Disfunção erétil e psicopatologia: um estudo clínico

Objective: To study psychopathological aspects in subjects with symptoms of psychogenic erectile dysfunction (ED), from a psychoanalytic perspective. Method:Evaluation and psychotherapeutic treatment (three-year follow-up – 1998-2001) on 25 men with diagnosis of psychogenic (ED), carried out at the psychiatric out-patient clinic at the UNICAMP, Brazil.Results: Of the 25 men studied, one showed ego-dissonance in aspects regarding his sexual preference (homosexual), and another was diagnosed with borderline personality disorder and substance abuse. Almost all presented high anxiety (23), low self-esteem (20) and depression (23) in facing life in general, with growing difficulties in their relationships as of the onset of the symptom. For 23 of the men, the fears associated with sexual failure revealed insecurities regarding their own masculinity, based psychically on their sexual performance by means of erection. Conclusion: The symptom of ED raises the issue of masculinity, affecting the men’s basic being and confirming the subjective feeling of sexual “impotence”. Both male subject and symptom become involved in the erective failure as “impotent”. We were able to observe the close correlation between sexual symptoms and their counterpart, the constitution of masculine identity. No attempt was made to exhaust all the symbolic possibilities of understanding the psychopathology of ED. Our purpose was rather to open up a field of dialogue and discussion of pathos, as the patients’ psychic suffering, and symptomatic expression. Keywords: erectile dysfunction; psychopathology; psychoanalysis.