Abstract
Objective
This article examines the positive and negative aspects of psychiatry encompassing sexual medicine within its purview.
Methods
MEDLINE searches for the period between 1980 to the present were performed with the terms “psychiatry,” “sexual medicine,” and “sexual dysfunction.” In addition, sexual medicine texts were reviewed for chapters relevant to this topic.
Results
Psychiatry, the only medical discipline trained to integrate both biological and psychological factors in making treatment decisions, has been minimally involved in the evolution of the multidisciplinary field known as sexual medicine.
Conclusion
If psychiatry is to maintain a role in the diagnosis and treatment of sexual disorders, it is critical that its training programs include training in sexual medicine.
Similar content being viewed by others
References
Kraft-Ebbing R: Psychopathia sexualis. New York, Putnam’s Sons, 1965
Freud S: Three Essays on the Theory of Sexuality. New York, Basic Books, 1996
Wolpe J: Pavlov’s contribution to behavior therapy: the obvious and not so obvious. Am Psychol 1997; 52:966–972
Brady JP: Behavioral medicine: scope and promise of an emerging field. Biol Psychiatry 1997; 16:319–3332
Masters W, Johnson VE: Human Sexual Inadequacy. Boston, Little, Brown, 1970
Brindley G: Intrapenile drug delivery systems. Int J STD AIDS 1996; 7(suppl 3):13–15
Lal TS, Laryea E, Thavundayil JX, et al: Apomorphine induced penile tumescence in impotent patients: preliminary findings. Prog Neuropsychopharmacol Biol Psychiatry 1987; 11:235–242
Chen Y, Dai Y, Wang R: Treatment strategies for diabetic patients suffering from erectile dysfunction. Expert Opin Pharmacother 2008; 9:257–266
Miner A, Seftel A: Centrally acting mechanisms for the treatment of male erectile dysfunction. Urol Clin North Am 2007; 34:483–496
Segraves RT: Effects of psychotropic drugs on human erection and ejaculation. Arch Gen Psychiatry 1989; 46:275–284
Waldinger M: Premature ejaculation—state of the art. Urol Clin North Am 2007; 34:591–599
Nkanginiene I, Segraves R: Neuropsychiatric aspects of sexual dysfunction, in Neuropsychiatry, 2nd ed. Edited by Schiffer R, Rao S, Fogel B. Philadelphia, Lippincott, Williams & Wilkins, 2003, pp 338–357
Segraves R, Schoenberg H: Diagnosis and treatment of erectile problems: current status, in Diagnosis and Treatment of Erectile Disturbances: A Guide For Clinicians. Edited by Segraves R, Schoenberg H. New York, Plenum, 1985, pp 1–22
Rosen R: Erectile dysfunction in middle-aged and older men, in Handbook of Clinical Sexuality for Mental Health Professional. Edited by Levine S, Risen C, Althof S. New York, Brunner-Routledge, 2003, pp 237–256
Boolell M: Sildenafil: a novel and effective oral therapy for male erectile dysfunction. Br J Urol 1996; 78:257–281
Levine S: Erectile dysfunction—why drug therapy isn’t always enough. Cleve Clin J Med 2003; 70:241–246
Melnik T, Soares B, Nasello A: The effectiveness of psychological interventions for the treatment of erectile dysfunction: systematic review and meta-analysis. J Sex Med 2008; 5:2562–2574
Goldstein I: Female sexual dysfunction and the central nervous system. J Sex Med 2007; 4(suppl 4):255–258
Sansone R, Wiederman M: Sexuality training for psychiatry residents: a national survey of training directors. J Sex Marit Ther 2000; 26:249–256
Balon R: Introduction and developments in the area of sexual dysfunction(s), in Sexual Medicine: The Brain Body Connection. Edited by Balon R. Basel, Karger, 2008, pp 1–7
Bancroft J: Human Sexuality and its Problems. Philadelphia, Churchill Livingstone, 2009
Segraves R, Balon R, Clayton A: Proposal for changes in diagnostic criteria for sexual dysfunctions. J Sex Med 2007; 4:567–580
Laumann E, Nicololsi A, Glasser D, et al: Sexual problems among men and women aged 40 to 80 years: prevalence and correlates identified in the global study of sexual attitudes and behaviors. Int J Impot Res 2005; 17:39–57
Laumann E, Gagnon J, Michael R, et al: The Social Organization of Sexuality: Sexual Practices in the United States. Chicago, University of Chicago Press, 1994
Laumannn E, Paik A, Rosen R: Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281: 537–545
Bancroft J, Loftus J, Long S: Distress about sex: a national survey of heterosexual relationships. Arch Sex Behav 2003; 32:193–208
Fugl-Meyer A, Fugl-Meyer K: Prevalence of data in Europe, in Women’s Sexual Function and Dysfunction: Study, Diagnosis, and Treatment. Edited by Goldstein I, Meston C, Davis S, et al. London, Taylor & Francis, 2006, pp 34–41
Kivela S, Pahkala K: Clinician rated symptoms and signs of depression in aged Finns. Int J Soc Psychiatry 1988; 34:274–284
Lindal E, Steffansson J: The lifetime prevalence of psychosocial dysfunction among 55 to 57-year-olds in Iceland. Soc Psychiatry Psychiatr Epidemiol 1993; 28:91–95
Casper R, Redmond E, Katz M, et al: Somatic symptoms in primary affective disorder. Arch Gen Psychiatry 1985; 42: 1098–1104
Mathews R, Weinmann M: Sexual dysfunction in depression. Arch Sex Behav 1982; 11:323–325
Angst R: Sexual problems in healthy and depressed patients, Int Clin Psychopharmacol 1998; 13(suppl 6):S1–3
Low W, Khoo E, Tan H, et al: Depression, hormonal status and erectile function in the aging male: results from a community study in Malaysia. J Mens Health Gend 2006; 3:263–270
Jamieson K, Gerner R, Mammen C, et al: Clouds with silver linings: positive experiences with primary affective disorders. Am J Psychiatry 1980; 137:198–207
Kotier M, Cohen H, Aizenberg D, et al: Sexual dysfunction in male posttraumatic stress disorder patients. Psychother Psychosom 2000; 69:109–118
Cosgrove D, Gordon Z, Bernie J, et al: Sexual dysfunction in combat veterans with posttraumatic stress disorder. Urol 2002; 60:881–884
Minnen A, Kampman M: The interaction between anxiety and sexual functioning: a controlled study of sexual functioning in women with anxiety disorders. Sex Relationship Ther 2000; 15:47–57
Figuiera I, Posidente E, Marques C, et al: Sexual dysfunction: a neglected complication of panic and social phobia. Arch Sex Behav 2001; 30:369–372
Bodinger L, Hermesh H, Aizenberg D, et al: Sexual function and behavior in social phobia. Clin Psychaitry 2002; 63:874–879
Raboch J, Faltus E: Sexuality of women with anorexia nervosa. Acta Psychiatr Scand 1991; 84:9–11
Morgan J, Lacey J, Reid F: Anorexia nervosa: changes in sexuality during weight restriction. Psychosom Med 1999; 61:541–545
Kockott G, Pfeiffer W: Sexual disorders in nonacute psychiatric patients. Comp Psychiatry 1996; 37:56–61
Friedman S, Harrison G: Sexual histories, attitudes, and behavior of schizophrenic and normal women. Arch Sex Behav 1984; 13:555–567
Aizenberg D, Zemishlany Z, Dorfman-Ertog P, et al: Sexual function in male schizophrenic patients. J Clin Psychiatry 1995; 56:137–141
Segraves R: Sexual dysfunction associated with antidepres-sant therapy. Urol Clin North Am 2007; 34:575–580
Segraves R: Recognizing and reversing sexual side effects of medications, in Handbook of Clinical Sexuality for Mental Health Professionals. Edited by Levine S, Risen C, Althof S. New York, Brunner-Routledge, 2003, pp 377–392
Palha A, Esteves M: Drugs of abuse and sexual functioning, in Sexual Dysfunction: The Brain-Body Connection. Edited by Balon R. Basel, Karger, 2008, pp 150–168
Engel G: The need for a new medical model: a challenge for biomedicine. Science 1977; 196:129–136
Segraves R: The role of the psychiatrist, in Women’s Sexual Function and Dysfunction: Study, Diagnosis, and Treatment. Edited by Goldstein I, Meston C, Davis S, et al. London, Taylor & Francis, 2006, pp 701–707
Fagan P: Sexual Disorders: Perspective on Diagnosis and Treatment. Baltimore, Johns Hopkins Press, 2004
Mezzich J, Hernandez-Serrano R: Psychiatry and Sexual Health: An Integrated Approach. New York, Jason Aronson, 2006
Perelman M: Combination therapy for sexual dysfunction: integrating sex therapy and pharmacotherapy, in Handbook of Sexual Dysfunction. Edited by Balon R, Segraves R. Boca Raton, Fla, Taylor & Francis, 2005, pp 13–42
Basson R: Integrating new biomedical treatments into the assessment and management of erectile dysfunction. Can J Hum Sex 1998; 7:213–229
Rosen R, Janssen E, Wiegel M, et al: Psychological and interpersonal correlates in men with erectile dysfunction and their partners: a pilot study of treatment outcomes with sildenafil. J Sex Marital Ther 2006; 32:215–234
Aubin S, Heiman J, Berger R, et al: Comparing sildenafil alone vs sildenafil plus brief couple therapy on erectile dysfunction and couples’ sexual and marital quality of life. J Sex Marital Ther 2009; 35:122–143
Banner L, Anderson R: Integrated sildenafil and cognitive-behavior sex therapy for psychogenic erectile dysfunction: a pilot study. Int Soc Sex Med 2007; 4:1117–1125
Bach A, Barlow D, Wincze J: The enhancing effects of manualized treatment for erectile dysfunction using sildenafil: a preliminary report. Behav Ther 2004; 35:55–73
Phelps J, Jain A, Monga M: The PsychoedPlusMed approach to erectile dysfunction treatment: the impact of combining a psychoeducational intervention with sildenafil. J Sex Marital Ther 2004; 30:305–314
Rosen R, Althof S: Impact of premature ejaculation: the psychological, quality of life and sexual relationship consequences. J Sex Med 2008; 5:1296–1307
Tasman A, Riba M, Silk K: The Doctor-Patient Relationship in Pharmacotherapy: Improving Treatment Effectiveness. New York, Guilford, 2000
Basson R, Brotto L: Disorders of sexual desire and subjective arousal, in Clinical Manual of Sexual Disorders. Edited by Balon R, Segraves R. Washington, DC, American Psychiatric Publishing, 2009, pp 119–160
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Segraves, R.T. Encompassing Sexual Medicine Within Psychiatry: Pros and Cons. Acad Psychiatry 34, 328–332 (2010). https://doi.org/10.1176/appi.ap.34.5.328
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1176/appi.ap.34.5.328