An interdisciplinary study towards a multiaxial classification of male sexual dysfunction.

The classification of male sexual dysfunction (SD) was investigated in a multidisciplinary study involving a sample of 25 outpatients whose phenomenology, course and biologic comorbidity is described. All 25 patients were suffering from arousal disorders; 9 men complained of lack of desire and 9 of orgasm disorders. For the vast majority (19/25), the arousal disorder preceded the other sexual dysfunctions. Eleven patients suffered from a psychopathological disorder according to DSM-III or DSM-III-R (Axis I and II), with general anxiety, major depression and obsessive-compulsive personality being the most common disorders. Only 6 patients were free of any organic disorder or pathological laboratory finding known to be related to sexual dysfunction. These results served as the basis for analyzing the fit of our data in the most prominent classification systems DSM-III, DSM-III-R, Mainz multiaxial classification model and the traditional dichotomy model. According to our data, the comorbidity of biologic and mental conditions was very high, as most patients (60%) suffered from more than one etiologic factor known to be related to SD. Based on these results, a modification of the DSM-III-R system is suggested.