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Z Sex Forsch 2022; 35(03): 137-147
DOI: 10.1055/a-1898-2516
Originalarbeit

Divergierende Konzeptionen sexueller Funktionsstörungen in DSM-5 und ICD-11: Konsequenzen für die Diagnostik, Forschung und Praxis

Divergent Conceptualizations of Sexual Dysfunctions in DSM-5 and ICD-11: Implications for Diagnosis, Research, and Practice
Rebekka Schwesig
1   Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
,
Peer Briken
2   Institut für Sexualforschung, Sexualmedizin und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf
,
Julia Velten
3   Fakultät für Psychologie, Forschungs- und Behandlungszentrum für psychische Gesundheit, Klinische Psychologie und Psychotherapie, Ruhr-Universität Bochum
,
Jürgen Hoyer
1   Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
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Erratum: Divergierende Konzeptionen sexueller Funktionsstörungen in DSM-5 und ICD-11: Konsequenzen für die Diagnostik, Forschung und PraxisZ Sex Forsch 2022; 35(03): E2-E2
DOI: 10.1055/a-1979-1414

Zusammenfassung

Einleitung Obwohl in vielen Bereichen psychischer Störungen in den letzten Jahrzehnten eine Harmonisierung der Diagnosekategorien gemäß DSM-5 und ICD-11 erreicht wurde, gilt dies für den Bereich der sexuellen Funktionsstörungen nicht.

Forschungsziele Anliegen dieser Übersicht ist ein Vergleich der Konzeptionen sexueller Funktionsstörungen in der ICD-11 und im DSM-5. In einem zweiten Schritt sollen Vor- und Nachteile beider Konzeptionen sowie deren Konsequenzen für die Diagnostik, Forschung und Praxis untersucht und kritisch diskutiert werden.

Methoden Die Konzeptionen und diagnostischen Entscheidungsregeln sexueller Funktionsstörungen in den zwei Klassifikationssystemen werden gegenübergestellt und hinsichtlich der Gemeinsamkeiten und Unterschiede auf Symptom- und Störungsebene untersucht.

Ergebnisse In der ICD-11 werden die sexuellen Funktionsstörungen nicht mehr den psychischen Störungen zugeordnet, sondern in einem neunen Kapitel „Conditions related to sexual health“ verortet. Während sich ICD-11 und DSM-5 in ihren Störungs- und Symptombeschreibungen deutlich angenähert haben, unterscheiden sie sich nun fundamental in ihrem Umgang hinsichtlich der Ätiologie sexueller Funktionsstörungen: Dem neuen integrativen, multifaktoriellen, (in Bezug auf die Diagnosevergabe) nicht-ätiologischen Ansatz der ICD-11 (bei dem aber gleichzeitig eine Ätiologie benannt werden kann) steht der ausschließlich psychische, Ätiologie-geleitete Ansatz des DSM-5 entgegen, der zum Ziel hat, sexuelle Funktionsstörungen isoliert als psychische Störungen zu definieren.

Schlussfolgerung Die Unterschiede in der Konzeption sexueller Funktionsstörungen erschweren die internationale Kommunikation und Forschungszusammenarbeit maßgeblich und sind auch für die Anwendungspraxis mit erheblichen Konsequenzen verbunden. Eine einheitliche Klassifikation sexueller Funktionsstörungen wäre daher wünschenswert. Dies scheint aber auch in Zukunft – aufgrund der unterschiedlichen Prioritäten und Zielgruppen der Weltgesundheitsorganisation und der American Psychiatric Association – nicht sehr wahrscheinlich.

Abstract

Introduction Over the past decades, the diagnostic criteria of mental disorders in DSM-5 and ICD-11 have been harmonized in many areas. However, this does not extend to the area of sexual dysfunctions.

Objectives The purpose of this review is to compare the conceptualizations of sexual dysfunctions in DSM-5 and ICD-11. Furthermore, we aim to analyze and discuss advantages and disadvantages of both conceptualizations as well as their consequences for diagnosis, research, and practice.

Methods We contrast the conceptualizations of sexual dysfunctions in the two classification systems and examine similarities and differences on the symptom and disorder level.

Results In ICD-11, sexual dysfunctions are no longer grouped under mental disorders but rather located in a new chapter called “Conditions related to sexual health”. While ICD-11 and DSM-5 have converged significantly in their operationalization of disorder and symptom descriptions, they now differ fundamentally in their approach to the etiology of sexual dysfunction. This is especially due to significant changes in ICD-11: The new inclusive, multifactorial, (regarding the assignment of the diagnosis) non-etiological approach of ICD-11 is opposed by the etiology-driven approach of DSM-5, which aims to define sexual dysfunction exclusively as a psychological disorder.

Conclusion Differences in the conceptualization of sexual dysfunction complicate international communication and research collaboration and have significant consequences for clinical practice. Therefore, a uniform classification of sexual dysfunction would be highly desirable. However, due to different priorities and target groups of the World Health Organization and American Psychiatric Association, this does not seem very likely in the future.

Schlüsselwörter

Diagnostik - DSM-5 - ICD-11 - Klassifikation sexueller Funktionsstörungen - sexuelle Funktionsstörungen

Key words

diagnosis - DSM-5 - ICD-11 - classification of sexual dysfunctions - sexual dysfunctions


Publication History

Article published online:
06 September 2022

© 2022. Thieme. All rights reserved.

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