Department of Obstetrics and Gynecology, University Women's Hospital Basel, Basel, Switzerland.
J Sex Med. 2013 Jan;10(1):50-7. doi: 10.1111/j.1743-6109.2012.02817.x. Epub 2012 Sep 12.
Taking into account that Hypoactive Sexual Desire Disorder (HSDD) is a patient-reported symptom and that the disorder is in general the result of the interaction of biological and psychosocial factors (see part 1), it is necessary to provide healthcare professionals with an operating procedure that is patient centered and multidimensional.
Describing a patient-centered and multidimensional standard procedure to diagnose and manage HSDD on a primary care level.
Review of the literature. Semistructured interview and description of process. RESULT.: The interactive process with the patient follows several steps: initiation, narrative of the patient to understand the individual profile of the disorder, differentiating questions, descriptive diagnosis, exploration of conditioning biomedical, individual psychological, interpersonal, and sociocultural factors (including biomedical examinations), establishment of a biopsychosocial comprehensive explanatory diagnosis, which can be summarized in a nine-field matrix. This matrix will serve as orientation for therapeutic interventions adapted to the individual person. These interventions should always be based on basic counseling as a basis of treatment. Then adapted to the individual condition specific hormonal treatments (mainly estrogen and testosterone alone or combined) can be used after exclusion of contraindications. In patients with predominant psychosocial factors contributing to HSDD individual or couple psychotherapy is indicated. Psychopharmacological drugs are in development and partially investigated and will add to the therapeutic possibilities in the future.
This model can serve as an ideal basis for the approach to the female patient with HSDD. It can be adapted to the individual clinical setting.
考虑到性欲低下障碍(HSDD)是一种患者报告的症状,且该障碍通常是生物和心理社会因素相互作用的结果(见第 1 部分),有必要为医疗保健专业人员提供以患者为中心且多维的操作程序。
描述一种以患者为中心且多维的标准程序,用于在初级保健水平上诊断和管理 HSDD。
文献回顾。半结构化访谈和过程描述。
与患者的互动过程遵循几个步骤:启动、患者叙述以了解障碍的个体特征、区分问题、描述性诊断、探索生物医学、个体心理、人际和社会文化因素(包括生物医学检查)、建立生物心理社会全面解释性诊断,该诊断可概括在一个九字段矩阵中。该矩阵将作为适应个体的治疗干预的指导。这些干预措施应始终基于基本咨询作为治疗的基础。然后,可以在排除禁忌症后,针对 HSDD 中主要起作用的特定生物医学因素的个体或夫妇心理治疗。精神药理学药物正在开发中并进行了部分研究,未来将增加治疗的可能性。
该模型可以作为治疗 HSDD 女性患者的理想基础。它可以根据个体的临床情况进行调整。