Psychological, Relational, and Biological Correlates of Ego-Dystonic Masturbation in a Clinical Setting

Giovanni Castellini, PhD, MD; Egidia Fanni, MA; Giovanni Corona, PhD; Elisa Maseroli, MD; Valdo Ricca, MD; Mario Maggi, MD

doi:10.1016/j.esxm.2016.03.024

Sexual Medicine (Sep 2016)

Psychological, Relational, and Biological Correlates of Ego-Dystonic Masturbation in a Clinical Setting

Giovanni Castellini, PhD, MD,
Egidia Fanni, MA,
Giovanni Corona, PhD,
Elisa Maseroli, MD,
Valdo Ricca, MD,
Mario Maggi, MD

Affiliations

Giovanni Castellini, PhD, MD: Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
Egidia Fanni, MA: Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
Giovanni Corona, PhD: Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy
Elisa Maseroli, MD: Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
Valdo Ricca, MD: Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, Florence, Italy
Mario Maggi, MD: Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy

DOI: https://doi.org/10.1016/j.esxm.2016.03.024
Journal volume & issue: Vol. 4, no. 3
pp. e156 – e165

Abstract

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Introduction: Attitudes toward masturbation are extremely varied, and this practice is often perceived with a sense of guilt. Aim: To evaluate the prevalence of ego-dystonic masturbation (EM), defined as masturbation activity followed by a sense of guilt, in a clinical setting of sexual medicine and the impact of EM on psychological and relational well-being. Methods: A series of 4,211 men attending an andrology and sexual medicine outpatient clinic was studied retrospectively. The presence and severity of EM were defined according to ANDROTEST items related to masturbation, determined by the mathematical product of the frequency of masturbation and the sense of guilt after masturbation. Main Outcome Measures: Clinical, biochemical, and psychological parameters were studied using the Structured Interview on Erectile Dysfunction, ANDROTEST, and modified Middlesex Hospital Questionnaire. Results: Three hundred fifty-two subjects (8.4%) reported any sense of guilt after masturbation. Subjects with EM were younger than the remaining sample (mean age ± SD = 51.27 ± 13.43 vs 48.31 ± 12.04 years, P < .0001) and had more psychiatric comorbidities. EM severity was positively associated with higher free-floating (Wald = 35.94, P < .001) and depressive (Wald = 16.85, P < .001) symptoms, and subjects with a higher EM score reported less phobic anxiety (Wald = 4.02, P < .05) and obsessive-compulsive symptoms (Wald = 7.6, P < .01). A higher EM score was associated with a higher alcohol intake. Subjects with EM more often reported the partner's lower frequency of climax and more problems achieving an erection during sexual intercourse. EM severity was positively associated with worse relational and intrapsychic domain scores. Conclusion: Clinicians should consider that some subjects seeking treatment in a sexual medicine setting might report compulsive sexual behaviors. EM represents a clinically relevant cause of disability, given the high level of psychological distress reported by subjects with this condition, and the severe impact on quality of life in interpersonal relationships.

Published in Sexual Medicine

ISSN: 2050-1161 (Online)
Publisher: Oxford University Press
Country of publisher: United Kingdom
LCC subjects: Medicine
Website: https://academic.oup.com/smoa

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Abstract

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