title: The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision as an appropriate diagnostic for premature ejaculation.
abstract: BACKGROUND
  The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) criteria for premature ejaculation (PE) are multifactorial, and include concepts of latency, perceived control over ejaculation, and personal distress and interpersonal difficulty related to the condition. Recent publications have suggested that these criteria are not supported by empirical evidence, leading to the proposal that a PE diagnosis should be based solely on intravaginal ejaculatory latency time (IELT), while the presence of other factors (such as perceived lack of control over ejaculation) may be used to guide treatment decisions.
  
  
  OBJECTIVE
  To examine the evidence supporting the elements of the DSM-IV-TR criteria for PE.
  
  
  METHODS
  Literature searches on IELT, perceived control over ejaculation, and personal distress and interpersonal difficulty related to ejaculation.
  
  
  RESULTS
  From a historical perspective, there has been a lack of large observational studies that evaluated the contributions of the DSM-IV-TR components in men with PE. However, recently performed large observational studies have generated data supporting the inclusion of perceived control over ejaculation and personal distress related to ejaculation in the definition of PE. Furthermore, emerging evidence indicates that a perceived lack of control over ejaculation is directly associated with elevated personal distress related to ejaculation and decreased satisfaction with sexual intercourse, while the effects of IELT on these parameters are indirect, and mediated by perceived control over ejaculation. A key advantage of the DSM-IV-TR approach to the diagnosis of PE is that it firmly links PE to a negative outcome for the patient, which is an element common to diagnostic criteria for other conditions, including depression, hypertension, and osteoporosis.
  
  
  CONCLUSIONS
  This new evidence strongly suggests that the DSM-IV-TR criteria for PE encompass aspects of the condition that patients describe as important.
authors.affiliation: Maimonides Medical Center, New York, NY, USA.
authors.forename: Ridwan
authors.initials: R
authors.lastname: Shabsigh
authors.forename: David
authors.initials: D
authors.lastname: Rowland
mesh_terms: D039721:Diagnostic and Statistical Manual of Mental Disorders; D004542:Ejaculation / Q000502:physiology*; D019317:Evidence-Based Medicine; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011594:Psychometrics; D015203:Reproducibility of Results; D012107:Research Design; D020377:Self Efficacy; D012735:Sexual Dysfunction, Physiological / Q000145:classification* / Q000175:diagnosis*