Sexual dysfunction and dual psychiatric diagnoses

Controversy continues to exist about whether a sexual dysfunction is a discrete problem or it is symptomatic of more elaborate psychiatric disorder. To date no study of this question has been reported on patients evaluated using DSM-III criteria. To meet such a need, 592 patients with various sex-related complaints and their partners were evaluated at the Sexual Behaviors Consultation Unit of the Johns Hopkins Hospital over a 2-year period. Two hundred and eighty-eight patients (males = 223; females = 65) fulfilled DSM-III criteria for psychosexual dysfunction. Of these 30.5% (N = 68) of the males and 30.8% (N = 20) of the females were assigned concurrent Axis I II diagnoses. Patients who had dual diagnoses reported more (P = .026) problems with alcohol. Despite equivalent psychosocial stressors on Axis IV they were rated less (P < .01) adjusted on Axis V. Dual diagnostic profiles were described for each of the psychosexual dysfunctions. Results support the hypothesis that while the majority of patients with sexual dysfunction have a discrete disorder, there is another group whose sexual dysfunction is but one of several conditions which deserve treatment.