R.Ballester-ArnalaJ. Castro-CalvobC. Giménez-GarcíaaB. Gil-Juliáb M.D.Gil-Llarioc
https://doi.org/10.1016/j.addbeh.2020.106384
Highlights
- Compulsive Sexual Behavior Disorder (CSBD) frequently co-occurs with other Axis I and II psychiatric disorders.
- We compared Axis I and II psychiatric comorbidity in a sample of 68 individuals with and 315 without CSBD.
- 91.2% of CSBD participants met the criteria for at least one comorbid Axis I disorder (66% in non-CSBD participants).
- CSBD participants were more likely to qualify for a substance use disorder, major depressive disorder, bulimia nervosa, adjustment disorders, and borderline personality disorder.
- Results support the use of the addiction paradigm in explaining CSBD.
Abstract
Compulsive Sexual Behavior Disorder (CSBD) is characterized by a persistent failure to control intense and recurrent sexual impulses, urges, and/or thoughts, resulting in repetitive sexual behavior that causes a marked impairment in important areas of functioning. Data collected from clinical populations suggest that CSBD frequently co-occurs with other Axis I and II psychiatric disorders; however, studies conducted so far suffer from methodological shortcomings that prevent the determination of accurate psychiatric comorbidity rates. The purpose of this study was to explore psychiatric comorbidity in a sample of individuals with and without CSBD. The study sample comprised 383 participants distributed into two groups through a cluster analyses: 315 participants without CSBD (non-CSBD) and 68 qualifying as sexually compulsives (CSBD). Participants were assessed for co-occurring Axis I and II clinical conditions using structured clinical interviews for the DSM-IV (SCID-I and II). The majority of CSBD participants (91.2%) met the criteria for at least one Axis I disorder, compared to 66% in non-CSBD participants. CSBD participants were more likely to report an increased prevalence of alcohol dependence (16.2%), alcohol abuse (44%), major depressive disorder (39.7%), bulimia nervosa (5.9%), adjustment disorders (20.6%), and other substances –mainly cannabis and cocaine– abuse or dependence (22.1%). Concerning Axis II, prevalence of borderline personality disorder was significantly higher in CSBD participants (5.9%). As expected, prevalence of different psychiatric conditions was significantly increased among sexually compulsive participants, revealing comorbidity patterns with important implications in the conceptualization, assessment, and treatment of patients with CSBD.
Keywords Compulsive Sexual Behavior Disorder (CSBD), psychiatric comorbidity, Axis I and II, cluster analysis
EXCERPTS:
The overlap between CSBD and SUDs may explain why conservative and often criticized therapeutic approaches originally developed for recovery from SUDs (i.e., the 12-step approach) are demonstrating their efficacy when applied to CSBD (Efrati & Gola, 2018a, 2018b). At a theoretical level, these results support the conceptualization of CSBD as an addictive disorder beyond other competing models (Potenza et al., 2017).
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