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Decreased Sexual Desire Screener (DSDS)

5 question diagnostic tool to assist in considering the diagnosis of Hypoactive Sexual Desire Disorder (HSDD) in women.

Provided by SMSNA
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Purpose: The Decreased Sexual Desire Screener (DSDS) is a brief diagnostic tool designed for primary care physicians and therapists to screen women for generalized, acquired Hypoactive Sexual Desire Disorder (HSDD). It helps identify patients who may warrant further evaluation for HSDD based on their self-reported sexual desire history, current state, and potential contributing factors. It is intended to facilitate discussion and guide clinical assessment.

 

The criteria align with the definition of HSDD characterized in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). HSDD is defined as a deficiency or absence of sexual fantasies and desire for sexual activity, causing marked distress or interpersonal difficulty, not better explained by other medical, substance-related, psychiatric, or sexual conditions. HSDD can be generalized or situational, acquired or lifelong. This screener focuses specifically on generalized, acquired HSDD. 

 

Clinical Workflow and Interpretation: 

Questions 1-4 assess if the patient 

  • previously had satisfying desire (Q1)
  • Experienced a decrease (Q2) 
  • Is bothered by the decrease (Q3)
  • Wishes for an increase (Q4). 

Question 5 identifies potential contributing factors (medical conditions, medications, relationship issues, stress, etc.).
 

The interpretation logic is as follows:

  • Does not qualify for the diagnosis of generalized, acquired HSDD: If the patient answers 'NO' to any of questions 1-4.
  • Qualifies for the diagnosis of generalized, acquired HSDD: If the patient answers 'YES' to all questions 1-4 AND 'None of the above"' to all factors listed in question 5.
  • Due to co-morbidities, consider a primary diagnosis other than generalized, acquired HSDD: If the patient answers 'YES' to all questions 1-4 AND 'YES' to any factor in question 5. In this case, the clinician must determine if these factors indicate a primary diagnosis other than HSDD. Co-morbid conditions (e.g., arousal disorder, orgasmic disorder) do not necessarily rule out a concurrent HSDD diagnosis, but careful assessment is needed.

 

All questions & possible results

Decreased Sexual Desire ScreenerTitle not visible
1. In the past, was your level of sexual desire or interest good and satisfying to you?

Select one option:

  • NO
  • YES
2. Has there been a decrease in your level of sexual desire or interest?

Select one option:

  • NO
  • YES
3. Are you bothered by your decreased level of sexual desire or interest?

Select one option:

  • NO
  • YES
4. Would you like your level of sexual desire or interest to increase?

Select one option:

  • NO
  • YES
5. Please check all the factors that you feel may be contributing to your current decrease in sexual desire or interest:

Select all that apply:

  • An operation, depression, injuries, or other medical condition
  • Medications, drugs or alcohol you are currently taking
  • Pregnancy, recent childbirth, menopausal symptoms
  • Other sexual issues you may be having (pain, decreased arousal or orgasm)
  • Your partner's sexual problems
  • Dissatisfaction with your relationship or partner
  • Stress or fatigue
  • None of the above
Possible results
Qualifies for the diagnosis of generalized, acquired HSDD

The patient meets the criteria for generalized, acquired HSDD as they reported all of the following:

  • Level of sexual desire or interest was good or satisfying in the past. 
  • A decrease in the level of sexual desire or interest.
  • Bothered by a decreased level of sexual desire or interest.
  • Would like the level of sexual desire or interest to increase. 

 

AND

 

The patient did NOT indicate any contributing factors (question 5).

 

 Consider management options for HSDD or refer to the appropriate level of care.

Does not qualify for the diagnosis of generalized, acquired HSDD
  • The patient does not meet the initial criteria for generalized, acquired HSDD because they answered "no" to one or more of the first four questions.  

 

  • Additionally, if they also indicated potential contributing factors (question 5), these factors may represent a primary diagnosis other than generalized, acquired HSDD, or co-morbid conditions. 

 

Further assessment may still be needed depending on clinical presentation.

Due to co-morbidities, consider a primary diagnosis other than generalized, acquired HSDD

The patient reported symptoms suggestive of HSDD:

  • Level of sexual desire or interest was not good or satisfying. 
  • A decrease in the level of sexual desire or interest.
  • Bothered by a decreased level of sexual desire or interest.
  • Would like the level of sexual desire or interest to increase. 

 

However, they also indicated potential contributing factors (question 5). These factors may represent a primary diagnosis other than generalized, acquired HSDD, or co-morbid conditions. 

 

Further clinical evaluation is required to differentiate. Co-morbid conditions such as arousal or orgasmic disorder do not rule out a concurrent diagnosis of HSDD.

Citation

Copyright © 2018 Sprout Pharmaceuticals, Inc.

 

Clayton, A. H., Goldfischer, E. R., Goldstein, I., DeRogatis, L. R., Lewis-D'Agostino, D. J., & McKay, S. (2009). Validation of the decreased sexual desire screener (DSDS): a brief diagnostic instrument for generalized acquired female hypoactive sexual desire disorder (HSDD). Journal of Sexual Medicine, 6(3), 730-738.

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