Too Much is Never Enough: Compulsive Sexual Behavior in Psychiatric Practice-View Presentation

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Video Summary

The presentation, led by Dr. Sarah West and a colleague, delved into compulsive sexual behavior disorder (CSBD), a new diagnosis included in the ICD-11, but not yet in the DSM-5. The talk covered the history, conceptualization, and treatment of CSBD, alongside related disorders such as hypersexuality disorder, which the DSM-5 declined to include over concerns it could pathologize normal behavior. Highlighting the complexity of these disorders, the presentation referenced historical perspectives, literature, and current diagnostic challenges, noting the ongoing debate regarding syndromes related to CSBD and the cultural and forensic implications.<br /><br />Prevalence studies show varying estimates of CSBD, with some finding higher rates due to differing diagnostic criteria, indicating the importance of consistent definitions. The disorder is often studied with an addiction framework, but limited data supports this fully. Neuroimaging studies suggest altered brain activation related to desire rather than enjoyment of sexual stimuli. Treatment includes medications such as naltrexone and SSRIs, alongside psychotherapy, although more data is necessary to establish robust guidelines.<br /><br />The forensic context is significant, particularly concerning legal implications for individuals with CSBD and potential civil commitments following criminal offenses. Case studies, including complex cases involving histories of trauma and other mental health disorders, highlight the need for careful assessment to disentangle overlapping symptoms from other conditions such as bipolar disorder or obsessive-compulsive disorder.<br /><br />In summation, CSBD requires careful clinical and cultural consideration with emerging research informing its treatment and legal management within varying contexts.

Keywords

Compulsive Sexual Behavior Disorder

ICD-11

DSM-5

CSBD

Hypersexuality Disorder

Diagnostic Challenges

Neuroimaging Studies

Addiction Framework

Naltrexone

SSRIs

Forensic Implications

Trauma

Mental Health Disorders