Considerations for an evidence-based definition of premature ejaculation in the DSM-V.
BACKGROUND
The Diagnostic and Statistical Manual of Mental Disorders, 4th Ed., text revision (DSM-IV-TR) criteria for premature ejaculation (PE) have been criticized on multiple grounds including that the criteria lack precision, that the requirement of marked distress is inappropriate, and that the specification of etiological subtypes should be deleted. Since these criteria were originally adopted, there has been a tremendous gain in knowledge concerning PE.


OBJECTIVE
The goal of this manuscript is to review evidence relevant to diagnostic criteria for PE published since 1990.


METHODS
Medline searches from 1990 forward were conducted using the terms PE, rapid ejaculation, ejaculatory disorder, and intravaginal ejaculatory latency. Early drafts of proposed alterations in diagnostic criteria were submitted to advisors.


METHODS
Expert opinion was based on review of evidence-based medical literature.


RESULTS
The literature search indicated possible alterations in diagnostic criteria for PE.


CONCLUSIONS
It is recommended that the Diagnostic and Statistical Manual committee adopt criteria similar to those adopted by the International Society of Sexual Medicine. It is proposed that lifelong PE in heterosexual men be defined as ejaculation occurring within approximately 1 minute of vaginal penetration on 75% of occasions for at least 6 months. Field trials will be necessary to determine if these criteria can be applied to acquired PE and whether analogous criteria can be applied to ejaculatory latencies in other sexual activities. Serious consideration should be given to changing the name from PE to rapid ejaculation. The subtypes indicating etiology should be eliminated.
Segraves
Robert Taylor
RT
Case Western Reserve University, Department of Psychiatry, Cleveland, OH, USA. rsegraves@metrohealth.org
D039721:Diagnostic and Statistical Manual of Mental Disorders; D004542:Ejaculation; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D011930:Reaction Time; D012016:Reference Values; D012735:Sexual Dysfunction, Physiological / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D009626:Terminology as Topic