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Psych EOR > Paraphiliac Disorders, Sexual Dysfunctions > Flashcards

Paraphiliac Disorders, Sexual Dysfunctions Flashcards

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1
Q

What is the diagnostic criteria for delayed ejaculation?

A

Marked delay in ejaculation, infrequency or absence of ejaculation for ≥ 6 months

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2
Q

How is delayed ejaculation treated?

A

sex therapy, CBT
* Off-label: testosterone, buspirone, amantadine, oxytocin, and cabergoline

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3
Q

What are RF for erectile disorder?

A
  • MC 40-70 y/o
  • atherosclerosis
  • antihypertensives
  • sickle cell
  • hx pelvic surgery or perineal trauma
  • alcohol abuse
  • hypogonadism
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4
Q

What labs would you get to work up erectile disorder?

A

free testosterone, serum prolactin, fasting glucose, lipids, TFTs

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5
Q

What is the diagnostic criteria for erectile disorder?

A

Recurring inability to achieve & maintain an erection sufficient for satisfactory sexual performance for ≥ 6 months

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6
Q

How is erectile disorder treated?

A

lifestyle modifications, PDE-5 inhibitors (sildenafil, tadalafil)

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7
Q

What will a patient typically complain of with female orgasmic disorder?

A

normal libido & sexual excitement w/o the ability to orgasm

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8
Q

What is the diagnostic criteria for female orgasmic disorder?

A

delayed, infrequent, or absent orgasm w/ ↓ intensity of orgasmic sensations ≥ 6 months

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9
Q

How is female orgasmic disorder treated?

A

directed masturbation
* If SSRI induced: substitute w/ bupropion, nefazodone, or duloxetine
* If typical antipsychotic-induced: substitute w/ aripiprazole, quetiapine, or olanzapine

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10
Q

What is the diagnostic criteria for female sexual intrest/arousal disorder?

A

≥3 sxs of lack/reduced sexual interest/arousal that causes distress and last ≥6 months
* Absent/reduced interest in sexual activity, sexual thoughts or fantasies, initiation, excitement/pleasure
* Absent/reduced sexual interest/arousal in response to any internal/external cues (written, verbal, visual), genital or nongenital sensations during sexual activity

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11
Q

How is female sexual intrest/arousal disorder treated?

A

CBT, couples therapy, topical creams/lubricants
* Off-label: bupropion, testosterone patches, sildenafil/tadalafil

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12
Q

What is the diagnostic criteria for genito-pelvic pain/penetration disorder?

A

≥1 sxs that causes significant distress for ≥ 6 months
* difficulty having intercourse
* genito-pelvic pain
* fear of pain or vaginal penetration
* tension of pelvic floor muscles

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13
Q

How is genito-pelvic pain/penetration disorder treated?

A

CBT, pelvic-floor rehab, vaginal creams/lubricants

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14
Q

What is the diagnostic criteria for male hypoactive sexual desire disorder?

A

persistent or recurring absence/deficiency of sexual/erotic thoughts, fantasies & desire for sexual activity for ≥ 6 months

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15
Q

How is male hypoactive sexual desire disroder treated?

A

CBT + behavioral sex therapy

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16
Q

What is the diagnostic criteria for premature (early) ejaculation?

A

Persistent or recurrent ejaculation during partnered sexual activ­ity w/in ~1 minute ofl penetration & before the individ­ual wishes for ≥ 6 month

17
Q

How is premature (early) ejaculation treated?

A

SSRIs – Paroxetine (daily dosing) or Clomipramine (PRN 4-6 hrs prior)
* Topical anesthetics (lidocaine, prilocaine), sex therapy

18
Q

What is the diagnostic criteria for voyeuristic disorder?

A

arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity for ≥6 months AND ≥18 y/o
* Has acted on these urges w/ a nonconsenting person or the urges/fantasies cause clinically significant distress or impairment

19
Q

How is voyeuristic disorder treated?

A

Psychotherapy, pornography, Fluoxetine

20
Q

What is the diagnostic criteria for exhibitionist disorder?

A

arousal from the exposure of one’s genitals to an unsuspecting person for ≥6 months
* Has acted on these urges w/ a nonconsenting person or the urges/fantasies cause clinically significant distress or impairment

21
Q

What are the specifications for exhibitionist disorder?

A
  • Sexually aroused by exposing genitals to prepubertal children
  • Sexually aroused by exposing genitals to physically mature individuals
  • Sexually aroused by exposing genitals to prepubertal children and physically mature individuals
22
Q

How is exhibitionist disorder treated?

A

CBT, SSRIs, antiandrogens

23
Q

What is the diagnostic criteria for frotteuristic disorder?

A

sexual gratification attained by touching or rubbing against a nonconsenting individual

24
Q

What is the treatment for frotteuristic disorder?

A

psychotherapy (identifying triggers) + behavior therapy (strategies to redirect thoughts & feelings)

25
Q

What is the diagnostic criteria for sexual masochism disorder?

A

arousal from the act of being humiliated, beaten, bound, or made to suffer, causing distress for ≥6 months
* Specify: if w/ asphyxiophilia → achieving sexual arousal by restriction of breathing

26
Q

What is the diagnostic criteria for sexual masochism disorders?

A

behavioral therapy, SSRIs, antiandrogens

27
Q

What is the diagnostic criteria for sexual sadism disorder?

A

Sexual gratification in response to inflicting humiliation, bondage, or suffering

28
Q

How is sexual sadism disorder treated?

A

not required unless causing significant impairment, distress, or harm to self or another has occurred
* Psychotherapy, SSRIs, testosterone blockers (antiandrogens, GnRH analogs)

29
Q

What is the diagnostic criteria for fetishistic disorder?

A

arousal from the use of nonliving objects or a highly specific focus on nongenital body parts causing distress for ≥6 months

30
Q

How is fetishistic disorder treated?

A

behavioral therapy, SSRIs

31
Q

What is the diagnostic criteria for pedophilic disorder?

A

arousing fantasies, urges, or behaviors about sexual activity w/ a prepubescent child (≤ 13 y/o) for ≥6 months
* ≥ 16 y/o and ≥ 5 years older than the child

32
Q

How is pedophilic disorder treated?

A

behavioral therapy, SSRIs, antiandrogens

33
Q

What is the diagnostic criteria for transvestic disorder?

A

arousal from wearing clothes of the opposite gender causing distress for ≥6 months

34
Q

How is transvestic disorder treated?

A

psychotherapy, group therapy, SSRIs

Psych EOR (9 decks)

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