Efficacy of Psychosocial Interventions in Men and Women With Sexual Dysfunctions—A Systematic Review of Controlled Clinical Trials
University Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Freiburg, Germany Rhein-Jura-Clinic for Psychiatry, Psychosomatic Medicine and Psychotherapy, Bad Säckingen, Germany Section for Sexual Medicine, German Society for Psychiatry and Psychotherapy (DGPPN), Berlin, Germany. Journal of Sexual Medicine
(Impact Factor: 3.15).
10/2012; 9(12). DOI: 10.1111/j.1743-6109.2012.02965.x
Introduction. As yet, a summary of the research evidence concerning the efficacy of psychological treatment in female sexual dysfunction is lacking. Previous reviews were often nonsystematic or explored one specific sexual dysfunction.
Aim. Our systematic review provides an overview of the efficacy of psychosocial interventions in all female sexual dysfunction.
Main Outcome Measures. Main outcome measures included for example psychometrically validated scales, diary notes, interviews, and vulvar algesiometer. The efficacy of psychosocial interventions was measured for example by the frequency of and satisfaction with sexual activity and sexual functioning. Safety and acceptance were evaluated on the basis of adverse events and dropout rates.
Methods. The systematic literature search included electronic database search, handsearch, contact with experts, and an ancestry approach. Studies were included if the woman was given a formal diagnosis of a sexual dysfunction (International Statistical Classification of Diseases and Related Health Problems—ICD10/-9; Diagnostic and Statistical Manual of Mental Disorders-IV/-III-R) and when the intervention was psychosocial or psychotherapeutic. The control group included either another treatment or a waiting-list control group. The report of relevant outcomes was necessary for inclusion as well as the design of the study (randomized, controlled trials [RCTs] and controlled clinical trials). The assessment of methodological quality comprised aspects of randomization, blinding, incomplete outcome data, selective reporting, and allegiance.
Results. We identified 15 RCTs that investigated efficacy in female sexual dysfunction and two further studies that examined male and female sexual dysfunction together. Most trials explored sexual pain disorders. About half of all studies in women used either a concept derived from Masters and Johnson or a cognitive-behavioral treatment program. Both approaches showed significant improvements compared with a control group. Benefit was not always maintained over the (variable) follow-up period.
Conclusions. Traditional sexual therapeutic concepts proved to be efficacious in the treatment of female sexual dysfunction. A shortcoming was the rather low methodological quality of included studies. Günzler C, and Berner MM. Efficacy of psychosocial interventions in men and women with sexual dysfunctions—A systematic review of controlled clinical trials. J Sex Med 2012;9:3108–3125.
Available from: Mary V. Seeman
[Show abstract] [Hide abstract]
ABSTRACT: Sexual dysfunction is common among women with schizophrenia treated with antipsychotic medication. Multiple factors influence sexual function and reproductive health in this patient population, including the effects of medications on prolactin secretion and the complexities of making contraceptive decisions in the context of a serious mental illness. The author explores the causes and management of loss of libido as illustrated by a case vignette and describes the course and outcome of a clinical intervention that was implemented to alleviate the sexual dysfunction. Possible approaches and potential pitfalls of the intervention are described. Clinicians must be open to discussions regarding sexual concerns, relationships with sexual partners, and reproductive issues with women suffering from schizophrenia. Both patients and clinicians need to be aware of unintended effects of intervention. Opportunities exist for improved education among clinicians to achieve a more proactive approach to sexual health in women receiving antipsychotic medication.
[Show abstract] [Hide abstract]
ABSTRACT: Female sexual dysfunctions (FSDs) range from short-term aggravations to major emotional disturbances adversely affecting family and workplace. This review highlights diagnosis and management of the four most widely diagnosed FSDs. It initially focuses on hypoactive sexual desire disorder (HSDD) as a driving force at the heart of all other FSDs; nothing happens without sexual desire. Successful resolution of HSDD frequently facilitates resolution of other disorders. Central to understanding HSDD is the impact of aging female sexual endocrinology and its effect on both prevalence and expression patterns of FSD. Advances in this field have enabled introduction of some the most effective treatments yet described for HSDD. Sexual arousal disorder, though commonly affected by the same factors as HSDD, is heavily associated with psychotropic drugs and mood elevators. Orgasmic disorder is frequently the downstream result of other sexual dysfunctions, particularly HSDD, or the result of a major psychosexual trauma. Successful management of the underlying disorder often resolves orgasmic disorder. Sexual pain disorder is frequently the result of a gynecologic disorder, such as endometriosis, that can be substantially managed through successful treatment of that disorder. This article ends with the article's most important note: how to initiate the conversation. (Fertil Steril (R) 2013; 100: 905-15. (C) 2013 by American Society for Reproductive Medicine.)
[Show abstract] [Hide abstract]
ABSTRACT: This review updates similar articles published in JFT in 2000 and 2009. It presents evidence from meta-analyses, systematic literature reviews and controlled trials for the effectiveness of couple and family therapy for adults with various relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, either alone or as part of multi-modal programmes, for relationship distress, psychosexual problems, intimate partner violence, anxiety disorders, mood disorders, alcohol problems, schizophrenia and adjustment to chronic physical illness.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.