184 Substance-Induced Sexual Dysfunction

DSM-IV-TR criteria

  • Clinically significant sexual dysfunction that results in marked distress or interpersonal difficulty predominates in the clinical picture.
  • There is evidence from the history, physical examination, or laboratory findings that the sexual dysfunction is fully explained by substance use as manifested by either (1) or (2):
    • 1. the symptoms in Criterion A developed during, or within a month of, Substance Intoxication
    • 2. medication use is etiologically related to the disturbance
  • The disturbance is not better accounted for by a Sexual Dysfunction that is not substance induced. Evidence that the symptoms are better accounted for by a Sexual Dysfunction that is not substance induced might include the following: the symptoms precede the onset of the substance use or dependence (or medication use); the symptoms persist for a substantial period of time (e.g., about a month) after the cessation of intoxication, or are substantially in excess of what would be expected given the type or amount of the substance used or the duration of use; or there is other evidence that suggests the existence of an independent non-substance-induced Sexual Dysfunction (e.g., a history of recurrent non-substance-related episodes).
  • NOTE: This diagnosis should be made instead of a diagnosis of Substance Intoxication only when the sexual dysfunction is in excess of that usually associated with the intoxication syndrome and when the dysfunction is sufficiently severe to warrant independent clinical attention.
  • Code [Specific Substance]-Induced Sexual Dysfunction:
    • 291.89 Alcohol
    • 292.89 Amphetamine [or Amphetamine-Like Substance]
    • 292.89 Cocaine
  • With Impaired Desire
  • With Impaired Arousal
  • With Impaired Orgasm
  • With Sexual Pain

With Onset During Intoxication: if the criteria are met for Intoxication with the substance and the symptoms develop during the intoxication syndrome

  • Associated Features
  • Child vs. adult presentation
  • Gender and cultural differences in presentation
  • Epidemiology
  • Etiology
  • Empirically supported treatments

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