Psych CASC / OSCE · Specialty psychiatry — sexual dysfunction and paraphilias
Explain antidepressant sexual side-effects and paraphilia thresholds — CASC communication station
MRCPsych/FRANZCP-style communication station: SSRI sexual SE, switch options, and non-pathologising education on paraphilic disorder thresholds.
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Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the outpatient clinic. [4]
Candidate instructions. Explain that sexual side-effects are common with SSRIs, outline options (continue with monitoring, dose review, switch strategies), warn about depression relapse if stopping abruptly without a plan, and educate that consensual adult fetishistic interest without distress or nonconsent is not a disorder and does not require antiandrogens. Check understanding and agree follow-up. [1][2][3]
References4ShowHide
- [1]Montejo AL, Llorca G, Izquierdo JA, et al. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients J Clin Psychiatry, 2001.PMID 11229449
- [2]Serretti A, Chiesa A Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis J Clin Psychopharmacol, 2009.PMID 19440080
- [3]Krueger RB, Reed GM, First MB, et al. Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11) Arch Sex Behav, 2017.PMID 28210933
- [4]Clayton AH, El Haddad S, Iluonakhamhe JP, et al. Sexual dysfunction associated with major depressive disorder and antidepressant treatment Expert Opin Drug Saf, 2014.PMID 25148932