(225) Peyronie´s disease and risk of depression. A nationwide 25-year cohort study

Background: Peyronie’s disease (PD) is a connective tissue disorder that leads to penile deformity. The prevalence among men is estimated to be around 3%. Previous studies have suggested that up to 50% of men with PD suffer from depressive symptoms. Yet, a recent Swedish study found a depression prevalence of 6.4% and cumulative 5-year incidence of depression around only 2% in a PD cohort but they defined depression based on diagnosis codes only.

Objectives: To investigate to what degree men with PD have an increased risk of depression.

Methods: This nationwide population-based cohort study included all men in Denmark with a diagnosis of PD (ICD-10 code: N486) in the period 1997-2021 and an age-matched comparison cohort of men without PD matched 1:10 on birth year. For both cohorts, we obtained complete medical history before the PD diagnosis/index date. We followed them for depression, defined as a diagnosis of depression (ICD-10 codes: F32, F33) and/or redemption of at least two prescriptions for an antidepressant (ATC-code: N06A). We computed the cumulative incidence (risk) and risk differences of depression at 5 and 10 years of follow-up and used Cox regression to provide hazard ratios for depression comparing the two cohorts, while adjusting for selected chronic diseases. We stratified analyses by age.

Results: We included 10 053 men with PD and 100 583 without (median age 55.6 years). At time of PD diagnosis, 19.6% men with PD had known depression (diagnosis or prescriptions) compared with 14.0% of men without. Men with PD also had higher prevalence of selected comorbidities but this was predominantly seen in men < 60 years. In this age group, 9.6% of PD patients had diabetes versus 4.3% of comparisons, 23.9% versus 18.4% had hypertension and 4.6% versus 3.2% had ischemic heart disease. Among men ≥ 60 years 10.1% of PD patients had diabetes versus 11.7% of comparisons, 47.2% versus 49.2% had hypertension and 12.0% versus 10.6% had ischemic heart disease.
In men without depression at time of diagnosis/index date, the 5-year risk of depression was 7.0% in those with PD and 4.4% in those without while the 10-year risks were 12.5% and 8.78%, respectively. The adjusted hazard ratio for depression was 1.42 (95% CI, 1.32-1.52). In patients with PD the risk of depression was highest in men < 45 years with a 10-year risk of 14.4% compared with 12.3 % in patients 45-55 years old, 10.9% in patients 55-65 year, 13.6% in men >65 years.
The risk difference of depression between PD patients and their comparisons similarly varied by age from a 5-year risk difference of 5.6 % (95% CI, 4.2-7.1) in men >45 years to 0.14% (95% CI, -1.3-1.6) in men >65 years.

Conclusions: Men with PD had a higher prevalence of depression at time of diagnosis and a higher risk of depression following diagnosis compared with age-matched men without PD.