DSM-5 Changes in Diagnostic Criteria of Sexual Dysfunctions

The Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria proved to be in a constant of evolution [1]. The first edition of the DSM, in 1952, catalogued 60 categories of abnormal behavior. By 1994, the fourth edition (DSM-IV) listed 297 separate disorders and over 400 specific psychiatric diagnoses [2]. As with other disorders, DSM criteria for sexual dysfunctions reflect the prevailing psychiatric thinking of the time of publication; they have thus evolved throughout the years, reflecting advancements in the understanding of sexual disorders. For instance, in the first edition of the DSM, in 1952, impotence” and “frigidity were listed under “psychophysiological autonomic and visceral disorders” [3]. Likewise, diagnostic categories of female sexual interest as described in the DSM IV 1994 [4] were based on the model of human sexual response proposed by Masters and Johnson [5], and further developed by Kaplan [6]. However, recent research has put into question the validity of that model; both the strict distinction between different phases of arousal and the linear model of sexual response were found to inadequately explain sexual behavior, particularly in women [7-9]. This has in turn led to several proposed changes in sexual dysfunction diagnostic criteria [1,10].