(PNM-58) Case report: sexual cognitive therapy for erectile dysfunction in an adolescent

Abstract Erectile Dysfunction (ED) in adolescents can significantly impact self-esteem, quality of life, and psychosexual development. Understanding possible interventions for ED in this age group is essential, especially given that it remains a topic scarcely explored in the scientific literature despite the aforementioned impairments. This case report aimed to describe the effectiveness of a Cognitive-Behavioral Therapy (CBT)-based intervention in an adolescent patient with ED. Case presentation J., 15 years old, heterosexual, with no previous history of psychotherapy or psychiatric medication use. He began psychotherapeutic follow-up in August 2022 due to complaints of ED that began in August 2021 after a traumatic event during his first attempt at sexual intercourse. Sessions were held weekly, and treatment was structured as follows: rapport building, assessment of dysfunctional beliefs, case conceptualization, psychoeducation, cognitive restructuring based on the reassessment of sexual myths and cognitive distortions, and mindfulness. The treatment plan was developed individually, considering the patient’s specific needs. Results Over seven months of intervention, a progressive reduction was observed in negative automatic thoughts, cognitive distortions, and the reproduction of sexual myths, along with decreased pelvic monitoring, restoration of erection during imaginative masturbation and oral sex without the need for sildenafil, and increased cognitive flexibility regarding sexuality. The patient began to relax during sexual activity, reporting sustained erections and reduced performance anxiety. Conclusion CBT proved effective in the remission of ED in an adolescent, promoting both cognitive and behavioral changes. This report highlights the potential of such an intervention for similar cases and recommends future studies with larger samples. Financing No conflict.