心因性勃起障碍的病因学研究进展
Progress on the Etiology of Psychogenic Erectile Dysfunction
摘要: 心因性勃起功能障碍是阴茎勃起功能障碍的一种。以往学术界认为,心因性勃起功能障碍是一种功能性障碍,主要归因于心理因素,如焦虑、抑郁、自尊丧失和心理社会压力。随着研究深入,目前发现其与童年依恋障碍、对女性气质的性别认同等人格障碍息息相关。而脑部相关改变可能也是导致勃起障碍心理因素的关键,譬如脑皮质功能异常、脑拓扑网络连接性紊乱都可能是导致与心因性勃起障碍相关心理因素的原因,心因性勃起功能障碍也存在一些诱发因素。随着人们对生活质量要求的提高,心因性勃起障碍的病因学研究越来越有前景,本文就目前的心因性勃起障碍的病因学研究结果作一综述。
Abstract: Psychogenic erectile dysfunction is a kind of penile erectile dysfunction. Previous academic circles believed that psychogenic erectile dysfunction is a kind of functional disorder, mainly due to psychological factors, such as anxiety, depression, loss of self-esteem and psychosocial pressure. With the deepening of research, it is found that it is closely related to childhood attachment disorder, gender identity of femininity and other personality disorders. The brain related changes may also be the key to the psychological factors of erectile dysfunction, such as abnormal cerebral cortex function, brain topological network connectivity disorder may be the cause of psychological factors related to psychogenic erectile dysfunction. Psychogenic erectile dysfunction also has some inducing factors. With the improvement of people’s quality of life, the etiology of psychogenic erectile dysfunction is more and more promising. This paper reviews the current etiology of psychogenic erectile dysfunction.
文章引用:沈忠杰, 葛成国. 心因性勃起障碍的病因学研究进展[J]. 临床医学进展, 2024, 14(9): 185-192. https://doi.org/10.12677/acm.2024.1492446

参考文献

[1] Hatzimouratidis, K., Amar, E., Eardley, I., Giuliano, F., Hatzichristou, D., Montorsi, F., et al. (2010) Guidelines on Male Sexual Dysfunction: Erectile Dysfunction and Premature Ejaculation. European Urology, 57, 804-814. [Google Scholar] [CrossRef] [PubMed]
[2] Lewis, R.W. (2010) Epidemiology of Sexual Dysfunction in Asia Compared to the Rest of the World. Asian Journal of Andrology, 13, 152-158. [Google Scholar] [CrossRef] [PubMed]
[3] Corona, G., Ricca, V., Boddi, V., Bandini, E., Lotti, F., Fisher, A.D., et al. (2010) Autoeroticism, Mental Health, and Organic Disturbances in Patients with Erectile Dysfunction. The Journal of Sexual Medicine, 7, 182-191. [Google Scholar] [CrossRef] [PubMed]
[4] Ludwig, W. and Phillips, M. (2013) Organic Causes of Erectile Dysfunction in Men under 40. Urologia Internationalis, 92, 1-6. [Google Scholar] [CrossRef] [PubMed]
[5] Brotto, L., Atallah, S., Johnson-Agbakwu, C., Rosenbaum, T., Abdo, C., Byers, E.S., et al. (2016) Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction. The Journal of Sexual Medicine, 13, 538-571. [Google Scholar] [CrossRef] [PubMed]
[6] Rajkumar, R.P. (2015) The Impact of Disrupted Childhood Attachment on the Presentation of Psychogenic Erectile Dysfunction: An Exploratory Study. The Journal of Sexual Medicine, 12, 798-803. [Google Scholar] [CrossRef] [PubMed]
[7] Tan, H., Low, W.Y., Ng, C.J., Chen, K., Sugita, M., Ishii, N., et al. (2007) Prevalence and Correlates of Erectile Dysfunction (ED) and Treatment Seeking for ED in Asian Men: The Asian Men's Attitudes to Life Events and Sexuality (MALES) Study. The Journal of Sexual Medicine, 4, 1582-1592. [Google Scholar] [CrossRef] [PubMed]
[8] Chen, J., Chen, Y., Gao, Q., Chen, G., Dai, Y., Yao, Z., et al. (2017) Brain Structural Network Topological Alterations of the Left Prefrontal and Limbic Cortex in Psychogenic Erectile Dysfunction. International Journal of Neuroscience, 128, 393-403. [Google Scholar] [CrossRef] [PubMed]
[9] Jin, C., Guan, M., Dong, M., Wu, J., He, Z., Chen, X., et al. (2017) Aberrant Baseline Brain Activity in Psychogenic Erectile Dysfunction Patients: A Resting State fMRI Study. Brain Imaging and Behavior, 12, 1393-1404. [Google Scholar] [CrossRef] [PubMed]
[10] Wang, Y., Dong, M., Guan, M., Wu, J., He, Z., Zou, Z., et al. (2017) Aberrant Insula-Centered Functional Connectivity in Psychogenic Erectile Dysfunction Patients: A Resting-State fMRI Study. Frontiers in Human Neuroscience, 11, Article 221. [Google Scholar] [CrossRef] [PubMed]
[11] Zhao, L., Guan, M., Zhu, X., Karama, S., Khundrakpam, B., Wang, M., et al. (2015) Aberrant Topological Patterns of Structural Cortical Networks in Psychogenic Erectile Dysfunction. Frontiers in Human Neuroscience, 9, Article 675. [Google Scholar] [CrossRef] [PubMed]
[12] Chen, J., Chen, Y., Chen, G., Dai, Y., Yao, Z. and Lu, Q. (2017) Altered Brain Networks in Psychogenic Erectile Dysfunction: A Resting‐State fMRI Study. Andrology, 5, 1073-1081. [Google Scholar] [CrossRef] [PubMed]
[13] Chen, J., Chen, Y., Gao, Q., Chen, G., Dai, Y., Yao, Z., et al. (2018) Impaired Prefrontal-Amygdala Pathway, Self-Reported Emotion, and Erection in Psychogenic Erectile Dysfunction Patients with Normal Nocturnal Erection. Frontiers in Human Neuroscience, 12, Article 157. [Google Scholar] [CrossRef] [PubMed]
[14] Yin, T., Liu, Q., Ma, Z., Li, Z., Sun, R., Ren, F., et al. (2020) Associations between Altered Cerebral Activity Patterns and Psychosocial Disorders in Patients with Psychogenic Erectile Dysfunction: A Mediation Analysis of fMRI. Frontiers in Psychiatry, 11, Article 583619. [Google Scholar] [CrossRef] [PubMed]
[15] Cera, N., Di Pierro, E.D., Ferretti, A., Tartaro, A., Romani, G.L. and Perrucci, M.G. (2014) Brain Networks during Free Viewing of Complex Erotic Movie: New Insights on Psychogenic Erectile Dysfunction. PLOS ONE, 9, e105336. [Google Scholar] [CrossRef] [PubMed]
[16] Chen, J., Huang, X., Liu, S., Lu, C., Dai, Y., Yao, Z., et al. (2019) Disrupted Topological Properties of Brain Networks in Erectile Dysfunction Patients Owing Predominantly to Psychological Factors: A Structural and Functional Neuroimaging Study. Andrology, 8, 381-391. [Google Scholar] [CrossRef] [PubMed]
[17] Zhao, L., Guan, M., Zhang, X., Karama, S., Khundrakpam, B., Wang, M., et al. (2015) Structural Insights into Aberrant Cortical Morphometry and Network Organization in Psychogenic Erectile Dysfunction. Human Brain Mapping, 36, 4469-4482. [Google Scholar] [CrossRef] [PubMed]
[18] Cera, N., Delli Pizzi, S., Di Pierro, E.D., Gambi, F., Tartaro, A., Vicentini, C., et al. (2012) Macrostructural Alterations of Subcortical Grey Matter in Psychogenic Erectile Dysfunction. PLOS ONE, 7, e39118. [Google Scholar] [CrossRef] [PubMed]
[19] Zhang, P., Liu, J., Li, G., Pan, J., Li, Z., Liu, Q., et al. (2014) White Matter Microstructural Changes in Psychogenic Erectile Dysfunction Patients. Andrology, 2, 379-385. [Google Scholar] [CrossRef] [PubMed]
[20] 李建军, 肖天兵, 王田辉, 等. 库区奉节县心因性勃起功能障碍的心理致病因素分析[J]. 中国现代药物应用, 2017, 11(18): 11-13.
[21] 黄晨, 陈斌, 王鸿祥, 等. 心因性勃起功能障碍的心理因素分析[C]//中国性学会性医学专业委员会第七次全国性医学学术会议论文集. 2011: 98.
[22] 马晓年, 刘明矾. 心因性勃起障碍影响因素的对照研究[J]. 生殖医学杂志, 1999(4): 217-221.
[23] 刘明矾. 性别角色对心因性勃起障碍的影响研究[J]. 中国临床心理学杂志, 2004, 12(1): 27-29.
[24] 刘明矾. 性操作焦虑对阴茎勃起障碍的影响研究[J]. 中国临床心理学杂志, 2002, 10(1): 47-49.
[25] de Oliveira, C.J.V., Carneiro Neto, J.A., Andrade, R.C.P., de La Glória Orge, M., Liberato de Matos, S.N.F., Rocha, P.N., et al. (2019) Hormonal and Psychogenic Risk Factors for Erectile Dysfunction in Men with HTLV-1. The Journal of Sexual Medicine, 16, 1763-1768. [Google Scholar] [CrossRef] [PubMed]
[26] Hsu, C., Lin, C. and Kao, C. (2015) Irritable Bowel Syndrome Is Associated Not Only with Organic but Also Psychogenic Erectile Dysfunction. International Journal of Impotence Research, 27, 233-238. [Google Scholar] [CrossRef] [PubMed]
[27] Kızılay, F., Kalemci, S., Şimşir, A. and Altay, B. (2019) Predisposing Factors for Erectile Dysfunction and Response to Treatment in Younger Males: Are They Different from Those of Older Men? An Observational‐Comparative Study. Andrologia, 52, e13495. [Google Scholar] [CrossRef] [PubMed]
[28] Hsu, C., Lin, C. and Kao, C. (2015) Gout Is Associated with Organic and Psychogenic Erectile Dysfunction. European Journal of Internal Medicine, 26, 691-695. [Google Scholar] [CrossRef] [PubMed]
[29] Wu, S., Chuang, E., Chuang, T., Lin, C., Lin, M., Yen, D., et al. (2016) A Nationwide Population-Based Cohort Study of Migraine and Organic-Psychogenic Erectile Dysfunction. Medicine, 95, e3065. [Google Scholar] [CrossRef] [PubMed]
[30] Jiang, T., Osadchiy, V., Mills, J.N. and Eleswarapu, S.V. (2020) Is It All in My Head? Self-Reported Psychogenic Erectile Dysfunction and Depression Are Common among Young Men Seeking Advice on Social Media. Urology, 142, 133-140. [Google Scholar] [CrossRef] [PubMed]