Validation of the Decreased Sexual Desire Screener (DSDS): A Brief Diagnostic Instrument for Generalized Acquired Female Hypoactive Sexual Desire Disorder (HSDD)

Abstract

Introduction An accurate diagnosis of Hypoactive Sexual Desire Disorder (HSDD) currently relies on a time-consuming interview with an expert clinician. Limited access to such expertise means that many women with HSDD remain undiagnosed. The Decreased Sexual Desire Screener (DSDS) was developed to provide clinicians who are neither trained nor specialized in Female Sexual Dysfunction (FSD) with a brief diagnostic procedure for the diagnosis of generalized acquired HSDD in women. Methods A prospective non-treatment multicenter study enrolled 263 women at 27 centers in North America in order to test the validity of the DSDS for diagnosing generalized acquired HSDD in women. Subjects completed the DSDS at the screening visit and their answers were reviewed with a clinician who was not an expert in FSD (“non-expert clinician”). Separately and while being unaware of the non-expert clinician’s diagnosis, an expert clinician conducted a standard diagnostic interview. Main Outcome Measures Diagnostic outcomes (generalized acquired HSDD or not) were compared. Primary endpoints included the sensitivity and specificity of the DSDS relative to the standard diagnostic interview. Subject and non-expert clinician debriefing were obtained via a written, structured interview. This ensured that a large sample could be tested under uniform conditions across multiple sites. Results Diagnostic assessment by DSDS and standard diagnostic interview were in agreement in 85.2% (224/263) of cases, with the sensitivity and specificity of the DSDS 83.6% and 87.8%, respectively. Debriefing showed that the five DSDS questions were well understood by 85.4% (76/89) of subjects included in the debriefing exercise, while non-expert clinicians considered the DSDS questions adequate to diagnose HSDD in 92.9% (235/253) of cases. Conclusions The DSDS is a sensitive and specific brief diagnostic instrument for generalized acquired HSDD in women that is quick and easy to use.

Characteristics of premenopausal and postmenopausal women with acquired, generalized hypoactive sexual desire disorder

“…21 The DSDS consists of five questions, four of which assess HSDD symptoms, and one of which provides a basis for differential diagnosis by the clinician in determining whether depression, relevant medical disorders, or potential adverse effects of prescription or nonprescription drugs might better account for the decreased desire. The DSDS enables a diagnosis of HSDD according to DSM-IV criteria, allowing the co-occurrence of other female sexual disorders (eg, arousal disorder, sexual pain).…”

Low Sexual Desire — Is it All in Her Head? Pathophysiology, Diagnosis, and Treatment of Hypoactive Sexual Desire Disorder

“…A "yes" answer to any part of question 5 would alert the clinician to discuss the answer given with the woman and decide if a primary diagnosis other than generalized acquired HSDD was appropriate. 40 Several psychometric instruments have been used to measure sexually related personal distress in women with HSDD. The validated FSDS, a 12-item self-rating instrument, distinguishes between sexually dysfunctional women and those with no sexual dysfunction and effectively measures sexually related personal distress in women with HSDD.…”

“…These brief diagnostic screening tools are designed to assist clinicians in making an accurate diagnosis of generalized acquired HSDD. 40 The first 4 questions of the DSDS, for example, assess components of FSD that are specific for generalized acquired HSDD, asking:…”

Cutoff Score of the Sexual Interest and Desire Inventory-Female for Diagnosis of Hypoactive Sexual Desire Disorder

“…18 As the SIDI-F was validated for use by clinicians trained in FSD, its use by untrained clinicians to evaluate patients against a normative sample can only be advisory. However, its ease of use and the low level of interpretation required with the cutoff value are compatible with use by all clinicians.…”