The Impact of Testicular Loss on The Psychopathology of Young Patients: Population-Based Analysis Of 4 Million Examinees of Manpower Administration Database

Abstract

Objective: Patients of hypogonadism have high risk of depression and anxiety with impaired quality of life but the psychopathological impact of testicular loss without hypogonadism is rarely reported. We studied the impact of unilateral or bilateral testicular loss on psychopathology. Design and Method: We retrospectively analyzed 4 million cases of Manpower Administration (MA) database for the evaluation of the psychopathological status of men with testicular loss. For screening psychopathological status, we used the Military Multiphasic Personality Inventory (MMPI). The examinees of testicular loss were defined at least 50% decrease of testicular volume at CT scan. The examinees without severe medical disability were classified as normal control group. The abnormal result of MMPI scale was defined as a score more than one standard deviation. Results: In this cross-sectional study, total 3932 unilateral testicular absent examinees (UTAE) and 203 bilateral testicular absent examinees (BTAE) were screened. After exclusion of examinees with abnormal response, total 3562 UTAEs and 171 BTAEs were included for final analysis. The abnormal rate of anxiety (15.5% vs. 9.5%), depression (18.3% vs. 10.6%), somatization (18.6% vs 8.7%) and personality disorder (16.8% vs. 13.7%) were higher in UTAE group than matched control. The abnormal rate of depression (18.3% vs. 15.8%) and somatization (18.6% vs. 12.6%) in UTAE group were even higher than in BTAE group. Conclusions: Our population based study suggests young patients with testicular loss are psychopathological vulnerable condition. More active psychopathological screening is indicated for young testicular loss patients.