Premature ejaculation and dysregulation of emotions: Research and clinical implications

The alexithymia construct describes a cluster of cognitive and affective characteristics initially observed among patients with classic psychosomatic diseases and later among patients with various medical and psychiatric disorders. The salient features of the construct are: difficulty in identifying and in describing subjective feelings, difficulty in distinguishing between feelings and the bodily sensations of emotional arousal, constricted imaginative activity and externally oriented cognitive style. This study shows significantly higher alexithymia levels in patients with lifelong premature ejaculation (PE) than in controls (p < 0.001). Moreover, alexithymia level is positively correlated with PE severity (p < 0.001). Alexithymia, assessed at baseline, could be a useful predictor of treatment outcome and could contribute to the therapeutic orientation. In the clinical relationship special attention should be paid to the patient's alexithymic difficulties. Body-oriented techniques, relaxation training, focalized body awareness, hypnosis, imaginative methods and combined pharmacological-psychological treatments could be particularly indicated in the treatment of alexithymic patients with PE. The partner's involvement is generally important in both the diagnostic process and the treatment of PE, but is particularly indicated if the PE patient presents alexithymic features. © 2007 Elsevier Masson SAS. All rights reserved.