Department of Obstetrics and Gynecology, University Women's Hospital Basel, Basel, Switzerland.
J Sex Med. 2013 Jan;10(1):36-49. doi: 10.1111/j.1743-6109.2012.02818.x. Epub 2012 Sep 13.
Hypoactive sexual desire disorder (HSDD) is defined in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition as persistent or recurrent deficiency (or absence) of sexual fantasies/thoughts, and/or desire for or receptivity to sexual activity, which causes personal distress. As a largely subjective experience, sexual desire may or may not be accompanied by externally observable changes in sexual behavior.
Describe the models of understanding HSDD and the contributing factors to provide the basis for a diagnostic interview and guidance for care for healthcare professionals as a standard operating procedure method. Review of the literature.
There are several models which have been developed to describe sexual desire, although there is still no universally accepted definition or description of it. The models are generally divided into more general two-factor models (e.g., excitation-inhibition, appetitive-consummatory) or more specific multifactorial models (in which the different components of sexual activity and their interaction are delineated). The etiology of the disorder is generally considered as multifactorial. Biomedical factors like diseases, drugs, and hormones, and psychological factors like life events, sexual biography, affective state, etc., as well as interpersonal factors like partner satisfaction, communication, duration of the relationship, and sociocultural factors interact with each other and contribute to the individual experience of desire or lack or absence of desire. In analogy to the multifactorial pathogenesis the therapeutic approach is usually multidimensional and includes basic counseling, individual and couple psychotherapy, hormonal and psychopharmacological treatment.
The standard operation procedure for HSDD in women must be based on a biopsychosocial, multidimensional, and integrative perspective.
在《精神障碍诊断与统计手册第四版》中,性欲减退障碍(HSDD)被定义为持续或反复缺乏(或不存在)性幻想/想法,以及/或对性活动的欲望或接受能力,这会引起个人的痛苦。由于性欲是一种主要的主观体验,它可能伴随着或不伴随着性行为的外部可观察到的变化。
描述理解 HSDD 的模型以及促成因素,为医疗保健专业人员提供诊断访谈和护理指导的基础,作为标准操作程序方法。文献回顾。
有几种模型被用来描述性欲,尽管目前还没有一个普遍接受的定义或描述。这些模型通常分为更一般的两因素模型(例如,兴奋-抑制、欲望-满足)或更具体的多因素模型(其中划分了不同的性活动成分及其相互作用)。该障碍的病因通常被认为是多因素的。生物医学因素如疾病、药物和激素,以及心理因素如生活事件、性经历、情绪状态等,以及人际关系因素如伴侣满意度、沟通、关系持续时间和社会文化因素相互作用,导致个体对欲望的体验或缺乏欲望。类似的多因素发病机制,治疗方法通常是多维的,包括基本咨询、个人和夫妻心理治疗、激素和精神药理学治疗。
女性 HSDD 的标准操作程序必须基于生物心理社会、多维和综合的观点。