Peyronie's Disease and Risk of Depression. A Nationwide 25-Year Cohort Study

Peyronie’s disease (PD) is often characterized as a disorder defined by penile deformity, pain, and sometimes erectile dysfunction. Yet its psychological burden is equally relevant and often underappreciated. Previous registry-based studies have suggested an association between PD and depression, but estimates have varied widely, in part due to differing definitions of depression.

In this large, nationwide Danish cohort study, more than 10,000 men with PD and 100,000 age-matched controls were followed for depression. Depression was defined by either an ICD-10 diagnosis or the redemption of at least two antidepressant prescriptions.

Men with PD were more likely to have depression both at baseline and during follow-up.

At baseline, men with PD had a higher prevalence of depression (19.6% versus 14.0%). During follow-up, the 5-year cumulative incidence of depression was 7.0% in men with PD versus 4.4% in controls, while the 10-year cumulative incidence was 12.5% and 8.7%, respectively. After adjustment for age and comorbidities, PD remained associated with depression, with a hazard ratio of 1.42 (95% CI, 1.32–1.52).

A methodological strength of this study was the use of multiple nationwide registries coupling patients’ unique social security numbers across registries, allowing capture of both hospital diagnoses and antidepressant prescriptions. The definition of depression in this study likely reflects real-world treatment patterns but may also have overestimated the prevalence of depression, since antidepressants are prescribed for other conditions such as anxiety and obsessive-compulsive disorder. Nonetheless, when restricting to diagnosis codes only, the association remained.

Unexpectedly, all-cause mortality was lower in men with PD despite a higher burden of comorbidity. This may reflect greater healthcare engagement among patients with PD, leading to earlier diagnosis and treatment of comorbid conditions.

These findings highlight the importance of addressing the psychological dimensions of PD in clinical practice. Screening for depression, particularly in younger men, should be considered an integral part of comprehensive PD management. Attention to mental health, in addition to symptom management and surgical intervention, may help reduce the overall burden of PD.

Written by: Katrine Schmidt Mortensen, MD, Department of Urology, Odense University Hospital, Denmark

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