Considerations for a Better Definition of Male Orgasmic Disorder in DSM V

摘要

Introduction. All of the Diagnostic and Statistical Manual of Mental Disorders, 4th Ed., text revision (DSM-IV-TR) criteria for sexual disorders have been criticized on multiple grounds, including that the criteria lack precision, that the requirement of marked distress is inappropriate, and that the specification of etiological subtypes should be deleted. Aim. The goal of this article is to review evidence relevant to diagnostic criteria for male orgasmic disorder published since 1990. Methods. Medline searches from 1990 forward were conducted using the terms male orgasmic disorder, anorgasmia, delayed ejaculation, retarded ejaculation, ejaculatory delay, and ejaculatory disorder. Early drafts of proposed alterations in diagnostic criteria were submitted to advisors. Main Outcome Measure. Evidence reviewed was judged by current usage of terminology, evidence allowing precise definition of the syndrome, and evidence concerning separation of the syndrome from distress. Results. The literature search indicated minimal use of the term male orgasmic disorder and minimal knowledge concerning psychogenic ejaculatory problems. Conclusions. It is recommended that the term male orgasmic disorder be replaced with the term delayed ejaculation. Duration and severity criteria are recommended. Since many ejaculatory problems are idiopathic, it is recommended that the etiological subtypes due to psychological or due to combined factors be eliminated.