The PDE-5 inhibitors and psychiatry.
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Combined Modality Therapy↗
Biomedical subjects
Stephen B Levine
Publications and source records attributed to Stephen B Levine.
A slightly different idea.
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Diagnostic and Statistical Manual of Mental Disord↗
Psychological and interpersonal dimensions of sexual function and dysfunction.
INTRODUCTION: There are limited outcome data on the efficacy of psychological interventions for male and female sexual dysfunction and the role of innovative combined treatment paradigms. AIM: To highlight the salient psychological and interpersonal issues contributing to sexual health and dysfunction; to offer a four-tiered paradigm for understanding the evolution and maintenance of sexual symptoms; and to offer recommendations for clinical management and research. METHODS: An International Consultation assembled over 200 multidisciplinary experts from 60 countries into 17 committees. The recommendations of committee members represent state-of-the-art knowledge and opinions of experts from five continents were developed in a process over a 2-year period. Concerning the Psychological and Interpersonal Committee of Sexual Function and Dysfunction, there were nine experts from five countries. MAIN OUTCOME MEASURE: Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. RESULTS: Medical and psychological therapies for sexual dysfunctions should address the intricate biopsychosocial influences of the patient, the partner, and the couple. The biopsychosocial model provides a compelling reason for skepticism that any single intervention (i.e., a phosphodiesterase type 5 inhibitor, supraphysiological doses of a hormone, processing of childhood victimization, marital therapy, pharmacotherapy of depression, etc.) will be sufficient for most patients or couples experiencing sexual dysfunction. CONCLUSIONS: There is need for collaboration between healthcare practitioners from different disciplines in evaluation, treatment, and education issues surrounding sexual dysfunction. In many cases, neither psychotherapy alone nor medical intervention alone is sufficient for the lasting resolution of sexual problems. Assessment of male, female, and couples' sexual dysfunction should ideally include inquiry about: predisposing, precipitating, maintaining, and contextual factors. Treatment of lifelong and/or chronic dysfunction will be different from acquired or recent dysfunction. Research is needed to identify efficacious combined and/or integrated treatments for sexual dysfunction.
Anxiety↗
Pharmacologic treatment of erectile dysfunction.
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Erectile Dysfunction↗
The nature of sexual desire: a clinician's perspective.
Sexual desire is the sum of the forces that lean us toward and away from sexual behavior. The ordinary spectrum of sexual desire's intensity ranges between aversion, disinclination, indifference, interest, need, and passion. Although many individuals have a characteristic pattern of desire throughout their adult lives, this spectrum evolves considerably over the life cycle. It is clinically useful to think of desire as consisting of drive (biological), motive (individual and relationship psychology), and wish (cultural) components. Four master variables--age, gender, social situation, and health--affect sexual desire so basically that many remain blind to their presence. Five dark paradoxes of desire envelop most people at some time in their privacy: (1) Drive and motive are not in sync; (2) Behavioral fidelity is often associated with longing for infidelity; (3) Despite moral proscriptions, lust is possible; (4) Familiarity diminishes sexual interest; and (5) Derogation enhances sexual expression. Clinicians cannot afford to simplify desire's inherent contradictions. Researchers must simplify desire in order to measure it. In both the clinician's and the researcher's hands, sexual desire is a slippery concept.
Adult↗
Erectile dysfunction: why drug therapy isn't always enough.
We increasingly recognize that erectile dysfunction (ED) usually arises from a mix of organic and psychogenic causes, yet management of this condition too often neglects the complexity of most cases of ED. While therapy with sildenafil and similar investigational drugs can play an important role in many cases of ED, physicians should recognize and try to address the psychological and interpersonal context in which ED exists in their patients.
Age Distribution↗
Reexploring the concept of sexual desire.
This article explores how sexual desire operates in ordinary life in both sexes. Fifteen considerations divided into six categories are provided: basic aspects; easily overlooked aspects; energy concepts; politically sensitive aspects; maintaining desire; and toward a definition. Sexual desire is the sum of the forces that incline us toward and away from sexual behavior. Clinicians need to conceptualize desire richly to understand its disorders. Scientists need to simplify the concept in order to conduct pharmacological research. Ideally, the limitations of both approaches must be accepted; in anyone's hands, sexual desire can be a slippery concept.
Female↗
What is love anyway?
This essay explores seven interlocking meanings of the term love. These meanings are the author's synthesis based on years of trying to understand what people mean by the word and why they are not more explicit in explaining themselves during psychotherapy. The meanings may help clinicians better grasp what seems to be the most basic context for understanding a person's sexual life. Love may be: a complex emotion--it is never a single feeling; an ambition; moral commitment; a private dynamic struggle; a deal; a stop sign to psychological inquiry. Many forces in culture and within individuals resist careful scrutiny of what we mean by love.
Female↗