Comments on: Hypersexuality: DSM 5, Are You Kidding?

By: Dr. Vollmer

Dr. Vollmer — Wed, 07 Jul 2010 18:03:59 +0000

Yes, but the main point is the impairment of social and occupational functioning, not the “hypersexuality. Thanks for your comments.

By: Jason

Jason — Wed, 07 Jul 2010 17:58:57 +0000

I will be interested to see the diagnostic criteria for hypersexuality. I was actually shocked to discover that this dysfunction (or something similar under another name) was not included, especially since hyposexuality IS a diagnosis. I would bet that the criteria are fairly stringent and that diagnosticians of all types would certainly need to be responsible in their diagnoses. I could see the legitimacy of this diagnosis if someone were CSDI by their behaviors–someone who, for example, thought about and/or acted on sexual impulses so frequently that s/he could not focus at work.

By: Dr. Vollmer

Dr. Vollmer — Tue, 16 Feb 2010 18:00:58 +0000

Yes the diagnosis matters a lot. Mental disorders can be used to discriminate against people. They can be used in courts to say that one parent is not fit to raise their children. They can be used to say that money should be exchanged because someone developed a mental disorder. This is no small matter. Thanks for your comments.

By: Lynette

Lynette — Tue, 16 Feb 2010 17:27:20 +0000

I think you have some very good points that aren’t limited to just the DSM, but anytime an objective criteria is applied to essentially subjective acts/events whether it’s sex, drug use, etc. “One size fits all” criteria like the DSM may not be a very good indicator for subjective disorders. As a practical matter, does the diagnoses really matter other than when seeking reimbursement from 3d party payors?

By: Dr. Vollmer

Dr. Vollmer — Tue, 16 Feb 2010 16:16:33 +0000

This is the tricky part. With psychosis, patients do not know they are disturbed, so the psychiatrist has to tell them. For neurotic disorders (a DSM II word), then the patient comes in complaining about their own behavior. DSM 5 seems to be fuzzy on this issue. The issue is “says who”. To me, the way the diagnosis is proposed, it is a slippery slope to where psychiatrists will lose all credibility.

By: Shelly

Shelly — Tue, 16 Feb 2010 06:00:13 +0000

Bravo, Shirah! Well done.

Isn’t the definition of a disorder something that causes the patient to be alarmed, uncomfortable, or unable to function normally in life? Then hypersexuality (as a disorder) would mean that the patient spends every spare second pursuing sexual activity or sexual imagery or thoughts? It is not for psychiatrists to tell the patients that they are disturbed; it is for the patients to say it about themselves.