The correlation between emotional distress and aging males’ symptoms at a psychiatric outpatient clinic: sexual dysfunction as a distinguishing characteristic between andropause and anxiety/depression in aging men

Ching-Yen Chen,^1,4,5 Chin-Pang Lee,^1,4 Yu Chen,^2,4,5 Jun-Ran Jiang,^3,4,5 Chun-Lin Chu,^1,4,5 Chun-Liang Chen<sup>3,4,5

1</sup>Department of Psychiatry, ²Department of Urology, ³Department of Traditional Chinese Medicine, ⁴Men’s Health Center, Chang Gung Memorial Hospital at Linkou, Taiwan; ⁵School of Medicine, Chang Gung University, Taoyuan, Taiwan

Background: Andropause and psychiatric disorders are associated with various symptoms in aging males and are part of the differential diagnosis of depression and anxiety. This study was designed to investigate the relationship between symptoms of aging, anxiety, and depression, and to determine if sexual dysfunction could be a differentiating characteristic in the psychiatric outpatient clinic.
Methods: One hundred seventy-six male psychiatric outpatients participated in the study and completed self-reported measures assessing symptoms of aging, depression, and anxiety. Symptoms of aging were assessed by the Aging Males’ Symptoms scale. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. Erectile dysfunction was considered if a response to item 15 on the Aging Males’ Symptoms scale (impaired sexual potency) was rated with 4 or 5 points. Affective disturbance was assessed by the total scores of the Hospital Anxiety and Depression Scale.
Results: Age was correlated with less anxiety and more sexual symptoms. Anxiety and depression were associated with more severe symptoms of aging, and depression was associated with more sexual symptoms than was anxiety. Impaired sexual potency was the only sexual symptom not significantly associated with depression and anxiety. Depression was associated with an interspousal age gap of ≥6 years. The point prevalence of erectile dysfunction was 28.4%, and age and affective disturbance were associated with the risk of erectile dysfunction.
Conclusion: Impaired sexual potency should raise the suspicion of androgen deficiency rather than depression and anxiety among middle-aged or older male psychiatric outpatients.

Keywords: androgen deficiency, depression, anxiety, erectile dysfunction