Basson R, Berman J, Burnett A, Derogatis L, Ferguson D, Fourcroy J, Goldstein I, Graziottin A, Heiman J, Laan E, Leiblum S, Padma-Nathan H, Rosen R, Segraves K, Segraves R T, Shabsigh R, Sipski M, Wagner G, Whipple B
J Urol. 2000 Mar;163(3):888-93.
Female sexual dysfunction is highly prevalent but not well defined or understood. We evaluated and revised existing definitions and classifications of female sexual dysfunction.
An interdisciplinary consensus conference panel consisting of 19 experts in female sexual dysfunction selected from 5 countries was convened by the Sexual Function Health Council of the American Foundation for Urologic Disease. A modified Delphi method was used to develop consensus definitions and classifications, and build on the existing framework of the International Classification of Diseases-10 and DSM-IV: Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, which were limited to consideration of psychiatric disorders.
Classifications were expanded to include psychogenic and organic causes of desire, arousal, orgasm and sexual pain disorders. An essential element of the new diagnostic system is the "personal distress" criterion. In particular, new definitions of sexual arousal and hypoactive sexual desire disorders were developed, and a new category of noncoital sexual pain disorder was added. In addition, a new subtyping system for clinical diagnosis was devised. Guidelines for clinical end points and outcomes were proposed, and important research goals and priorities were identified.
We recommend use of the new female sexual dysfunction diagnostic and classification system based on physiological as well as psychological pathophysiologies, and a personal distress criterion for most diagnostic categories.
女性性功能障碍极为普遍,但定义并不明确,也未得到充分理解。我们对女性性功能障碍的现有定义和分类进行了评估与修订。
美国泌尿疾病基金会性功能健康委员会召集了一个由来自5个国家的19位女性性功能障碍专家组成的跨学科共识会议小组。采用改良的德尔菲法来制定共识定义和分类,并在国际疾病分类第10版和美国精神病学协会的《精神疾病诊断与统计手册》第四版(DSM-IV)的现有框架基础上进行拓展,后者仅限于对精神障碍的考量。
分类得以扩展,涵盖了性欲、性唤起、性高潮及性交疼痛障碍的心理性和器质性病因。新诊断系统的一个关键要素是“个人痛苦”标准。特别是,制定了性唤起和性欲减退障碍的新定义,并新增了一类非性交性疼痛障碍。此外,还设计了一种用于临床诊断的新亚型分类系统。提出了临床终点和结果的指南,并确定了重要的研究目标和优先事项。
我们建议采用基于生理和心理病理生理学的新女性性功能障碍诊断和分类系统,以及针对大多数诊断类别的个人痛苦标准。