L14: Psychosexual & Eating Disorders Flashcards
Def of Sexual Dysfunction
- Sexual dysfunctions are an inability to respond to sexual stimulation, or the experience of pain during the sexual act.
- They are defined by disturbance in the subjective sense of pleasure or desire associated with sex, or by the objective performance.
Characters of Sexual Dysfunction
Sexual dysfunctions can be:
- Lifelong or acquired
- Generalized or situational
- A result from psychological factors, physiologic factors, or combined factors.
Types of Sexual Dysfunction
- DESIRE, INTEREST AND AROUSAL DISORDERS
- ORGASMIC DISORDERS
- SEXUAL PAIN DISORDERS
- GENDER DYSPHORIA
Disorders of Desire, Interest & Arousal Disorders
- MALE HYPOACTIVE SEXUAL DESIRE DISORDER
- FEMALE SEXUAL INTEREST/AROUSAL DISORDER
Characters of Male Hypoactive Sexual Desire Disorder
- Lack or absence of sexual fantasies and desire for minimum duration of 6 months.
- The dysfunction can be lifelong.
Epidemeolgy of Male Hypoactive Sexual Desire Disorder
Etiology of Male Hypoactive Sexual Desire Disorder
Many factors such as age and culture should inform whether the patient fits within the bounds for normal sexual desire.
In sex therapy clinic populations, ………. is one of the most common complaints among married couples, with ……… more affected than ……..
- Lack of desire
- women more affected than men (F>M).
Characters of female Sexual Interest/Arousal Disorder
what are types of Orgasmic Disorders
- FEMALE ORGASMIC DISORDER
- PREMATURE (EARLY) EJACULATION
What is another name of Female Orgasmic Disorder?
(ANORGASMIA OR INHIBITED FEMALE ORGASM)
Def of Female Orgasmic Disorder
- Reduction in frequency, immediacy, or intensity of orgasm.
- In lifelong female orgasmic disorder, one has never experienced an orgasm by any kind of stimulation.
Epidemeology of Female Orgasmic Disorder
- The estimated proportion of married women over age 35 who never have achieved orgasm is 5%
- The proportion is higher in unmarried women and younger women.
- The overall prevalence of inhibited female orgasm is 30%.
NB: Not related to relationship significant stressors.
Characters of Premature Ejaculation
In premature ejaculation, men persistently or recurrently achieve orgasm and ejaculation before they wish to.
Dx of Premature Ejaculation
The diagnosis is made when a man regularly ejaculates before or within approximately 1 minute after penetration.
Premature ejaculation is the chief complaint of 35% to 40% of men treated for sexual disorders.
Types of Genito-Pelvic Pain/Penetration Disorder
- Dyspareunia
- Vaginismus
def & Characters of Dyspareunia
- Dyspareunia is recurrent or persistent genital pain occurring before, during, or after intercourse.
- Not related to relationship significant stressors.
Def of Vaginismus
- A constriction of the outer third of the vagina due to involuntary pelvic floor muscle tightening or spasm.
Characters of Vaginismus
Characters of Gender Dysphoria
- Persistent discomfort with one’s biologic sex and in some cases.
- The desire to have sex organs of the opposite sex.
Subtypes of Gender Dysphoria
A. Gender Dysphoria in Children
B. Gender Dysphoria in Adolescents and Adults.
Def of Anorexia nervosa
Anorexia nervosa is a syndrome characterized a self induced starvation to a significant degree leading to the presence of medical signs and symptoms resulting from starvation.
Characters of Anorexia nervosa
- It is often associated with disturbances of body image
- The perception that one is distressingly large despite obvious thinness.
Epidemeology of Anorexia nervosa
- The most common age of onset is between 14 and 18 years.
- Anorexia nervosa is estimated to occur in about 0.5% to 1% of adolescent girls
- It occurs 10 to 20 times more often in females than in males (F:M = 10~20 : 1)
Etiology of Anorexia nervosa
Types of Anorexia nervosa
DSM 5 Criteria of Anorexia nervosa
- Disturbed body image.
- Have intense fear of gaining weight or becoming fat.
- Amenorrhea.
- Body weight < 15% below normal.
Physical Symptoms of Anorexia nervosa
Prognosis & Course of Anorexia nervosa
- Varies greatly, some patients spontaneously recovered, some experienced course of remission and relapse.
- For others they experience progressive course with deteriorating course.
TTT of Anorexia nervosa
- Psychotherapy.
- Psychotropics.
- Admission is a must for deteriorating cases.
Def of Bulimia Nervosa
Bulimia nervosa is defined as binge eating combined with inappropriate ways of stopping weight gain (such as laxative abuse, vomiting, diuretics, fasting, or excessive exercise).
Characters of Bulimia Nervosa
- Social interruption or physical discomfort that is, abdominal pain or nausea terminates the binge eating.
- Often followed by feelings of guilt, depression, or self-disgust
- Unlike patients with anorexia nervosa, those with bulimia nervosa may maintain a normal body weight.
Epidemeology of Bulimia Nervosa
- Bulimia nervosa is more prevalent than anorexia nervosa.
- Estimates of bulimia nervosa range from 1% to 4% of young women.
- As with anorexia nervosa, bulimia nervosa is significantly more common in women than in men, but its onset is often later in adolescence than that of anorexia nervosa.
Etiology of Bulimia Nervosa
DSM 5 Criteria of Bulimia Nervosa
- Recurrent episodes of binge eating.
- Recurrent inappropriate attempts to compensate for overeating and prevent weight gain.
- These behaviors occur at least twice a week for 3 months.
- Perception of self-worth is excessively influenced by body weight and shape.
Physical Symptoms of Bulimia Nervosa
Prognosis & Course of Bulimia Nervosa
- Better prognosis than anorexia nervosa.
- Symptoms exacerbated by stressful conditions.
- One half fully recover with treatment.
- One half have chronic course with fluctuating symptoms.
TTT of Bulimia Nervosa
- Psychotherapy.
- Pharmacotherapy.
- Treatment of comorbidities.
