Erectile Dysfunction: Group Psychotherapy Can Help
Taking part in group psychotherapy can help men who have erectile dysfunction to over come their problem, and adding sildenafil to group therapy was more effective that sildenafil alone. In addition, group psychotherapy was more effective than taking sildenafil on its own, a Cochrane Systematic Review has found.
Normal sexual function relies on the coordination of psychological, endocrine, vascular and neurological factor. Recent research has increased attention on the role of psychological issues. In particular, depression, low self-esteem, anxiety and other psychosocial stresses can play a large role in erectile dysfunction.
A team of Cochrane Researchers drew data from nine randomised trials and two quasi-randomised trials. These involved 398 men with erectile dysfunction who had been given psychotherapy, medication, psychotherapy plus medication or vacuum devices. A further 59 were in non-treatment control groups.
“We found that 95% of men in the psychosocial therapy group benefited from the treatment, while there was no change in over the same period of time in the controls,” says Professor Tamara Melnik, a psychiatrists working at the Universidade de São Paulo in Brazil.
“We now need some large randomised trials with longer follow-up periods in order to measure exactly how effective psychosocial therapy can be. This research will need to group the men carefully, and also consider different forms of psychosocial treatment,” says Melnik.
“One problem with psychosocial therapy is that we are still uncertain which patients are most likely to benefit from it and if effectiveness depend upon personality factors, psychiatric co-morbid diagnosis, length of therapy time,” says Melnik.
J Sex Marital Ther. 2005 May-Jun;31(3):243-55.
Psychogenic erectile dysfunction: comparative study of three therapeutic approaches.
Melnik T, Abdo CH.
Sexuality Project, Institute of Psychiatry of the Medical School of the University of São Paulo, São Paulo, Brazil.
We administered the International Index of Erectile Function (IIEF; Rosen et al., 1997) questionnaire to 30 patients with psychogenic erectile dysfunction (ED) at baseline, immediately after treatment, and 3 months after treatment. We randomized patients into three groups: group I, who had weekly sessions of time-limited theme-based group psychotherapy for 6 months and 50 mg sildenafil citrate orally on demand; group II, who had an intake of 50 mg sildenafil citrate orally on demand for 6 months only; and group III, who had weekly sessions of time-limited theme-based group psychotherapy for 6 months. We analyzed data (15-item IIEF) for each group at three times during the study and compared by the data using analysis of variance (ANOVA), followed by the Bonferroni multiple comparison test. We used Cochran’s Q-test for analysis between baseline and posttreatment stages of patients with remission of symptoms (EF equal to or higher than 26 points). Group III had a mean score higher than group II, with the difference being statistically significant (immediately after treatment, p = 0.033; at 3 months after treatment, p = 0.049; p < 0.05). All three therapeutic alternatives resulted in an improvement of erectile function domain score. However, significant differences from baseline were observed in groups I (p = 0.0009) and III (p = 0.0002) but not in group II (p = 0.135). The psychotherapy groups, I and III, had significantly higher scores compared with group II, in which patients were exclusively treated with sildenafil citrate. These findings suggest that time-limited theme-based group psychotherapy is an effective treatment for psychogenic ED.
PMID: 16020142 [PubMed – indexed for MEDLINE]