Erectile Dysfunction, Case Study Example

The case

A client is a man who came to see a physician due to erectile disorder. He was accompanied by his wife. From the interview with the physician, it is not clear for how long the condition has existed. Regarding their work, the client’s wife is a part-time nurse and has no work issue. The man is in the marketing field, and he has an issue at work. For instance, he was recently reprimanded when he was caught watching porn at work. Also, He has been taking some online business course that has caused him distress.

Other than the erectile problem the man has no other major health issues. However, he confesses that he sometimes drinks alcohol. From what we learn, when an erectile dysfunction became an issue the man took medication that didn’t work. Besides, the condition has made him seek sexual fulfillment from practices such as masturbation. He uses pornography to masturbate and during masturbation he can ejaculate.  It is also clear that the man has been using porn for long hours a situation that has caused him distress.

There is no major issue in the family relationship, especially regarding the parent-children relationship. However, the wife feels that the man has been disengaged with the family. He spends most of his time with a computer and wife to feel that computer come first and family second. Moreover, he has not been sleeping well recently.

From the information gathered in the history examination the following differential diagnostic can be posted:

Diagnostic criteria

1. At least of the following symptom must be experienced in at least 75% of the sexual occasions: marked difficulty in obtaining an erection during sexual activity marked difficulty in maintaining a sexual erection until the end of sexual activity, marked decrease I erectile rigidity.

The client meets the criterion A because he has repeated difficulty in obtaining or maintaining an erection during partnered sexual activity. In fact, the man cannot completely get an erection during all sexual activity with his wife.

1. The symptom of Criterion A has persisted for more than six month

No diagnosis. It is not possible to determine for how long he had the condition. However from the video we learn that the condition is new to them.

1. The symptom of Criterion A has caused clinically significant distress in the individual

The client meets Criterion C; the condition has caused psychological distress to him. He is worried that he let his wife down, and he has had issues at work. Moreover, he has not been sleeping well.

1. The sexual dysfunction cannot be explained by any non-sexual mental disorder or as a consequence of severe relationship distress is not attributable to the effects of a substance/medication or another medical condition. (Wincze & Weisberg, 2015).

The client does not meet Criterion D because his sexual dysfunction can be explained by sexual disorder and work and relationship stress.

The condition is acquired since it emerged after a period of the relatively normal sexual function.  Since the criterion meets criterion A and C, we can conclude he has an erectile dysfunction that need to be treated

More specification

The condition is situational since the man confesses that he is unable to get an erection or ejaculate with the partner.  However, he obtains an erection and ejaculate with porn stimulation.

The current severity can be classified as moderate because although he cannot get an erection with a partner, he gets an erection with another form of stimulation such as porn.

Although we can conclude that the man has erectile dysfunction, additional information that is necessary to make proper diagnostic.  Such information includes their sexual history and general health.  Sexual history is key in ascertaining that the condition has been present for a significant duration (more than six months).  Sexual history will reveal other necessary information such as to whether the condition occurs the majority of sexual situation.  A general health check is also important in revealing whether there is another cause of the condition.

Reference

Wincze, J. P., & Weisberg, R. B. (2015). Sexual dysfunction: A guide for assessment and treatment.