Classification of sexual dysfunctions: towards DSM-V and ICD-11

This article reports on the changes in the classification of sexual dysfunctions since DSM-III, and on the results of the efforts to make these disorders compatible in DSM-IV and ICD-10. A comparison is made between the ways in which sexual dysfunctions are conceptualized in DSM-III, DSM-III-R, DSM-IV, and ICD-10. Special attention is given to the extent to which: (1) in the diagnostic criteria due weight is given to the physiological and psychological aspects, and to the different phases of the sexual response cycle; and (2) these disorders apply to people of different sexes and sexual orientations, and to problems arising while using different sexual techniques. After publication of DSM-III, the classification of sexual dysfunctions has evolved considerably. Moreover, there are still important differences between DSM-IV and ICD-10. Suggestions for DSM-V and ICD-11 are (among others): (1) introduction of excessive (hyperactive) sexual desire in addition to diminished (hypoactive) sexual desire; (2) differentiation between genital arousal disorder and sexual excitement disorder; and (3) differentiation between orgasmic disorder, anhedonic orgasm, ejaculation disorder, and premature orgasm.