Peyronie's disease and risk of depression. A nationwide 25-year cohort study.

Abstract

Background: Peyronie's disease leads to penile deformities and can cause physical symptoms, for example, penile pain, and erectile dysfunction, along with psychological issues, such as depressive symptoms.

Aim: The aim of this study was to investigate whether men with Peyronie's disease have an increased risk of depression.

Methods: This nationwide cohort study included men with Peyronie's disease (ICD-10 code: N486) from 1997 to 2021 and age-matched (1:10) men without Peyronie's disease. We obtained complete medical history before the Peyronie's disease diagnosis/index date. We followed both cohorts for depression. We computed the cumulative incidence of depression at 5 and 10 years of follow-up and estimated hazard ratios for depression comparing the 2 cohorts while adjusting for selected chronic diseases using Cox regression.

Outcome: The primary outcome, depression, was defined by ICD-10 code: F32, F33 recorded in the Danish National Patient Registry or the Psychiatric Central Research Registry and/or redemption of at least 2 prescriptions for an antidepressant (ATC-code: N06A).

Results: We included 10 053 men with Peyronie's disease and 100 530 without (median age 55.6 years). At the index date, 19.6% men with Peyronie's disease had depression versus 14.0% men without. At baseline, men with Peyronie's disease had a 5-year risk of depression of 7.0% versus 4.4% in men without, while the 10-year risks were 12.5% and 8.7%, respectively. The adjusted hazard ratio was 1.42 (95% CI, 1.32, 1.52).Men with Peyronie's disease had a 10-year all-cause mortality of 5.9%, while it was 9.1% in men without.

Clinical implications: Health professionals should ensure that men with Peyronie's disease are examined for depression.

Strengths and limitations: A limitation of our study is the potential underdiagnosis of men with Peyronie's disease, which may lead to an incorrect estimation of depression among Peyronie's disease patients. It is a strength that we include a nationwide cohort of men with Peyronie's disease and age-matched controls. Other strengths are that we included information from several Danish medical databases and depression was defined as a clinic diagnosis and/or redemption of at least 2 prescriptions for an antidepressant.

Conclusions: Men with Peyronie's disease had a higher prevalence of depression at the time of diagnosis and a higher risk of depression following diagnosis compared with men without.