Estimating the Prevalence of Sexual Function Problems: The Impact of Morbidity Criteria

Abstract

Establishing the clinical significance of symptoms of sexual dysfunction is challenging. To address this, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced two new morbidity criteria (duration and symptom severity) to the existing criteria of distress. This study sought to establish the impact of these three criteria on the population prevalence of sexual function problems. The data come from a national probability survey (Natsal-3) and are based on 11,509 male and female participants aged 16–74, reporting at least one sexual partner in the past year. The key outcomes were: proportion of individuals reporting proxy measures of DSM-5 problems, and the proportion of those meeting morbidity criteria. We found that among sexually active men, the prevalence of reporting one or more of four specific sexual problems was 38.2%, but 4.2% after applying the three morbidity criteria; corresponding figures for women reporting one or more of three specific sexual problems, were 22.8% and 3.6%. Just over a third of men and women reporting a problem meeting all three morbidity criteria had sought help in the last year. We conclude that the DSM-5 morbidity criteria impose a focus on clinically significant symptoms.

Keywords:

• Prevalence
• DSM-5
• sexual function problems
• morbidity criteria
• classification

Acknowledgments

Natsal-3 is a collaboration between University College London (London, UK), the London School of Hygiene and Tropical Medicine (London, UK), NatCen Social Research, Public Health England (formerly the Health Protection Agency), and the University of Manchester (Manchester, UK). We thank the study participants, the team of interviewers from NatCen Social Research, Heather Wardle, Vicki Hawkins, Cathy Coshall, and operations and computing staff from NatCen Social Research. KRM and CHM had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Anne M. Johnson is a Governor of the Wellcome Trust. All other authors declare that they have no conflicts of interest.

Funding

The study was supported by grants from the Medical Research Council (G0701757) and the Wellcome Trust (084840), with contributions from the Economic and Social Research Council and Department of Health. NF is funded by a NIHR Academic Clinical Lectureship. KGJ was funded by a NIHR Research Methods Fellowship. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Supplemental Material

Supplemental data for this article can be found online at http://www.tandfonline.com/hjsr.

Notes

¹ Defined as one person with whom they had had sex on at least one occasion, where sex is defined as vaginal intercourse, oral sex or anal sex.

² Estimate based on 2014 census estimates for adults aged 16-74. Data for UK from Office for National Statistics (2015), and for US from US Census Bureau, Population Division (2015).

Additional information

Funding

The study was supported by grants from the Medical Research Council (G0701757) and the Wellcome Trust (084840), with contributions from the Economic and Social Research Council and Department of Health. NF is funded by a NIHR Academic Clinical Lectureship. KGJ was funded by a NIHR Research Methods Fellowship. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.