Psychiatric comorbidity in compulsive sexual behavior disorder (CSBD)

• Published in: Addictive behaviors 2020-08, Vol.107, p.106384-106384, Article 106384
• Main Authors: Ballester-Arnal, R., Castro-Calvo, J., Giménez-García, C., Gil-Juliá, B., Gil-Llario, M.D.
• Format: Article
• Language: English
• Subjects: Axis I and II; Cluster analysis; Comorbidity; Compulsive Behavior - epidemiology; Compulsive Sexual Behavior Disorder (CSBD); Depressive Disorder, Major - epidemiology; Diagnostic and Statistical Manual of Mental Disorders; Humans; Mental Disorders - epidemiology; Prevalence; Psychiatric comorbidity; Psychiatric Status Rating Scales; Sexual Dysfunctions, Psychological
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2020.106384

•Compulsive Sexual Behavior Disorder (CSBD) co-occurs with psychiatric disorders.•We compared psychiatric comorbidity in individuals with and without CSBD.•91.2% of CSBD participants met the criteria for one comorbid Axis I disorder.•CSBD participants were more likely to qualify mainly for substance use disorders.•Results support the use of the addiction paradigm in explaining CSBD as an addictive disorder beyond other competing models. 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 (e.g., small sample sizes, reliance on non-reliable assessment methods in the estimation of comorbidity or the non-inclusion of healthy individuals to compare prevalence 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.