Objectives According to the DSM-5, in men, the inability to achieve or sustain an erection for satisfactory sexual activity can be of organic or psychological nature. The risk factors for Psychogenic Erectile Dysfunction (PED) include exposure to episodic, acute or chronic stressors, dysfunctional lifestyle factors and relationship patterns, anxiety, mood and personality disorders, neurotic or submissive temperamental traits. We hypothesized that worsening socioeconomic condition may lead to PED, and that depression and temperament (harm avoidance) may act as mediators or moderators of this relationship. Methods Eighty-four patients with psychogenic erectile dysfunction and fifty healthy control subjects participated in a retrospective study that investigated stressful events (e.g., lifestyle factors) potentially associated with PED and our hypothesized mechanism linking stress, depression, temperament, and erectile dysfunction. Results In our clinical sample, loss of economic resources was a risk factor for PED and its effects were statistically mediated by depression, especially among individuals who scored high in harm avoidance. Conclusions Our findings are consistent with the rank theory of depression and emphasize the importance of an evolutionary approach to understanding clinical conditions such as psychogenic erectile dysfunction.

中文翻译：

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社会经济状况和精神勃起功能障碍的丧失：气质和抑郁的作用

目标根据DSM-5，在男性中，无法实现或维持勃起以达到令人满意的性活动可能是自然的或心理的。心因性勃起功能障碍（PED）的风险因素包括暴露于发作性，急性或慢性应激源，功能障碍的生活方式因素和关系模式，焦虑，情绪和人格障碍，神经质或顺从性情特征。我们假设社会经济状况的恶化可能导致PED，抑郁和性情（避免伤害）可能充当这种关系的调解人或调解人。方法八十四名精神病性勃起功能障碍患者和五十名健康对照者参加了一项回顾性研究，调查了压力事件（例如，生活方式因素）可能与PED以及我们假设的将压力，抑郁，气质和勃起功能障碍联系在一起的机制相关。结果在我们的临床样本中，经济资源损失是PED的危险因素，其影响在统计学上由抑郁症介导，尤其是在避免伤害的得分较高的人群中。结论我们的发现与抑郁的等级理论是一致的，并强调了进化方法对理解临床状况（如心因性勃起功能障碍）的重要性。