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The State of the Art of Psychological Interventions for Male Sexual Dysfunction: New research Findings and Clinical Implications

The State of the Art of Psychological Interventions for Male Sexual Dysfunction: New research Findings and Clinical Implications

Despite the accumulated knowledge on the role of psychological factors on sexual problems and the development of conceptual models, with particular emphasis on cognitive and affective processes, the transference of this knowledge to the development of evidence-based treatments for sexual dysfunctions is still scarce. A recent systematic review and meta-analysis of studies on the efficacy of psychological treatments for sexual problems found 20 randomized controlled studies comparing psychological interventions with awaiting-list conditions (Fruhauf et al., 2013).

Overall, findings have indicated moderate effect sizes for symptom severity and sexual satisfaction, suggesting that psychological interventions are effective treatments for sexual dysfunction in men and women. Regarding male sexual dysfunction, Fruhauf et al. (2013) identified two studies comparing a combination of psychological treatment (Cognitive Behaviour Therapy) and medication with medication only group for erectile dysfunction. In both studies, the combined treatment led to improved sexual function and maintenance of treatment gains in the follow-up compared to medication alone. Similar findings have also been observed in a pilot study conducted by Bach et al (2004) suggesting that CBT may enhance the benefits of medication.

Finally, preliminary findings comparing the effects of CBT to PDE5-I have indicated similar positive effects at the end of treatment but higher levels of treatment gains at 3 and 6 months follow-up (Nobre et al., 2015). Taking these findings into consideration, and bearing in mind that CBT has proved to be the most efficacious treatment for a variety of psychological problems (Chambless & Hollendick, 2001) and to present long-term effects superior to pharmacological treatments (Shapiro et al., 2007), we think that the systematic test of the treatment efficacy of CBT for sexual dysfunction, as well as the study of the underlying mechanisms of change, may play an important role in developing better treatment options for these major clinical complaints.