR 1.52 with 95% confidence intervals [1.02, 2.26]) and adjusted (RR/OR 1.71 [1.05, 2.78]) meta-analyses but not in the partially adjusted model (RR/OR 1.41 [0.90, 2.23]). There was significant heterogeneity between studies, but after removal of a single outlying study was diminished and the pooled partially adjusted, RR/OR increased to 1.69 (1.15, 2.47). Sexual dysfunction increased the odds of depression in the pooled unadjusted (OR 2.30 [1.74, 3.03]), adjusted (OR 3.12 [1.66, 5.85]), and partially adjusted (OR 2.71 [1.93, 3.79]) meta-analyses; heterogeneity was significant only in the adjusted model. Meta-regression analyses did not detect significant sources of heterogeneity in either examination. CONCLUSIONS: Clinicians should be aware of a bidirectional association between depression and sexual dysfunction. Patients reporting sexual dysfunction should be routinely screened for depression, whereas patients presenting with symptoms of depression should be routinely assessed for sexual dysfunction.
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Several studies have suggested a reciprocal relationship between depression and ED.
“Regarding depression, several studies have suggested a reciprocal relationship with ED.”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [45]
The prevalence of ED is almost 5-fold higher in men with depression and, vice versa, men with ED often report higher rates of depression.
“The prevalence of ED is almost 5-fold higher in men with depression and, vice versa, men with ED often report higher rates of depression.44, 45, 46”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [45]
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- Authors
- Atlantis, E., & Sullivan, T.
- Affiliations
- South Australia Pathology (AU)
- The University of Adelaide (AU)
- Corresponding author
- Atlantis, Evan
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-06-01
- Volume
- 9
- Issue
- 6
- Pages
- 1497-1507
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- OpenAlex
- W2110227939
- Cited by
- 472
- References
- 36
- Citations by year
- 2026: 48 · 2025: 43 · 2024: 41 · 2023: 31 · 2022: 46 · 2021: 41 · 2020: 39 · 2019: 40 · 2018: 28 · 2017: 30 · 2016: 36 · 2015: 17 · 2014: 15 · 2013: 15 · 2012: 1
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, sexual dysfunction, bidirectional relationship, depression screening, sexual dysfunction screening, male sexual health, women's sexual health, prospective cohort
- MeSH terms
- Adult, Depressive Disorder, Female, Humans, Male, Middle Aged, Regression Analysis, Risk, Sexual Dysfunction, Physiological, Comorbidity, Prevalence
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