Sexual disorders The following is from DSM-IV-TR or First and Tasman’s text. As of 13Mar07.

Sexual disorders - division Q. What are the two major divisions of sexual disorders?

Sexual disorders - divisions Ans. 1] Sexual dysfunctions 2] Paraphilias

Sexual dysfunctional disorders Q. Name the four sexual dysfunctions.

Sexual dysfunctions Ans. 1] Sexual desire disorders 2] Sexual arousal disorders 3] Orgasmic disorders 4] Sexual pain disorders

Sexual desire disorders Q. Name the two sexual desire disorders.

Sexual desire disorders Ans. 1] Hypoactive sexual desire disorder. 2] Sexual aversion disorder [Nymphomania has never been in any of the DSMs. It can be dxed under Other Psychosexual Disorders, , in the ICD-9-CM 2007 edition.]

Sexual arousal disorders Q. Name the two types of sexual arousal disorders.

Sexual arousal disorders Ans. 1] Female sexual arousal disorder 2] Male erectile disorder

Orgasmic disorders Q. Name the three orgasmic disorders.

Orgasmic disorders Ans. 1] Female orgasmic disorder. 2] Male orgasmic disorder 3] Premature ejaculation

Sexual pain disorder Q. Name the two types of sexual pain disorder.

Sexual pain disorders Ans. 1] Dyspareunia 2] Vaginismus

Hypoactive sexual desire disorder criteria Q. Criteria for sexual desire disorder?

Sexual desire disorder criteria Ans. 1] Persistent decrease sexual desire or fantasies. 2] Decrease in such is causing distresses for the person. 3] Not better accounted for as part of another disorder.

Male erectile disorder specifiers Q. What are the DSM-IV specifiers?

Male erectile disorder specifiers Ans. Lifelong type Acquired type ---- Generalized type Situational type ---- Due to psychological factors Due to combined factors

Lifelong type Q. Lifelong erectile disorder is associated with what identities or fears?

Lifelong type Ans. Sexual fear of closeness or sexual identity upon which the pt does not want to act, such as transvestism, gender identity disorder or one of the paraphilias.

Prognosis of lifelong and acquired type Q. Which prognosis is better?

Prognosis of lifelong and acquired type Ans. Acquired type has the better prognosis.

Common anxiety with erectile disorder Q. What anxiety is common to almost all pts with erectile disorder?

Common anxiety with erectile disorder Ans. Almost all have performance anxiety.

Sildenafil Q. How does sildenafil work?

Sildenafil Ans. By preventing the degradation of cGMP.

Female orgasmic disorder Q. Criteria of female orgasmic disorder?

Female orgasmic disorder Ans. 1] Persistent delay or absence of orgasm given the pt’s age, sexual experience, and adequacy of sexual stimulation she receives. 2] Causes marked distress of interpersonal difficulties 3] Not part of another Disorder

Female orgasmic disorder specifiers Q. What are DSM’s specifiers for this disorder?

Female orgasmic disorder specifiers Ans. Same as for males: Lifelong type Acquired type ---- Generalized type Situational type ---- Due to psychological factors Due to combined factors

Female orgasmic disorders therapies Q. Name four therapies that are effective?

Female orgasmic disorder therapies Ans. 1.Individual psychotherapy 2.Group psychotherapy 3.Couple psychotherapy 4.Bibliotherapy

Male orgasmic disorder Q. DSM criteria for male orgasmic disorder?

Male orgasmic disorder Ans. 1.Persistent inability to have an orgasm even though he has a long-lasting erection. 2.Causes distress or interpersonal difficulties. 3.Not part of another disorder

Premature ejaculation Q. DSM criteria for premature ejaculation?

Premature ejaculation Ans. 1] Persistent or recurrent ejaculation before or soon after penetration. 2] Causes distress or interpersonal difficulties 3] Not part of another Disorder

Premature ejaculation treatments Q. Name the three treatments.

Premature ejaculations treatments Ans. 1.Reassurance that the problem will cease with time. 2.Serotonergic meds, e.g., clomipramine in small doses [25 – 50 mg] 3.Squeeze technique

Dyspareunia Q. DSM criteria for dyspareunia?

Dyspareunia Ans. 1.Recurrent or persistent pain with sexual intercourse – both genders. 2.Distressing or causing interpersonal difficulties 3.Not part of another disorder, lack of lubrication, and so forth.

Vaginismus Q. DSM criteria for vaginismus?

Vaginismus Ans. 1.Recurrent of persistent muscular spasm that prevent sexual intercourse. 2.Distressing or causing interpersonal difficulties 3.Not part of another disorder.

Exhibitionism Q. How is exhibitionism defined in DSM-IV?

Exhibitionism Ans. For a period of at least 6 months, has had sexual fantasies or acts of exposure of genitalia to an unsuspecting stranger to where it causes personal distress or interpersonal difficulties.

Sex with dead bodies Q. What term is used for those who enjoy sex with dead bodies?

Sex with dead bodies Ans. Necrophilia.

16 year old Q. Define pedophilia?

16 year old boy Ans. 16 is the minimal age and there has to be a five year difference. Also, there needs to be: 1] a hx of this attraction for at least 6 months. 2] has acted on these urges or, if not acted, has caused distress. [DSM-IV-TR, 572]

Fetishism Q. What is fetishism?

Fetishism Ans. For at least 6 months, sexually arousing fantasies or behaviors involving non-living objects, fantasies or behaviors that cause significant personal distress or social, occupational or educational dysfunctions. Excludes transvestic fetishism.

Transvestic fetishism Q. What is transvestic fetishism?

Transvestic fetishism Ans. For at least 6 months, for a heterosexual male, the fetish is cross-dressing to where it is personally distressing or causing interpersonal difficulties. [So, limited to the male gender. Very hypothetically, I guess if it were a problem for a female, NOS would be used. ]

Frotteurism Q. What is Frotteurism?

Frotteurism Ans. For at least 6 months, sexual fantasies or behavior involving rubbing against a non- consenting person to where is causes personal distress or interpersonal difficulty.

Sexual masochism Q. What is sexual masochism?

Sexual masochism Ans. For at least six months, sexual fantasies or behaviors of being humiliated, beaten, bound, or otherwise made to suffer to where it is personally distressing or impairs important areas of functioning.

Sexual sadism Q. What is sexual sadism?

Sexual sadism Q. What is sexual sadism?

Sexual sadism Ans. For over six months, sexual fantasies or behaviors of acts psychological or physical suffering of the partner is sexually exciting to where this causes personal distress or interpersonal difficulties.

Voyeurism Q. What is voyeurism?

Voyeurism Ans. For a period of at least 6 months, sexual fantasies or behaviors involving the act of observing an unsuspecting person who is naked, undressing or engaged in sexual activity – to where it personally distressing or causing interpersonal difficulties.

Satyriasis Q. What is satyriasis?

Satyriasis Ans. Hypersexuality in the male. Like nymphomania in the female, listed in ICD- 9-CM, but not in the DSMs. Concept may return for discussion among developers of DSM-V on the topic of “sexual addiction.”

Zoophilia What is zoophilia?

Zoophilia Ans. Sexual fantasies or behavior that involves animals. In ICD-9-CM 2007 edition, and in some DSMs of the past, but not DSM-IV- TR. If personally distressing or causing interpersonal difficulties, then you can use NOS.

Reduce sex drive Q. What meds are used to reduce sex drive?

Reduce sex drive Ans. 1. Most frequently used are SSRIs But answer may be: 2. depo-medroxyprogesterone [Provera] Or 3. gonadotrophin-releasing blockers