(101) RISK FACTORS FOR SUICIDALITY AND MENTAL HEALTH COMPLAINTS AMONG MEN WITH SEXUAL DYSFUNCTION
Authors: Kehm A , Buller D , Channa L , Staff I , Mclaughlin T , Tortora J , Pinto K , Olivo Valentin L , Bieniek J 
Published: December 2024

Abstract

Introduction
Male sexual dysfunction (MSD) in the form of erectile dysfunction (ED), Peyronie’s disease, or orgasmic dysfunction is a motivating condition for men to seek care. The impact on self-image and sexual confidence negatively affects the mental health (MH) of patients to varying degrees, some severe. Identifying individuals at risk of MH crises (eg, self harm or suicidal ideation [SI]) in the urology outpatient setting may allow for timely behavioral health interventions.

Objective
The objective of this study is to identify risk factors associated with SI and MH complaints among men presenting with MSD.

Methods
We retrospectively identified men seeking urologic care from a men’s health clinic with a primary complaint of MSD presenting 3/1/2019–2/29/2020 (pre-COVID). MH struggles were self-reported on men’s health checklists and patients were screened for SI on chart review. Positive SI screening was defined as any positive answer on the Columbia-Suicide Severity Rating Scale or a non-zero score on question 9 of the Patient Health Questionnaire-9. To increase group size, the SI cohort also included men with MSD and positive SI screening identified by an embedded men’s health psychologist from 3/1/2021–8/31/2022. Clinical and demographic characteristics were compared for men reporting SI, MH struggles but no SI, and no MH struggles. Kruskal Wallis tests were used to compare groups on nonparametric continuous data and Pearson's chi-squared and Fisher Freeman Halton exact tests for categorical data. Logistic regressions (LR) were used to predict any MH issue, specifically SI. SPSSv26 and R v4.3.1 were used for statistical analyses.

Results
A total of 289 men with MSD were identified including 275 from a men’s health checklist and 14 by the psychologist. Six men from the checklist group were missing MH struggles data leaving 283 men in the overall cohort (see Table). Of the checklist-screened men, 52 (18.9%) self-identified as struggling with mental health, 12 (4.4%) of whom demonstrated SI on chart review. Including men identified by the psychologist, 26 men (9.0%) in our overall population were at risk of suicide. Significant differences were noted in age, insurance type, and self-reported struggles with weight among groups. Men with SI tended to be younger and have private insurance while all reported being up to date with PCP visits. A higher proportion of men struggling with weight reported MH struggles but not SI. LR confirmed that weight struggles significantly predicted any MH issue without SI. Age, particularly being under 40, was a significant predictor of SI.

Conclusions
Nearly 1 in 5 men presenting to the urology office with MSD and completing a men’s health checklist are struggling with mental health. Nearly 5% harbor SI. The key predictive risk factor for SI is younger age. Screening should be considered for all men with MSD, particularly younger men, with intervention plans in place to address active SI.

Disclosure
No.