Patients with erectile dysfunction (ED) and their partners (n = 18) were compared on perceived distress caused by the ED, attribution of responsibility for the ED and marital communication. Comparisons were also made between couples in whom the ED was organically based versus those in whom it was psychogenically based. No differences were found between organic versus psychogenic ED couples on perceived distress, attributions, or marital communication skills. Patients and partners differed on communication (P < 0.001), attributions (P < 0.001) and perceptions of distress experienced by their spouse (P < 0.001). However, both members of the couple found the ED equally distressing. Partners tended to attribute more responsibility for the ED to themselves when they believed it was psychogenic (P < 0.001), while patients claimed sole responsibility regardless of their perceptions of its etiology. Patients had clinically problematic communication scores (P < 0.001), while partners did not. Contrary to initial hypotheses, communication scores did not predict agreement/disagreement between patients and partners on perceived etiology, attributions or distress. Discussion is focused on the need for therapy to address couples' communication specific to sexual activity and the effects of the ED.

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