Decreased Sexual Desire Screener (DSDS)

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.