L14: Psychosexual & Eating Disorders

Question 1

Def of Sexual Dysfunction

Answer 1

• Sexual dysfunctions are an inability to respond to sexual stimulation, or the experience of pain during the sexual act.
• They are defined by disturbance in the subjective sense of pleasure or desire associated with sex, or by the objective performance.

Question 2

Characters of Sexual Dysfunction

Answer 2

Sexual dysfunctions can be:

• Lifelong or acquired
• Generalized or situational
• A result from psychological factors, physiologic factors, or combined factors.

Question 3

Types of Sexual Dysfunction

Answer 3

• DESIRE, INTEREST AND AROUSAL DISORDERS
• ORGASMIC DISORDERS
• SEXUAL PAIN DISORDERS
• GENDER DYSPHORIA

Question 4

Disorders of Desire, Interest & Arousal Disorders

Answer 4

• MALE HYPOACTIVE SEXUAL DESIRE DISORDER
• FEMALE SEXUAL INTEREST/AROUSAL DISORDER

Question 5

Characters of Male Hypoactive Sexual Desire Disorder

Answer 5

1. Lack or absence of sexual fantasies and desire for minimum duration of 6 months.
2. The dysfunction can be lifelong.

Question 6

Epidemeolgy of Male Hypoactive Sexual Desire Disorder

Answer 6

Question 7

Etiology of Male Hypoactive Sexual Desire Disorder

Answer 7

Many factors such as age and culture should inform whether the patient fits within the bounds for normal sexual desire.

Question 8

In sex therapy clinic populations, ………. is one of the most common complaints among married couples, with ……… more affected than ……..

Answer 8

• Lack of desire
• women more affected than men (F>M).

Question 9

Characters of female Sexual Interest/Arousal Disorder

Answer 9

Question 10

what are types of Orgasmic Disorders

Answer 10

• FEMALE ORGASMIC DISORDER
• PREMATURE (EARLY) EJACULATION

Question 11

What is another name of Female Orgasmic Disorder?

Answer 11

(ANORGASMIA OR INHIBITED FEMALE ORGASM)

Question 12

Def of Female Orgasmic Disorder

Answer 12

• Reduction in frequency, immediacy, or intensity of orgasm.
• In lifelong female orgasmic disorder, one has never experienced an orgasm by any kind of stimulation.

Question 13

Epidemeology of Female Orgasmic Disorder

Answer 13

• The estimated proportion of married women over age 35 who never have achieved orgasm is 5%
• The proportion is higher in unmarried women and younger women.
• The overall prevalence of inhibited female orgasm is 30%.

NB: Not related to relationship significant stressors.

Question 13

Characters of Premature Ejaculation

Answer 13

In premature ejaculation, men persistently or recurrently achieve orgasm and ejaculation before they wish to.

Question 14

Dx of Premature Ejaculation

Answer 14

The diagnosis is made when a man regularly ejaculates before or within approximately 1 minute after penetration.

Premature ejaculation is the chief complaint of 35% to 40% of men treated for sexual disorders.

Question 15

Types of Genito-Pelvic Pain/Penetration Disorder

Answer 15

• Dyspareunia
• Vaginismus

Question 16

def & Characters of Dyspareunia

Answer 16

• Dyspareunia is recurrent or persistent genital pain occurring before, during, or after intercourse.
• Not related to relationship significant stressors.

Question 17

Def of Vaginismus

Answer 17

• A constriction of the outer third of the vagina due to involuntary pelvic floor muscle tightening or spasm.

Question 18

Characters of Vaginismus

Answer 18

Question 19

Characters of Gender Dysphoria

Answer 19

1. Persistent discomfort with one’s biologic sex and in some cases.
2. The desire to have sex organs of the opposite sex.

Question 20

Subtypes of Gender Dysphoria

Answer 20

A. Gender Dysphoria in Children
B. Gender Dysphoria in Adolescents and Adults.

Question 21

Def of Anorexia nervosa

Answer 21

Anorexia nervosa is a syndrome characterized a self induced starvation to a significant degree leading to the presence of medical signs and symptoms resulting from starvation.

Question 22

Characters of Anorexia nervosa

Answer 22

• It is often associated with disturbances of body image
• The perception that one is distressingly large despite obvious thinness.

Question 23

Epidemeology of Anorexia nervosa

Answer 23

• The most common age of onset is between 14 and 18 years.
• Anorexia nervosa is estimated to occur in about 0.5% to 1% of adolescent girls
• It occurs 10 to 20 times more often in females than in males (F:M = 10~20 : 1)

Question 24

Etiology of Anorexia nervosa

Answer 24

Question 25

Types of Anorexia nervosa

Answer 25

Question 26

DSM 5 Criteria of Anorexia nervosa

Answer 26

1. Disturbed body image.
2. Have intense fear of gaining weight or becoming fat.
3. Amenorrhea.
4. Body weight < 15% below normal.

Question 27

Physical Symptoms of Anorexia nervosa

Answer 27

Question 28

Prognosis & Course of Anorexia nervosa

Answer 28

• Varies greatly, some patients spontaneously recovered, some experienced course of remission and relapse.
• For others they experience progressive course with deteriorating course.

Question 29

TTT of Anorexia nervosa

Answer 29

1. Psychotherapy.
2. Psychotropics.
3. Admission is a must for deteriorating cases.

Question 30

Def of Bulimia Nervosa

Answer 30

Bulimia nervosa is defined as binge eating combined with inappropriate ways of stopping weight gain (such as laxative abuse, vomiting, diuretics, fasting, or excessive exercise).

Question 31

Characters of Bulimia Nervosa

Answer 31

• Social interruption or physical discomfort that is, abdominal pain or nausea terminates the binge eating.
• Often followed by feelings of guilt, depression, or self-disgust
• Unlike patients with anorexia nervosa, those with bulimia nervosa may maintain a normal body weight.

Question 32

Epidemeology of Bulimia Nervosa

Answer 32

• Bulimia nervosa is more prevalent than anorexia nervosa.
• Estimates of bulimia nervosa range from 1% to 4% of young women.
• As with anorexia nervosa, bulimia nervosa is significantly more common in women than in men, but its onset is often later in adolescence than that of anorexia nervosa.

Question 33

Etiology of Bulimia Nervosa

Answer 33

Question 34

DSM 5 Criteria of Bulimia Nervosa

Answer 34

1. Recurrent episodes of binge eating.
2. Recurrent inappropriate attempts to compensate for overeating and prevent weight gain.
3. These behaviors occur at least twice a week for 3 months.
4. Perception of self-worth is excessively influenced by body weight and shape.

Question 35

Physical Symptoms of Bulimia Nervosa

Answer 35

Question 36

Prognosis & Course of Bulimia Nervosa

Answer 36

• Better prognosis than anorexia nervosa.
• Symptoms exacerbated by stressful conditions.
• One half fully recover with treatment.
• One half have chronic course with fluctuating symptoms.

Question 37

TTT of Bulimia Nervosa

Answer 37

1. Psychotherapy.
2. Pharmacotherapy.
3. Treatment of comorbidities.