Considerations for diagnostic criteria for erectile dysfunction in DSM V

Area of Science:

• Urology
• Psychiatry
• Sexual Medicine

Background:

• The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, text revision (DSM-IV-TR) criteria for erectile disorder face criticism for imprecision and inappropriate distress requirements.
• Existing criteria for erectile disorder lack precise operational definitions and may not adequately differentiate normal function fluctuations from pathological states.

Purpose of the Study:

• To review evidence published since 1990 concerning diagnostic criteria for erectile disorder.
• To assess the suitability of proposed modifications for the DSM V diagnostic criteria for erectile dysfunction.

Main Methods:

• Conducted Medline searches from 1990 onwards using terms 'erectile disorder' and 'impotence'.
• Reviewed evidence to determine if precise criteria could be adopted for homogenous research groups.
• Assessed data for reliable differentiation between normal function and pathological erectile states.

Main Results:

• A substantial body of literature exists on erectile disorder.
• However, there is minimal evidence supporting an established operational definition for erectile disorder.

Conclusions:

• Precise definition of erectile disorder is recommended to distinguish normal function from medical conditions and aid clinical research.
• Proposed definition: erectile dysfunction characterized by failure to obtain/maintain an erection sufficient for sexual activity or decreased erectile turgidity on 75% of sexual occasions for at least 6 months.
• Erectile disorder should be defined independently of psychological distress.