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The role of sexuality as an association of medical student well-being has not been extensively studied. We explored the relationship between depressive symptoms, sexuality, and sexual dysfunction in male North American medical students. North American medical students were invited to participate in an Internet-based survey.

Subjects completed an ethnodemographic survey, a sexuality survey, and instruments for the quantification Michael j nelson wife sexual dysfunction anxiety, sexuality, and psychosocial function. Descriptive statistics, odds ratios ORsand Michael j nelson wife sexual dysfunction regression were used to analyze our data. Erectile dysfunction ED was associated with significantly greater likelihood of depressive symptoms OR 2.

After adjusting for ethnodemographic and sexual history factors, ED remained significantly positively associated with depressive symptoms OR 2. Healthy sexuality and relationships may be Michael j nelson wife sexual dysfunction against depressive symptoms in medical students. Attention to these factors may enhance medical student well-being. Sexual function and depressive symptoms among male North American medical students.

J Sex Med ;7: The psychological well-being of medical students in training has been a topic of interest for many years. A recent review of psychological morbidity in medical students identified 40 manuscripts published between and on this topic [ 1 ]. While individual studies have varied in Michael j nelson wife sexual dysfunction and results, the general consensus has been that depression and anxiety are prevalent among medical students at a rate higher than that observed in the general age-matched population, particularly among students after the first year of training [ 1 ].

The underlying cause of psychological stress in medical Michael j nelson wife sexual dysfunction has been a subject of speculation. An obvious hypothesis is that the substantial demands e. While cause and effect are difficult to accurately ascertain, there can be little contention that the prevalence of depression and anxiety symptoms in medical students Michael j nelson wife sexual dysfunction a pressing problem in need of attention to maximize student well-being, educational achievement, and possibly patient Michael j nelson wife sexual dysfunction [ 25 ].

Interest in the sexual lives of medical students, both as a factor in their capacity to manage sexuality concerns in the clinical context and for their own personal quality of life, was a topic of particular interest during sexuality curriculum reform that occurred in s American medical schools [ 10 ].

The sexual lives of medical students have received scant attention since that time, although a small pilot study suggested that sexual problems were prevalent in contemporary medical students [ 11 ]. To our knowledge, there have been no recent investigations on the interplay between psychological and sexual factors in overall medical student quality of life. The purpose of the current study was to ascertain the prevalence of depression and anxiety in a population of male North American medical students.

Furthermore, we sought to examine the interrelationship between sexual function and psychological stress in this population. Finally, we investigated the role that sociodemographic factors play in the psychological and sexual life of medical students. We hypothesized that depression and anxiety is prevalent in this population, and that sexual problems tend to be co-morbid with psychological stress.

Medical students in North American medical schools were invited to participate in an Internet-based survey.

95 Christian J. Nelson The...

Invitations were extended via postings on the American Medical Student Association list-serves, the Student—Doctor Network, and a news story posted on Medscape. The survey was available at QuestionPro. Approval for this study and Michael j nelson wife sexual dysfunction Michael j nelson wife sexual dysfunction instrument was granted by the Committee for Human Research at our institution.

Implied consent was assumed by subject participation in, and completion of, the survey instrument. Subjects were asked to complete the Center for Epidemiological Studies Depression Scale CES-Da item instrument designed to assess presence and severity of depressive symptoms [ 12 ].

A CES-D score of 16 was utilized as a cut-off for risk of clinically significant depressive symptoms [ 13 ]. We elected to divide STAI scores into quartiles for subsequent analysis; cut-off variables for clinically significant anxiety have been developed for the long-form STAI [ 15 ] but have not been adequately validated for use with this abbreviated instrument. Subjects completed the International Index of Erectile Function IIEFa item validated instrument for the assessment of five domains of male sexuality desire, erectile function, intercourse satisfaction, orgasmic function, and overall satisfaction [ 16 ].

The Michael j nelson wife sexual dysfunction instruments were not designed to assess sexual function in individuals who have not engaged in sexual intercourse; for this reason, subjects who had never engaged in sexual intercourse as they defined it were excluded from analyses using these instruments.

Furthermore, these instruments were initially developed and validated for use in subjects engaging in heterosexual coitus. At the time of this study, there were no widely used and validated quantitative instruments for the Michael j nelson wife sexual dysfunction of sexual function in men who have sex with men. To make this study as inclusive as possible, minor modifications to instructions and wording were made to the sexuality instruments so as to maximize their applicability to subjects whose primary means of sexual expression is not heterosexual coitus i.

These changes consisted primarily of: The variables for age, race, sexual orientation, prior children, anxiety STAI divided in quartileslifetime sexual partners, monthly sexual frequency, number of sexual partners in the past 6 months, Michael j nelson wife sexual dysfunction being in a sexual relationship were included in the primary model.

To explore the role that psychosocial Michael j nelson wife sexual dysfunction play in the association between ED and depression, we adjusted for SEAR domains. SEAR scores were rescaled from 1-unit increments to 0. This adjustment has been utilized by others to analyze clinically significant differences in the medical context [ 21 ]. Mean age was Bivariate analysis for ethnodemographic associations of depressive symptoms are presented in Table 3a.

Students between the ages of Michael j nelson wife sexual dysfunction and 27 years were less likely to endorse depressive symptoms relative to students younger than 22 years.

Introduction

In addition, depressive symptoms were significantly associated with both homosexual orientation and increasing levels of anxiety in a dose—effect fashion. Bivariate relationship between sociodemographic and sexuality characteristics, anxiety, and depressive symptoms. Bivariate Michael j nelson wife sexual dysfunction Michael j nelson wife sexual dysfunction sexuality-specific associations of depressive symptoms is presented in Table 3b.

Being a virgin and having ED were both associated with a greater likelihood of depressive symptoms. In contrast, being in a sexual relationship, having at least one sexual partner over the past 6 months, higher intercourse frequency in the past month, and better scores on the SEAR were all significantly associated with less risk of depressive symptoms. Individuals who had engaged in Michael j nelson wife sexual dysfunction sex had lower odds of significant depressive symptoms OR 0.

After multivariate adjustment for age, race, sexual orientation, children, anxiety, lifetime sexual partners, sex frequency, number of partners in the last 6 months, and currently being in a sexual relationship, mild ED was associated with nearly a three-fold Michael j nelson wife sexual dysfunction in the odds of significant depressive symptoms OR 2.

In the model including SEAR, each 0. Relative to the lowest quartile of anxiety scores, each successively higher quartile of anxiety scores remained strongly and independently associated with greater odds of significant depressive symptoms data not shown.

No other factors or any specific sexual activities remained significantly associated with depressive symptoms after SEAR was included in the multivariate analysis. Associations of depressive symptoms after multivariate adjustment for anxiety and Michael j nelson wife sexual dysfunction characteristics. Although direct comparison is not advisable due to differences in Michael j nelson wife sexual dysfunction methods, it is apparent that students in Michael j nelson wife sexual dysfunction cohort have a high burden of depressive symptoms compared to normative data.

Our findings are in line with prior reports in medical student populations; a study of medical students at a large U. These results are similar to our findings and lend credence to our data collection.

Numerous studies have reported a prevalence of depression and anxiety similar to Michael j nelson wife sexual dysfunction general population in entering medical students [ 225 — 27 ], implying that the medical school process may precipitate increased psychological stress.

Depression and anxiety symptoms are important concerns in their own right but are of particular concern in a medical student population as they may impair scholastic aptitude and patient care. Michael j nelson wife sexual dysfunction students indicate that stress, depression, and anxiety are some of the greatest potential negative influences on their academic performance Michael j nelson wife sexual dysfunction 2829 ].

An objective Michael j nelson wife sexual dysfunction analysis with data gathered before and 8 months into the first year of training reported that academic performance was inversely associated with depression Michael j nelson wife sexual dysfunction anxiety at both time points; however, the predictive power of stress was significantly lessened after controlling for premedical school academic performance [ 30 ].

In a less tangible but no less significant finding, Thomas et al. Perhaps most concerning, depressive symptoms have been clearly linked to higher risk of suicidal ideation in medical students [ 33 ]. It is evident that both intrinsic and extrinsic factors may contribute to the severity and impact of psychological stress in medical students and that intervention to improve medical student psychological well-being is of value [ 2273435 ].

While generally better positive life factors have been associated with decreased psychological stress [ 26 ], we are not aware of any prior studies linking sexuality practices and function as predictors of depression and anxiety in this population. Those men in relationships who endorse greater confidence and self-esteem within the relationship context appear to be at the lowest risk for depressive symptoms.

Indeed, the addition of the SEAR self-esteem domain scores to the multivariable strongly abrogated the association between ED and depression, suggesting that self-esteem is the key factor in this analysis. Medical students with active sexual lives whether in a relationship or not and no evidence of sexual dysfunction are less likely to endorse symptoms of depression and anxiety. While association does not prove causation, it is apparent that relationship status is worthy of consideration when evaluating for depressive symptoms in this population.

Medical educators have made efforts to enhance medical student well-being by providing classes on stress management, workshops on mindfulness, and making counseling services easily accessible with positive results [ 36 — 39 ].

In the absence of a clinical trial it cannot be definitively stated that attention to this aspect of life will improve medical student well-being; however, it is an intriguing concept and worthy of further attention by those involved with and concerned for medical student welfare. Furthermore, subjects who are willing to participate in an online sexuality survey may not be representative of the overall medical student population volunteer bias.

The IIEF-EF domain Michael j nelson wife sexual dysfunction not been utilized extensively in men not in heterosexual relationships; ergo, IIEF-based findings in our men who were not in relationships should be interpreted cautiously. More importantly, conclusive diagnosis of psychological state Michael j nelson wife sexual dysfunction sexual function cannot be definitively gleaned entirely from numeric survey data. This was not a longitudinal study trial so the causality of depressive symptoms from sexual problems cannot be deduced from these data.

Despite these limitations, these data support the notion that psychological morbidity is common in medical students and that Michael j nelson wife sexual dysfunction is associated with certain definable sexual issues.

Additional research on means and mechanisms to alleviate both psychological and sexual distress in this population is warranted; this may involve providing resources such as workshops on maintaining healthy psychosocials in medical school, Michael j nelson wife sexual dysfunction counseling, information on sexual health, access to contraceptives, etc.

Psychological morbidity is common in male North American medical students and may lead to problems not just Michael j nelson wife sexual dysfunction the individual student but for their social network, colleagues, and patients. Sexuality and intimate relationships are important contributors to overall quality of life for many people; in this population better erectile function and greater confidence in intimate relationships are independently associated with lower risk of depressive symptoms.

Shindel has served as an informal consultant for Boeheringer Ingelheim. National Center for Biotechnology InformationU. Author manuscript; available in PMC Feb 6.

Author information Copyright and License information Disclaimer. The publisher's final edited version of this article is available at J Sex Med. See other articles in PMC that cite the published article. Michael j nelson Michael j nelson wife sexual dysfunction sexual dysfunction Introduction The role of sexuality as an association of medical student well-being has not been extensively studied.

Aim We explored the relationship between depressive symptoms, sexuality, and sexual dysfunction in male North American medical students. Main Michael j nelson wife sexual dysfunction Measure North American medical students were invited to participate in an Internet-based survey.

Methods Subjects completed an ethnodemographic survey, a sexuality survey, and instruments for the quantification of anxiety, sexuality, and psychosocial function. Conclusion Michael j nelson wife sexual dysfunction sexuality and relationships Michael j nelson wife sexual dysfunction be protective against depressive symptoms in medical students.

Introduction The psychological well-being of medical students in training has been a topic of interest for many years. Methods Study Population Medical students in North American medical schools were invited to participate in an Internet-based survey.

Sexual Quality of Life Subjects completed the International Index of Erectile Function IIEFa item validated instrument for the assessment of five domains of male sexuality Michael j nelson wife sexual dysfunction, erectile function, intercourse satisfaction, orgasmic function, and overall satisfaction [ Michael j nelson wife sexual dysfunction ]. Statistical Analysis Descriptive statistics e. Open in a separate window.

Alan W. Shindel, Christian J....

Table 2 Sexuality characteristics of male subjects. Table 3 Bivariate relationship between sociodemographic and sexuality characteristics, anxiety, and depressive symptoms.

Not deleting pics of my ex on Facebook for my bf? and Christian J. Nelson Chapter 3 Pathophysiology of Erectile Dysfunction 55 Victoria J. Croog and Michael J. Zelefsky Chapter 5 Evolution of Radical. Christian J. Nelson a clinical strategy for the diagnosis and treatment of erectile dysfunction. guideline on the management of erectile dysfunction. Harris E. Foster, Michael J. Barry, Philipp Dahm, Manhar C. Gandhi..

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Influential prostate cancer treatment is often associated with significant adverse physiological and psychical effects including pregnant sexual problems. The survey study hardened a cross-sectional sketch out and a associated recruitment procedure. Patients were recruited past the prostate cancer patient advocate organizations in Denmark, Norway, and Sweden Scandinavia. The final representative included 1, prostate cancer patients.

Since analyses, participants were stratified into 4 groups according to their total treatment burden. Outcomes included subjective reporting of erectile functioning, orgasm, and sexual functioning, and satisfaction with one's sex living. After socio-demographic variables were controlled appropriate for, patients who did not receive prostatic cancer treatment were 3.

Among older prostate cancer patients, who at their time of analyse were sexually strenuous, sexual satisfaction is low and sway rates of sensual problems is sky-high, thus underlining the strong clinical necessity to address sexy problems and damages among this platoon of patients in order to kick upstairs sexual health and well-being following quick cancer treatments. Prostate cancer is the most prevalent feather of male cancer in the Partnership States 1 Principally, 2 and is among the unsurpassed causes of masculine cancer deaths worldwide with mortality being among the highest in the Scandinavian countries.

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HIV - injection drug users Recruitment: Small number of women in sample. Medical students indicate that stress, depression, and anxiety are some of the greatest potential negative influences on their academic performance [ 28 , 29 ]. To make this study as inclusive as possible, minor modifications to instructions and wording were made to the sexuality instruments so as to maximize their applicability to subjects whose primary means of sexual expression is not heterosexual coitus i.

Aging, sleep disorders, and male sexual function.


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