tailieunhanh - Ebook Pocket handbook of clinical psychiatry (6/E): Part 2

(BQ) Part 2 book “Pocket handbook of clinical psychiatry” has contents: Sexual dysfunction and gender dysphoria, feeding and eating disorders, obesity and metabolic syndrome, child psychiatry, psychosomatic medicine, geriatric psychiatry, psychopharmacological treatment and nutritional supplements, brain stimulation therapies, and other contents. | 18 Sexual Dysfunction and Gender Dysphoria Sexual dysfunctions are an inability to respond to sexual stimulation, or the experience of pain during the sexual act. It is defined by disturbance in the subjective sense of pleasure or desire associated with sex, or by the objective performance. In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), the sexual dysfunctions include male hypoactive sexual desire disorder, female sexual interest/arousal disorder, erectile disorder, female orgasmic disorder, delayed ejaculation, premature (early) ejaculation, genitopelvic pain/penetration disorder, substance/medication-induced sexual dysfunction, other specified sexual dysfunction, and unspecified sexual dysfunction. If more than one dysfunction exists, they should all be diagnosed. Sexual dysfunctions can be lifelong or acquired, generalized or situational, and result from psychological factors, physiologic factors, or combined factors. As per DSM-5 dysfunction due to a general medical condition, substance use, or adverse effects of medication should be noted. Sexual dysfunction may be diagnosed in conjunction with another psychiatric disorder (depressive disorders, anxiety disorders, personality disorders, and schizophrenia). I. Desire, Interest, and Arousal Disorders A. Male hypoactive sexual desire disorder. Characterized by a lack or absence of sexual fantasies and desire for minimum duration of 6 months. Men may have never experienced erotic/sexual thoughts and the dysfunction can be lifelong. The prevalence is greatest in the younger (6% of men ages 18 to 24) and older (40% of men ages 66 to 74) with only 2% aged 16 to 44 affected by this disorder. Patients with desire problems often use inhibition of desire defensively, to protect against unconscious fears about sex. Lack of desire can also result from chronic stress, anxiety, or depression or the use of various psychotropic drugs and other drugs that depress the central .