Abstract
Sexual problems and sexual dysfunctions are probably among the most common psychological or psychosomatic syndrome complexes of all. Estimates for the 12-month prevalence of sexual problems are 51% for women and 42% for men, with around 10% of men and 11% of women reporting that they suffer from them in a clinically significant way (Mitchel et al. 2013). However, sexual dysfunctions are rarely diagnosed in healthcare practice (Beier et al. 2000; Hoyer 2013; Reinecke et al. 2006). One reason for this is the complex diagnostic exclusion processes that are required before a diagnosis of sexual dysfunction can be made. Sexual problems can be triggered or caused by a variety of medical disease factors or substance or medication use, as well as by psychological disorders, relationship problems or other serious stressors (see DSM-5, German: Falkai et al. 2015). Recognizing whether the sexual symptoms are either accompanying symptoms of the disorders mentioned (or stress factors) or whether they meet the criteria for an independent (possibly comorbid) disorder requires the complex compilation and evaluation of a wealth of diagnostic information. A functioning, interdisciplinary network of doctors, psychotherapists, sex therapists or sexual medicine specialists would be desirable in this regard, but is only available in specialized institutions. Last but not least, avoidance motives on the part of patients make it difficult to form a clear diagnostic judgment (see Hoyer 2013). A simple solution to the problems mentioned lies in the use of screening procedures. Screening tests are time- and cost-effective preliminary tests for the initial identification of people with clinically relevant characteristics. One example is mammography for the detection of breast cancer. Evidence from the screening then leads to an in-depth, comprehensive diagnostic examination. Another possible use of screening procedures is to identify patients with particularly psychological problems in the medical care system (e.g. in psycho-oncology) or in the psychosocial care system (e.g. in advice centers). Questionnaires are increasingly being used for screening purposes (see Hoyer et al. 2003), which make it easier to assess whether further psychodiagnostic or therapeutic measures are required. One example of this is the Hospital Anxiety and Depression Scale (German: Hermann-Lingen et al. 2011), which is used to record anxiety and depression in patients with physical illnesses or (possibly psychogenic) physical complaints. Studies using a simple screening instrument that asks about the sexual dysfunctions mentioned in the classification systems for mental disorders show that it is very easy to handle and accept and at the same time has good results in terms of validity (Labbate and Lare 2001; Hoyer et al. 2009). In view of the current revision of the section “Sexual Dysfunctions” in the DSM-5 (Falkai et al. 2015: 577), it makes sense to adapt the “Short Questionnaire on Sexuality” (cf. Hoyer and Jahnke 2014) in accordance with the requirements of the DSM-5. According to DSM-5, sexual dysfunction is diagnosed when a specified minimum number of disorder-specific symptoms are present (A criteria) and the person is bothered in a clinically significant way (C criterion) for at least approximately six months (B criterion). The diagnosis is only given when the symptoms cannot be better explained by (a) a nonsexual disorder, (b) they cannot be understood as the result of serious strain within the relationship or as the result of other significant stressors, and (c) they cannot be attributed exclusively to the effects of a substance or medication or a medical condition.
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