Sexual dysfunction: classification and assessment

Abstract

SummarySexual dysfunction is one of the most common psychiatric disorders, but it is often ignored in assessment. It can be primary or secondary (a result of psychiatric disorder or medication). Success rates in managing sexual dysfunction are relatively high, with good response to psychological and medical interventions. In ICD-10 and DSM-IV-TR, sexual dysfunctions are broadly classified on the basis of the stages of sexual activity, from arousal to orgasm. There are major similarities between ICD and DSM in diagnosis and classification of sexual dysfunction, but both systems raise challenges. These include definitions of what is ‘normal’ and how abnormality is defined. In this article, we describe the role of the two systems and possible amendments that might help researchers and clinicians. We also present key principles for the assessment and treatment of people who experience sexual dysfunction. We consider problems that need to be managed in engaging and in the therapeutic alliance.

Emotion dysregulation and hypersexuality: review and clinical implications

“…Johnson argued, from a clinical perspective, that treatment for couples experiencing sexual problems should focus on the emotional life of the couples and the ER abilities of both partners (Johnson & Zuccarini, 2010). Although Johnson did not mention hypersexuality specifically, it can be argued that the theoretical and clinical framework proposed is still useful in the treatment of couples with sexual dysfunction related to the hypersexual behavior of one or both partners (see, for example, Bhugra & Colombini, 2013). It has been estimated that approximately 15%À20% of marital vitality and satisfaction is attributable to good sexual functioning in the relationship; when sexual behavior becomes problematic, it has a disproportionate impact on relationship satisfaction as it has been reported that sexual problems account for 50%À70% of distress in relationships (McCarthy, 2003;Woolley, 2006).…”

Prevalence of sexual dysfunction among prenatal women attending the Greater Accra Regional Hospital, Ghana

“…Sexual dysfunction generally refers to a group of disorders that affect sexual desire (libido), arousal, and orgasm, and that may or may not involve pain. 1 Although the condition affects both sexes, females experience it more. 2,3 Female sexual dysfunction (FSD) can be regarded as an umbrella term that encompasses problems associated with sexual desire (hypoactive sexual desire disorder), arousal (female sexual arousal disorder), orgasm (female orgasmic disorder), and pain disorders (dyspareunia).…”

Cultural factors and sexual dysfunction in clinical practice

“…Furthermore, the categorisation of sexual conditions and behaviours raises a number of theoretical and semantic difficulties which are described in our previous article (Bhugra 2013). In terms of the level of interest it has garnered by researchers, the study of sexual dysfunction has lost out to gender identity disorders and paraphilias, perhaps because of the perceived 'exotic' nature of these conditions.…”

“…The influence of culture on the development of personality and maintenance of well-being is an important aspect of clinical work with disorders of behaviour, including sexual dysfunction. Medically, sexual dysfunction may be defined as a group of problems occurring in the domains of desire, arousal and orgasm, that may or may not involve pain (Bhugra 2013). We might also add that some sexual dysfunctions are genderspecific, for example vaginismus and ejaculatory and erectile dysfunction, whereas others, such as disorders of desire and orgasm, are diagnosed in both genders.…”

“…† For a related article, see Bhugra D, Colombini G (2013) think about the link between the cultural aspects of behaviour and distress, must lie at the heart not only of diagnosis but also of management. The factors listed in Box 1 appear vital in understanding this relationship, particularly in heterosexual couples.…”