Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-19T08:45:30.653Z Has data issue: false hasContentIssue false

Impulsive-Compulsive Sexual Behavior

Published online by Cambridge University Press:  07 November 2014

Abstract

Impulsive-compulsive sexual behavior is a little studied clinical phenomenon which affects ~5% to 6% of the population. In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision, it is classified as an impulse control disorder not otherwise specified or a sexual disorder not otherwise specified. It may be placed in a possible new category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition called substance and behavioral addictions.This clinical entity is reviewed and the merit of classifying it as an addiction is assessed. Information is presented regarding its diagnostic criteria, epidemiology, types of behavior it can involve, relationship to hypersexuality, comorbidities, treatment, and etiology. The data regarding this disorder and its overlap with chemical addiction is limited. If the two disorders are to be grouped together, further data are needed.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Coleman, E. Is your patient suffering from compulsive sexual behavior? Psychiatr Ann. 1992;22:320325.Google Scholar
2. Coleman, E. Compulsive Sexual Behavior: new concepts and treatments. J Psychol Hum Sex. 1991:4:3752.Google Scholar
3. Money, J. Lovemaps: Clinical Concepts of Sexual/Erotic Health and Pathology, Paraphilia, and Gender Transposition in Childhood. Adolescence and Maturity. New York, NY: Irvington Publishers; 1986.Google Scholar
4. Bradford, JM. The paraphilas, obsessive compulsive spectrum disorder and the treatment of sexually deviant behaviour. Psychiatr Q. 1999;70:209219.Google Scholar
5. Kafka, MP, Prentky, R. Fluoxetine treatment of nonparaphilic sexual addictions and paraphilias in men. J Clin Psychiatry. 1992;53:351358.Google Scholar
6. Carnes, P. Out of the Shadows: Understanding Sexual Addiction. Minneapolis, Minn: CompCare Publishers; 1983.Google Scholar
7. Carnes, P. The Sexual Addiction. Minneapolis, Minn: CompCare Publishers; 1983.Google Scholar
8. Barth, RJ, Kinder, BN. The mislabeling of sexual impulsivity. J Sex Marital Ther. 1987;13:1523.Google Scholar
9. Hollander, E, Allen, A. Is compulsive buying a real disorder, and is it really compulsive? Am J Psychiatry. 2006;10:16701672.Google Scholar
10. Coleman, E, Raymond, N, McBean, A. Assessment and treatment of compulsive sexual behavior. Minn Med. 2003;86:4247.Google Scholar
11. Coleman, E. Is your patient suffering from compulsive sexual behavior? Psychiatr Ann. 1992;22:320325.Google Scholar
12. Carnes, P. The obsessive shadow. Professional Counselor. 1998;13:1517.Google Scholar
13. Kinsey, AC, Pomeroy, WB, Martin, CE. Sexual Behavior in the Human Male. Philadelphia, Penn: Saunders; 1948.Google Scholar
14. Kafka, MP. Hypersexual desire in males: an operational definition and clinical implications for males with paraphilias and paraphilia-related disorders. Arch Sex Behav. 1997;26:505526.Google Scholar
15. Laumann, E, Michael, R, Gagnon, J. The Social Organization of Sexuality. Chicago, Ill: University of Chicago Press; 1994.Google Scholar
16. Kafka, MP, Hennen, J. Hypersexual desire in males: are males with paraphilias different from males with paraphilia-related disorders? Sex Abuse. 2003;15:307321.Google Scholar
17. Kafka, MP, Prentky, R. Preliminary observations of the DSM-III-R Axis I comorbidity in men with paraphilias and paraphilia-related disorders. J Clin Psychiatry. 1994;55:481487.Google Scholar
18. Kafka, MP, Prentky, RA. Attention-deficit/hyperactivity disorder in males with paraphilias and paraphilia-related disorders: a comorbidity study. J Clin Psychiatry. 1998;59:388396.Google Scholar
19. Kafka, MP, Hennen, J. A DSM-IV Axis I comorbidity study of males (n = 120) with paraphilias and paraphilia-related disorders. Sex Abuse. 2002;14:349366.Google Scholar
20. Black, DW, Kehrberg, LLD, Flumerfelt, DL, Schlosser, SS. Characteristics of 36 subjects reporting compulsive sexual behavior. Am J Psychiatry. 1997;154:243249.Google Scholar
21. Raymond, NC, Coleman, E, Miner, MH. Psychiatric comorbidity and compulsive/impulsive traits in compulsive sexual behavior. Compr Psychiatry. 2003;44:370380.Google Scholar
22. Quadland, MC. Compulsive sexual behavior: definition of a problem and an approach to treatment. J Sex Marital Ther. 1985;11:121132.Google Scholar
23. Derogatis, LR, Melisaratos, N. The Brief Symptom Inventory: an introductory report. Psychol Med. 1983;13:595605.Google Scholar
24. Wainberg, ML, Muench, F, Morgenstern, J, et al. Citalopram vs. placebo in the treatment of compulsive sexual behaviors in gay and bisexual men. J Clin Psychiatry. In press.Google Scholar
25. Grant, JE, Kim, SW, Potenza, MN, et al. Paroxetine treatment of pathological gambling: a multi-centre randomized controlled trial Int Clin Psychopharmacol. 2003 18:243249.Google Scholar
26. Kafka, MP. Sertraline pharmacotherapy for paraphilias and paraphilia-related disorders: An open trial. Ann Clin Psychiatry. 1994;6:189195.Google Scholar
27. Kafka, M, Hennen, J. Psychostimulant augmentation during treatment with selective serotonin reuptake inhibitors in men with paraphilias and paraphilia-related disorders: a case series J Clin Psychiatry. 2000;61:664670.Google Scholar
28. Coleman, E, Gratzer, T, Nevacsil, L, Raymond, NC. Nefazodone and the treatment of nonparaphilic compulsive sexual behavior: a retrospective study. J Clin Psychiatry. 2000;61:282284.Google Scholar
29. Cesnik, JA, Coleman, E. Use of lithium carbonate in the treatment of autoerotic asphyxia. Am J Psychother. 1989;43:277285.Google Scholar
30. Fedoroff, JP. Buspirone hydrochloride in the treatment of transvestic fetishism. J Clin Psychiatry. 1988;49:408409.Google Scholar
31. Fedoroff, JP. Buspirone hydrochloride in the treatment of atypical paraphilia. Arch Sex Behav. 1992;21:401406.Google Scholar
32. Azhar, MZ, Varma, SL. Response to clomipramine in sexual addiction. Eur Psychiatry. 1995;10:263265.Google Scholar
33. Kruesi, MJ, Fine, S, Valladares, L, Phillips, RA Jr, Rapoport, JL. Paraphilias: a double-blind crossover comparison of clomipramine versus desipramine. Arch Sex Behav. 1992;21:587593.Google Scholar
34. Stein, DJ, Hollander, E, Anthony, DT, et al. Serotonergic medications for sexual obsessions, sexual addictions, and paraphilias. J Clin Psychiatry. 1992;53:267271.Google Scholar
35. Bourgeois, JA, Klein, M. Risperidone and fluoxetine in the treatment of pedophilia with comorbid dysthymia [letter]. J Clin Psychopharmacol. 1996;16:257258.Google Scholar
36. Raymond, NC, Grant, JE, Kim, SW, Coleman, E. Treatment of compulsive sexual behaviour with naltrexone and serotonin reuptake inhibitors: two case studies. Int Clin Psychopharmacol. 2002; 17:201205.Google Scholar
37. Khazaal, Y, Zullino, DF. Topiramate in the treatment of compulsive sexual behavior: case report. BMC Psychiatry. 2006;6:22.Google Scholar
38. Fong, TW, De La Garza, R, Newton, TF. A case report of topiramate in the treatment of nonparaphilic sexual addiction. J Clin Psychopharmacol. 2005;25:512514.Google Scholar
39. Coleman, E. Treatment of compulsive sexual behavior. In: Rosen RC, SR. Leiblum, SR, eds. Case Studies in Sex Therapy. New York, NY: Guildford Press; 1995:333349.Google Scholar
40. Bond, AJ. Drug-induced behavioral disinhibition: incidence, mechanisms, and therapeutic implications. CNS Drugs. 1998;9:4157.Google Scholar
41. Hollander, E, Stein, DJ. Clinical Manual of Impulse Control Disorders. Arlington, Va: American Psychiatric Publishing; 2006.Google Scholar
42. Trimble, MR, Mendez, MF, Cummings, JL. Neuropsychiatric symptoms from the temporolimbic lobes. J Neuropsychiatry Clin Neurosci. 1997;9:429438.Google Scholar
43. Lishman, WA: Brain Damage in relation to psychiatric disability after head injury. Br J Psychiatry. 1968;114:373412.Google Scholar
44. Miller, BL, Cumming, JL, Mclntyre, H, et al. Hypersexuality or altered sexual preference following brain injury. J Neurol Neurosurg Psychiatry. 1986;49:867873.Google Scholar
45. Gondim, FA, Thomas, FP. Episodic hyperlibidism in multiple sclerosis. Mult Scler. 2001;7:6776.Google Scholar
46. Devinsky, O, Vazquez, B. Behavioral changes associated with epilepsy. Neurol Clin. 1993;11:127149.Google Scholar
47. Alkalhil, C, Tanvir, F, Alkalhil, B, et al. Treatment of sexual disinhibition in dementia: case reports and review of the literature. Am J Ther. 2004;11:231235.Google Scholar
48. Uitti, RJ, Tanner, CM, Rajput, AH, et al. Hypersexuality with antiparkinsonism therapy. Clin Neuropharmacol. 1989;12:375383.Google Scholar
49. Udry, JR, Billy, JO, Morris, NM, Groff, TR, Raj, MH. Serum androgenic hormones motivate sexual behavior in adolescent boys. Fertil Steril. 1985;43:9094.Google Scholar
50. Halpen, CT, Udry, JR, Campbell, B, Suchindran, C, Mason, GA. Testosterone and religiosity as predictors of sexual attitudes and activity among adolescent males: a biosocial model. J Biosoc Sci. 1994;26:217234.Google Scholar
51. Sherwin, BB. A comparative analysis of the role of androgen in human male and female sexual behavior: the behavioral specificity, critical thresholds, and sensitivity. Psychobiology. 1988;16:416425.Google Scholar
52. Martin, PR, Petry, NM. Are non substance related addictions really addictions? Am J Addictions. 2005;14:17.Google Scholar
53. Gold, SN, Heffner, CL. Sexual addiction: many conceptions, minimal data. Clin Psychol Rev. 1998;18:367381.Google Scholar
54. Barth, RJ, Kinder, BN. The mislabeling of sexual impulsivity. J Sex Marital Ther. 1987;13:1523.Google Scholar
55. Potenza, MN. Should addictive disorders include non-substance-related conditions? Addiction. 2006;101(suppl 1):142151.Google Scholar
56. Goodman, A. Sexual addiction: designation and treatment. J Sex Marital Ther. 1992;18:303314.Google Scholar
57. Jenike, MA. Obsessive-compulsive and related disorders: a hidden epidemic. N Engl J Med. 1989;321:539–41.Google Scholar
58. McElroy, SL, Pope, HG, Keck, PE, Hudson, JI, Phillips, KA, Strakowski, SM. Are impulse-control disorders related to bipolar disorder? Compr Psychiatry. 1996;37:229240.Google Scholar