SIEDY Scale 3, a New Instrument to Detect Psychological Component in Subjects with Erectile Dysfunction Giovanni Corona, MD, PhD,* § Valdo Ricca, MD, † Elisa Bandini, MD,* Giulia Rastrelli, MD,* Helen Casale, MD,* Emmanuele A. Jannini, MD, ‡ Alessandra Sforza, MD, § Gianni Forti, MD, ¶ Edoardo Mannucci, MD,** and Mario Maggi, MD* *Andrology and Sexual Medicine Unit, Department of Clinical Physiopathology, University of Florence, Florence Italy; † Psychiatry Unit, Department of Neurological and Psychiatric Sciences, University of Florence, Florence Italy; ‡ School of Sexology, Department of Experimental Medicine, University of L’Aquila, L’Aquila, Italy; § Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy; ¶ Endocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence Italy; **Diabetes Section Geriatric Unit, Department of Critical Care, University of Florence, Italy DOI: 10.1111/j.1743-6109.2012.02762.x ABSTRACT Introduction. We previously developed and validated a structured interview (SIEDY) dealing with the organic (Scale 1), relational (Scale 2), and psychological (Scale 3) components of erectile dysfunction (ED). Aim. To identify a pathological threshold for SIEDY Scale 3 and to analyze Scale 3 score with biological and psychological correlates in subjects with sexual dysfunction. Method. A pathological threshold of SIEDY Scale 3 score in predicting subjects with a medical history of psycho- pathology and using psychiatric drugs was identified through receiver operating characteristic (ROC) curve analysis in a sample of 484 patients (Sample A). Main Outcome Measure. Sensitivity and specificity, along with possible interactions with biological and psycho- logical (Middlesex Hospital Questionnaire, MHQ-score) correlates were verified in a further sample of 1,275 patients (Sample B). Results. In sample A, 39 (8%) and 60 (12.4%) subjects reported a positive medical history for psychiatric distur- bances or for the use of psychotropic medication, respectively. The association with both conditions was present in 28 (5.8%) subjects. ROC curve showed that SIEDY Scale 3 score predicts psychopathology with an accuracy of 69.5  5.9% (P < 0.002), when a threshold of 3 was chosen. When the same threshold was applied in Sample B, it identified a higher ranking in MHQ-A (free-floating anxiety), MHQ-S (somatized anxiety) and MHQ-D (depressive symptoms) subscales, even after adjustment for age and S-MHQ (a broader index of general psychopathology). In the same sample, we also confirmed that pathological Scale 3 score was related to a higher risk of psychopathology at medical history or to the use of psychotropic drugs as well as with risky lifestyle behaviors, including smoking and alcohol abuse, and elevated BMI. Conclusions. SIEDY represents an easy tool for the identification of patients with a relevant intra-psychic compo- nent who should be considered for psychological/psychiatric treatment. Corona G, Ricca V, Bandini E, Rastrelli G, Casale H, Jannini EA, Sforza A, Forti G, Mannucci E, and Maggi M. SIEDY Scale 3, a new instrument to detect psychological component in subjects with erectile dysfunction. J Sex Med **;**:**–**. Key Words. Erectile Dysfunction; Depression; Anxiety Introduction U ntil a few decades ago sexual dysfunctions, especially in young subjects, were mostly related to psychological disturbances and, there- fore, the only recognized treatment was psycho- therapeutic, e.g., psychoanalysis and/or cognitive- behavioral therapy, the so-called “sex therapy” [1,2]. Nowadays, it is well recognized that this assumption is too limited. The introduction of 1 © 2012 International Society for Sexual Medicine J Sex Med **;**:**–**