Robert Taylor Segraves (born 1941) is an American psychiatrist who works on sexual dysfunction and its pharmacologic causes and treatments.
Segraves attended the Baylor School in Chattanooga, Tennessee and graduated with a Bachelor of Arts from Vanderbilt University in 1963 and would later receive a M.D. from the same institution. He completed his residency in psychiatry at the University of Chicago and earned a Ph.D. from the University of London. Segraves is professor of psychiatry at Case Western Reserve University School of Medicine and chair of the department of psychiatry at MetroHealth medical center.
He was a member of the Diagnostic and Statistical Manual of Mental Disorders task forces on sexual disorders for the DSM-III-R, DSM-IV and DSM-IV-TR editions. He is editor of the Journal of Sex and Marital Therapy and on the editorial board of the International Journal of Impotence Research.
Much of Segraves' work focuses on female sexual arousal disorder (FSAD). Noting that "somehow depression and libido are interconnected," [1] Segraves has examined the interplay between antidepressants and libido. [2] He has conducted pilot studies and clinical trials on drugs that show promise in improving female sexual response, including bupropion. [3]
Segraves was section co-editor with Stephen B. Levine for the section on sexual and gender identity disorders in Treatments of Psychiatric Disorders by Glen Gabbard. Notable contributors included Martin Kafka (paraphilias) and Kenneth Zucker (gender identity disorder in children and adolescents). [4]
Antidepressants are medications used to treat major depressive disorder, some anxiety disorders, some chronic pain conditions, and to help manage some addictions. Common side-effects of antidepressants include dry mouth, weight gain, dizziness, headaches, sexual dysfunction, and emotional blunting. There is a slight increased risk of suicidal thinking and behavior when taken by children, adolescents, and young adults. A discontinuation syndrome can occur after stopping any antidepressant which resembles recurrent depression.
Paraphilia is the experience of intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals.
Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The diagnostic label gender identity disorder (GID) was used until 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder.
Hypersexuality is extremely frequent or suddenly increased libido. It is controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomania and satyriasis were terms previously used for the condition in women and men, respectively.
Anorgasmia is a type of sexual dysfunction in which a person cannot achieve orgasm despite adequate stimulation. Anorgasmia is far more common in females than in males and is especially rare in younger men. The problem is greater in women who are post-menopausal. In males, it is most closely associated with delayed ejaculation. Anorgasmia can often cause sexual frustration.
Bupropion, sold under the brand names Wellbutrin and Zyban among others, is an atypical antidepressant primarily used to treat major depressive disorder and to support smoking cessation. It is also popular as an add-on medication in the cases of "incomplete response" to the first-line selective serotonin reuptake inhibitor (SSRI) antidepressant. Bupropion has several features that distinguish it from other antidepressants: it does not usually cause sexual dysfunction; it is not associated with weight gain and sleepiness, and it is more effective than SSRIs at improving symptoms of hypersomnia and fatigue. Bupropion does, however, carry a much higher risk of seizure than many other antidepressants and extreme caution must be taken in patients with a history of seizure disorder.
Hypoactive sexual desire disorder (HSDD), hyposexuality or inhibited sexual desire (ISD) is sometimes considered a sexual dysfunction, and is characterized as a lack or absence of sexual fantasies and desire for sexual activity, as judged by a clinician. For this to be regarded as a disorder, it must cause marked distress or interpersonal difficulties and not be better accounted for by another mental disorder, a drug, or some other medical condition. A person with ISD will not start, or respond to their partner's desire for, sexual activity. HSDD affects approximately 10% of all pre-menopausal women in the United States, or about 6 million women.
Sexual dysfunction is difficulty experienced by an individual or partners during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm. The World Health Organization defines sexual dysfunction as a "person's inability to participate in a sexual relationship as they would wish". This definition is broad and is subject to many interpretations. A diagnosis of sexual dysfunction under the DSM-5 requires a person to feel extreme distress and interpersonal strain for a minimum of six months. Sexual dysfunction can have a profound impact on an individual's perceived quality of sexual life. The term sexual disorder may not only refer to physical sexual dysfunction, but to paraphilias as well; this is sometimes termed disorder of sexual preference.
Psychosexual disorder is a sexual problem that is psychological, rather than physiological in origin. "Psychosexual disorder" was a term used in Freudian psychology. The term of psychosexual disorder used by the TAF for homosexuality as a reason to ban the LGBT people from military service.
Sexual medicine or Psychosexual medicine as defined by Masters and Johnsons in their classic Textbook of Sexual Medicine, is “that branch of medicine that focuses on the evaluation and treatment of sexual disorders, which have a high prevalence rate." Examples of disorders treated with sexual medicine are erectile dysfunction, hypogonadism, and prostate cancer. Sexual medicine often uses a multidisciplinary approach involving physicians, mental health professionals, social workers, and sex therapists. Sexual medicine physicians often approach treatment with medicine and surgery, while sex therapists often focus on behavioral treatments.
Biological psychiatry or biopsychiatry is an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system. It is interdisciplinary in its approach and draws on sciences such as neuroscience, psychopharmacology, biochemistry, genetics, epigenetics and physiology to investigate the biological bases of behavior and psychopathology. Biopsychiatry is the branch of medicine which deals with the study of the biological function of the nervous system in mental disorders.
Female sexual arousal disorder (FSAD) is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity. The diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time.
Richard Green was an American-British sexologist, psychiatrist, lawyer, and author specializing in homosexuality and transsexualism, specifically gender identity disorder in children. He endorsed conversion therapy aimed at preventing young children becoming gay or transgender adults by stating parents should fully and only encourage gender conformity. Green was the founding editor of the Archives of Sexual Behavior (1971), and served as Editor until 2001. He was also the founding president of the International Academy of Sex Research (1975), which made the Archives its official publication. He served on the American Psychiatric Association DSM-IV Subcommittee on Gender Identity Disorders.
Delayed ejaculation (DE) describes a man's inability or persistent difficulty in achieving orgasm, despite typical sexual desire and sexual stimulation. Generally, a man can reach orgasm within a few minutes of active thrusting during sexual intercourse, whereas a man with delayed ejaculation either does not have orgasms at all or cannot have an orgasm until after prolonged intercourse which might last for 30–45 minutes or more. Delayed ejaculation is closely related to anorgasmia.
Stephen Barrett Levine is an American psychiatrist known for his work in human sexuality, particularly sexual dysfunction and transsexualism.
Lori Anne Brotto is a Canadian psychologist best known for her work on female sexual arousal disorder (FSAD).
Yitzchak M. "Irv" Binik is an American-Canadian psychologist whose main research interest is human sexuality, specifically sexual pain.
Courtship disorder is a theoretical construct in sexology developed by Kurt Freund in which a certain set of paraphilias are seen as specific instances of anomalous courtship instincts in humans. The specific paraphilias are biastophilia, exhibitionism, frotteurism, telephone scatologia, and voyeurism. According to the courtship disorder hypothesis, there is a species-typical courtship process in humans consisting of four phases, and anomalies in different phases result in one of these paraphilic sexual interests. According to the theory, instead of being independent paraphilias, these sexual interests are individual symptoms of a single underlying disorder.
Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions.