Does Illness Perception Influence Treatment Outcomes in Erectile Dysfunction? an Observational Study on Depressive Symptoms and Short-Term Treatment Response

Abstract

Objective: To investigate the relationship between illness perceptions, depressive symptoms, and erectile function (EF) in men with erectile dysfunction (ED) and to evaluate longitudinal changes following treatment.Materials and Methods: Patients with ED (IIEF-5 ≤21) were enrolled at a tertiary urology outpatient clinic between June and October 2025. Participants completed the International Index of Erectile Function-5 (IIEF-5), Patient Health Questionnaire-9 (PHQ-9), and Brief Illness Perception Questionnaire (B-IPQ) at baseline and at 1 and 3 months. All patients received lifestyle counseling and phosphodiesterase type-5 inhibitor therapy. Associations were analyzed using correlation and multivariable linear regression analyses.Results: A total of 120 patients completed follow-up. More negative illness perceptions were significantly associated with higher depressive symptom severity and worse ED severity (p < 0.05). B-IPQ scores increased progressively across categories of both depressive symptoms and ED severity. Multivariable analysis showed that education level, IIEF-5 score, and PHQ-9 score were independently associated with illness perception scores (all p