Login to Access Video or Poster Abstract: MP84-03
Sources of Funding: none

Introduction

The Peyronie's Disease Questionnaire (PDQ is a validated self-reported questionnaire that measures the impact and severity of Peyronie's Disease (PD) in 3 domains, including Symptom Bother (6 items, score range 0-16). Mean baseline bother score in the IMPRESS trials was 8 (7.8±3.7). However, the clinical significance of the PDQ bother score has not been evaluated. We aimed to find the optimal PDQ symptom bother score cut-off predicting the presence of clinical bother and distress.

Methods

Men with PD completed a series of validated questionnaires at initial consultation, including the PDQ, the Center for Epidemiological Studies-Depression scale (CESD), and the Self-Esteem and Relationship questionnaire (SEAR). We used a receiver operating characteristic (ROC) curve to determine the optimal cutoff score of PDQ bother by separately predicting: (1) depressive symptoms as defined as a score of ≥16 on the CESD (2) low sexual self-esteem defined as a score of ≤35 on the SEAR (the score reported by those with severe ED) and (3) the combination of depressive symptoms and low sexual self-esteem. The Youden index was used to determine the optimal cut-off maximizing both sensitivity and specificity.

Results

The mean age of the 204 men was 56±12 years of age. 82% of the sample had a partner, with an average length of relationship of 16±14 years. The mean duration of PD was 16±21 months and the average curvature was 39±20 degrees. When using depressive symptoms (CESD) as the criterion, the ROC curve analysis produced an area under the curve (AUC) of 0.61 (p=0.04), indicating a cut-off score of 8, which produced the best sensitivity (0.61) and specificity (0.58). When using low sexual self-esteem (SEAR) as the criterion, the ROC curve analysis produced an AUC of 0.70 (p=0.001), and indicated a cut-off score of 9 producing the optimum sensitivity (0.67) and specificity (0.69). The combination of both criteria failed to produce a significant AUC (0.48, p=0.56). Since using sexual self-esteem as the criterion produced better AUC and higher sensitivity and specificity, the cut-off score of 9 is suggested.

Conclusions

A bother score of 9 on the PDQ appears to represent the optimal cut-off score indicating clinically significant bother. In our opinion, such a score warrants a consideration to refer the patient to a mental health professional.

Funding

none