Investigation on psychological symptoms improves ANDROTEST accuracy in predicting hypogonadism in subjects with sexual dysfunction
Rastrelli G, Corona G, Bandini E, Strada C, Maseroli E, Ricca V, Faravelli C, Mannucci E, Maggi M. Int J Impot Res. 2012 Sep 20. doi: 10.1038/ijir.2012.33. [Epub ahead of print]


Department of Clinical Physiopathology, Sexual Medicine and Andrology Unit, University of Florence, Florence, Italy.


The role of psychological symptoms in recognizing late-onset hypogonadism (LOH) is still controversial. The aim of the study is to evaluate the association between LOH and specific psychological symptoms, and to verify whether investigating intra-psychic domain improves the accuracy of a validated case-history tool (ANDROTEST) in detecting LOH. A consecutive series of 1009 subjects (mean age 49.23±13.34) consulting for sexual dysfunction was studied. Intra-psychic symptoms were investigated by Middlesex Hospital Questionnaire (MHQ), a self-reported questionnaire for screening of mental disorders. A minimum set of two MHQ items was identified through iterative receiver-operating characteristic analysis, with assessment of sensitivity and specificity for hypogonadism (calculated free testosterone <0.225 nmol l(-1)) in an exploratory sample of 462 patients. Sensitivity and specificity were verified in a validation sample of 547 subjects, in which the final two-item version showed an accuracy of 58.4±3.2% in detecting hypogonadism. The combination of the two-item score with ANDROTEST increased the accuracy in predicting hypogonadism (0.741±0.029; P<0.0001) when compared with ANDROTEST (0.696±0.018; P<0.0001) and the two-item score (P<0.05) alone. Hence, combining these two psychological symptoms with a physical scoring system improves its ability in detecting hypogonadism. The combination of the scores should be tested in other studies.International Journal of Impotence Research advance online publication, 20 September 2012; doi:10.1038/ijir.2012.33.