{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T22:01:21Z","timestamp":1778623281054,"version":"3.51.4"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,2,1]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Psychosexual counseling may enhance sexual performance outcomes in men with erectile dysfunction (ED) treated with a phosphodiesterase type 5 (PDE5) inhibitor.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n To determine the potential long-term effects of cognitive behavioral therapy (CBT) on Pakistani men with ED who had undergone treatment with a PDE5 inhibitor (PDE5i).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In a 15\u201318-month follow-up, we reassessed a subsample of 20 men who had been treated with either PDE5is (monotherapy group) or CBT\u00a0+ PDE5i (combined group) on 2 dimensions: sexual functioning and mental health functioning.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure<\/jats:title>\n International Index of Erectile Function was used to assess sexual function, and 2 Mental Health Inventory subscales were used to assess anxiety and depression. A brief semi-structured interview assessed men\u2019s current sexual status and evaluation of their CBT experience.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Men in the combined group continued to show improvement on erectile function and several other sexual parameters, whereas men in the monotherapy group showed either no further improvement or a decrement in sexual response parameters. The results did not appear to be related to changes in relationship satisfaction or mental health indices.<\/jats:p>\n <\/jats:sec>\n \n Clinical Implications<\/jats:title>\n Adjunctive CBT shows long-term benefits in men with ED treated with a PDE5i.<\/jats:p>\n <\/jats:sec>\n \n Strength & Limitations<\/jats:title>\n Effect sizes were strong, overcoming the small sample size, but attrition may affect the generalizability of the findings.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In the first long-term follow-up study of its kind, CBT proved an effective and supportive adjunctive treatment for Pakistani men with ED taking a PDE5i, with benefits extending long after the end of treatment.<\/jats:p>\n 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