性機能障碍에 對한 最近槪念 : DSM-Ⅲ-R을 中心으로 Centered on DSM-Ⅲ-R criteria = Recent Concept of Sexual Dysfunctions

다국어 초록 (Multilingual Abstract)

The author presented introductory remarks including the brief historical review of the changes in sexual concepts from Freud's thinking to the recoent trends of human sexuality, and also described the differential comments on classification and definition of sexual dysfunctions according to DSM-Ⅱ, ICD-9, DSM-Ⅲ and DSM-Ⅲ-R, and finally centered to emphasize them adopted by DSM-Ⅲ-R.
In DSM-Ⅲ, sexual dysfunctions constitute a separate category of Axis I disorders and eight distinct syndromes(table 1), and the sexual response cycle is divided into four phases : appetitive, excitement, orgasm and resolution.
Before DSM-Ⅲ, sexual dysfunction was based on a biphasic model of the human sexual response and of sexual disorders, dividing them into two classes ; those characterized by disturbances of the exicitement phase, namely impotence and inhibited female excitement, and the orgasm phase dysfunctions ; premature ejaculation and retarded ejaculation in male and inhibited female orgasm.
DSM-Ⅲ-R, the various observations led to the conceptualization of the triphasic concept of the human sexual responses, and to the development of specific more effective treatment approaches for the desire phase disorders.
Thus, it became apparent that the sexual response cyele is comprised of three phase: desire, excitement and orgasm.
DSM-Ⅲ emphasized a lack of sexual desire which previously had not been recognized as a distinct clinical entity.
The notion that inhibited sexual desire constitutes a distinct clinical entity was rapidly accepted to the extent that the triphasic concept provided the theoretical basis for the new classification for sexual dysfunction adopted by DSM-Ⅲ.
More recently, disorders of sexual desire have been further subdivied into two separate clinical entities in DSM-Ⅲ-R : Hypoactive sexual desire and sexual aversion disorder.
The author described briefly classification and definition of six major categories of sexual disorders listed in DSM-Ⅲ-R(Table 2).