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Handbook of Sexual Dysfunction DK2479 Half-Series-Title.Qxd 3/8/05 1:03 PM Page B DK2479_half-series-title.qxd 3/8/05 1:03 PM Page A Handbook of Sexual Dysfunction DK2479_half-series-title.qxd 3/8/05 1:03 PM Page B Medical Psychiatry Series Editor Emeritus William A. Frosch, M.D. Weill Medical College of Cornell University New York, New York, U.S.A. Advisory Board Jonathan E. Alpert, M.D., Ph.D. Siegfried Kasper, M.D. Massachusetts General Hospital and University Hospital for Psychiatry Harvard University School of Medicine and University of Vienna Boston, Massachusetts, U.S.A. Vienna, Austria Bennett Leventhal, M.D. Mark H. Rapaport, M.D. University of Chicago School of Medicine Cedars-Sinai Medical Center Chicago, Illinois, U.S.A. Los Angeles, California, U.S.A. 1. Handbook of Depression and Anxiety: A Biological Approach, edited by Johan A. den Boer and J. M. Ad Sitsen 2. Anticonvulsants in Mood Disorders, edited by Russell T. Joffe and Joseph R. Calabrese 3. Serotonin in Antipsychotic Treatment: Mechanisms and Clinical Practice, edited by John M. Kane, H.-J. Möller, and Frans Awouters 4. Handbook of Functional Gastrointestinal Disorders, edited by Kevin W. Olden 5. Clinical Management of Anxiety, edited by Johan A. den Boer 6. Obsessive-Compulsive Disorders: Diagnosis • Etiology • Treatment, edited by Eric Hollander and Dan J. Stein 7. Bipolar Disorder: Biological Models and Their Clinical Application, edited by L. Trevor Young and Russell T. Joffe 8. Dual Diagnosis and Treatment: Substance Abuse and Comorbid Medical and Psychiatric Disorders, edited by Henry R. Kranzler and Bruce J. Rounsaville 9. Geriatric Psychopharmacology, edited by J. Craig Nelson 10. Panic Disorder and Its Treatment, edited by Jerrold F. Rosenbaum and Mark H. Pollack 11. Comorbidity in Affective Disorders, edited by Mauricio Tohen 12. Practical Management of the Side Effects of Psychotropic Drugs, edited by Richard Balon DK2479_half-series-title.qxd 3/8/05 1:03 PM Page C 13. Psychiatric Treatment of the Medically Ill, edited by Robert G. Robinson and William R. Yates 14. Medical Management of the Violent Patient: Clinical Assessment and Therapy, edited by Kenneth Tardiff 15. Bipolar Disorders: Basic Mechanisms and Therapeutic Implications, edited by Jair C. Soares and Samuel Gershon 16. Schizophrenia: A New Guide for Clinicians, edited by John G. Csernansky 17. Polypharmacy in Psychiatry, edited by S. Nassir Ghaemi 18. Pharmacotherapy for Child and Adolescent Psychiatric Disorders: Second Edition, Revised and Expanded, David R. Rosenberg, Pablo A. Davanzo, and Samuel Gershon 19. Brain Imaging In Affective Disorders, edited by Jair C. Soares 20. Handbook of Medical Psychiatry, edited by Jair C. Soares and Samuel Gershon 21. Handbook of Depression and Anxiety: A Biological Approach, Second Edition, edited by Siegfried Kasper, Johan A. den Boer, and J.M. A. Sitsen 22. Aggression: Psychiatric Assessment and Treatment, edited by Emil Coccaro 23. Depression in Later Life: A Multidisciplinary Psychiatric Approach, edited by James Ellison and Sumer Verma 24. Autism Spectrum Disorders, edited by Eric Hollander 25. Handbook of Chronic Depression: Diagnosis and Therapeutic Management, edited by Jonathan E. Alpert and Maurizio Fava 26. Clinical Handbook of Eating Disorders: An Integrated Approach, edited by Timothy D. Brewerton 27. Dual Diagnosis and Psychiatric Treatment: Substance Abuse and Comorbid Disorders: Second Edition, edited by Henry R. Kranzler and Joyce A. Tinsley 28. Atypical Antipsychotics: From Bench to Bedside, edited by John G. Csernansky and John Lauriello 29. Social Anxiety Disorder, edited by Borwin Bandelow and Dan J. Stein 30. Handbook of Sexual Dysfunction, edited by Richard Balon and R. Taylor Segraves DK2479_half-series-title.qxd 3/8/05 1:03 PM Page i Handbook of Sexual Dysfunction edited by Richard Balon Wayne State University Detroit, Michigan, U.S.A. R. Taylor Segraves Case Western Reserve University Cleveland, Ohio, U.S.A. Boca Raton London New York Singapore DK2479_Discl Page 1 Thursday, February 17, 2005 11:39 AM Published in 2005 by Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2005 by Taylor & Francis Group, LLC No claim to original U.S. Government works Printed in the United States of America on acid-free paper 10987654321 International Standard Book Number-10: 0-8247-5826-9 (Hardcover) International Standard Book Number-13: 978-0-8247-5826-4 (Hardcover) This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials or for the consequences of their use. No part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC) 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Catalog record is available from the Library of Congress Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com Taylor & Francis Group is the Academic Division of T&F Informa plc. Foreword When it comes to human nature, there is something about complexity that most people find troubling. Magazines and newspaper articles are fond of announcing, with a flourish, that a “brain center” has been discovered that explains violence, sexual desire, overeating, or why we don’t keep New Year’s resolutions. Similar articles inform us that the cause of infidelity is purely a product of evolutionary principles, or that a single neurotransmitter is the cause of gambling. As the co-editors of this splendid new volume point out in their preface, psychiatry has not escaped this popular trend toward biological reductionism. The discovery of the genome and the remarkable advances in the neurosciences have fueled the desire to find discrete causes of complicated human behaviors. Simple biological causes call for simple pharmacologic treatments, and a “magic pill” is the panacea with which psychiatry is enamored at this historical moment. To a remarkable extent, this reductionist trend within psychiatry as a whole is even more striking when we examine the recent trends in the under- standing and treatment of sexual disorders. The irony, of course, is that no area of human behavior is more mysterious than sexuality. Moreover, if one wanted to confirm the value of the principle of multiple causation in psychiatric disturb- ance, one could do no better than to start with sexual disorders as the prime exem- plar of this principle. As several of the authors in this collection of outstanding contributions point out, approaching the complexities of sexual desire by study- ing problems with genital congestion are likely to produce a limited yield. Balon and Segraves have assembled an international group of experts who share a broad biopsychosocial perspective in their understanding of human sexual dysfunction. To their credit, they in no way give short shrift to biological causes and pharmacologic treatments. Indeed, readers of this book will gain a sophisti- cated understanding of how physiological factors contribute to sexual problems and how to integrate sound medication strategies in their treatments. What is particularly admirable is that the authors who contribute to this volume are iii iv Foreword deeply committed to the concept of breadth in the understanding and treatment of sexual dysfunctions, and they convincingly persuade the reader why a broad- based approach is necessary. Handbook of Sexual Dysfunction comes at an auspicious moment within psychiatry. Going against the grain, it restores a biopsychosocial perspective to the understanding and treatment of sexual dysfunction. It also provides the clinician reader with a practical, commonsense guide to treatment planning that treats the patient as an individual rather than a disease entity. I know of no other text in the field that can match this state-of-the-art treatment of the subject. Both students and experienced clinicians will find it of enormous value. Glen O. Gabbard, M.D. Brown Foundation Chair of Psychoanalysis and Professor of Psychiatry Director, Baylor Psychiatry Clinic Baylor College of Medicine Houston, Texas Preface The area of treatment of sexual disorders has undergone an enormous expansion during the last few decades. The introduction of pharmacological treatment of these disorders (e.g., sildenafil for erectile dysfunction or antidepressants for paraphilias) rekindled the interest of physicians from different disciplines (psychiatrists, urologists, gynecologists) in sexual dysfunctions. Physicians are finding these disorders amenable to pharmacotherapy. However,
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