Hostname: page-component-5d59c44645-mhl4m Total loading time: 0 Render date: 2024-03-01T11:22:42.266Z Has data issue: false hasContentIssue false

Multiaxial Classification of Male Sexual Dysfunction

Published online by Cambridge University Press:  29 January 2018

Otto Benkert*
Department of Psychiatry, School of Medicine, University of Mainz, Langenbeckstrasse, 6500 Mainz, Federal Republic of Germany


Sexual dysfunction in male subjects is a multifaceted illness, not appropriately classifiable by any of the current diagnostic systems, in most of which a major disadvantage is their poor inter-rater reliability. This results in over-or underestimation of minor biological (e.g. hormonal) disturbances, which occur in conjunction with the disorder, but are unlikely to be only its pathophysiological correlate. These biological factors can be important in some cases, however, as they indicate therapeutic strategies (e.g. correction of a minor hormonal deficit). The broad acceptance of classificatory systems with multi-axial dimensions has prompted the construction of a new system. In accordance with DSM III this consists of seven equivalent axes and sub-axes, supplemented by five sub-types, from which the diagnostic attribution can be derived.

Research Article
Copyright © 1985 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. DSM-III. Washington, DC.Google Scholar
Benkert, O. (1977) Sexuelle Impotenz. Neuroendokrinologische und pharmakotherapeutische Untersuchungen. Berlin: Springer Verlag.CrossRefGoogle Scholar
Benkert, O. & Holsboer, F. (1984) Sexual dysfunction in male patients; biological indices and classification. In Psychopharmacology of Sexual Disorders (ed. Segal, M.), London, Libbey, (in press).Google Scholar
Benkert, O. Steiger, A., & Holsboer, F. (1985) Simultaneous determination of neuroendocrinological and neurophysiological parameters in males with effective disorders and sexual dysfunction . In Proceedings of the VII. World Congress of Psychiatry (ed. Berner, P.), New York Plenum (in press).Google Scholar
Conte, H. R. (1983) Development and use of self-report techniques for assessing sexual functioning: a review and critiques. Archives of Sexual Behaviour, 12, 555576.CrossRefGoogle Scholar
Cooper, A. J. (1972). Diagnosis and management of “endocrine impotence”. British Medical Journal, 5, 3436.CrossRefGoogle Scholar
Cooper, A. J. Ismail, A. A. A., Smith, C. A. & Lorraine, J. A. (1970) Androgen function in “psychogenic” and “constitutional” types of impotence. British medical Journal (i), 3437.CrossRefGoogle Scholar
Essen-Möller, E. & Wohlfahrt, S. (1947) Suggestions for the amendment of the official Swedish classification of mental disorders. Acta psychiatrica scandinavica 37, 119126.CrossRefGoogle Scholar
Fordney-Settlage, D. S. (1975) Heterosexual dysfunction. Evaluation and treatment for the general practitioner. Archives of Sexual Behaviour, 4, 367387.Google Scholar
Graber, B. & Kline-Graber, G. (1981) Research Criteria for male erectile failure. Journal of Sexual and Marital Therapy, 47, 3748.CrossRefGoogle Scholar
Helmchen, H. (1980) Multiaxial systems of classification. Acta Psychiatrica Scandinavica, 61, 4349.CrossRefGoogle ScholarPubMed
International Classification of Diseases, 9th Revision (1980) (eds. Degkwitz, R., Helmchen, H., Kockott, G. & Mombour, W.) Berlin: Springer Verlag.Google Scholar
Kaplan, H. S. (1974) The New Sex Therapy. New York: Brunner/Marcel.Google Scholar
Marshall, P., Surridge, D. & Delva, N. (1981) The role of nocturnal penile tumescence in differentiating between organic and psychogenic impotence. Archives of Sexual Behaviour, 10, 111.CrossRefGoogle ScholarPubMed
Robins, E. & Guze, S. B. (1970) Establishment of diagnostic validity in psychiatric illness. American Journal of Psychiatry, 126, 983987.Google ScholarPubMed
Roffwarg, H. B., Sachar, E. J., Halpern, F. & Hellman, L. (1982) Plasma testosterone and sleep: relationship to sleep stage variables. Psychosomatic Medicine, 44, 7384.CrossRefGoogle ScholarPubMed
Schmitt, G. & Arentewicz, G. (1977) Sexuelle Funktionsstörungen. Klinisce Psychologie, 2, 22692282.Google Scholar
Schover, L. R., Friedman, J. M., Weiler, S. J., Heiman, J. R. & Lo Piccolo, J. (1982) Multiaxial problem-oriented system for sexual dysfunctions. An alternative to DSM III. Archives of General Psychiatry, 39, 614619.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1975) Clinical criteria for psychiatric diagnosis and DSM-III. American Journal of Psychiatry, 132, 11871192.Google ScholarPubMed
Spitzer, R. L. (1978) Problems of classification. In Psychopharmacology: A Generation of Progress (eds. Lipton, R., di Mascio, A., Killian, K. F.), New York: Raven Press.Google Scholar
Strauss, J. S. (1975) A comprehensive approach to psychiatric diagnosis. American Journal of Psychiatry, 132, 11931197.Google ScholarPubMed
Submit a response


No eLetters have been published for this article.