Evaluating Sexual Addiction

Hypersexual disorder now has a set of diagnostic criteria in the field of mental health

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Is hypersexual behavior a symptom of another mental health condition or a disorder in and of itself? The psychiatric community may have developed the necessary test to distinguish.

A recent study tested whether a new survey could diagnose hypersexual disorder.

This study’s findings could provide the basis for diagnosing sexual addiction in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

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Rory Reid, PhD, assistant professor of psychiatry at the Semel Institute of Neuroscience and Human Behavior at the University of California Los Angeles, led a team to form the criteria for diagnosing sexual addiction.

Dr. Reid said, “The criteria for hypersexual disorder (sexual addiction) that have been proposed, and now tested, will allow researchers and clinicians to study, treat and develop prevention strategies for individuals at risk for developing hypersexual behavior.”

For the study, 207 psychiatric patients filled out a survey by themselves and then were evaluated twice by a team of raters, who did not know they were testing evaluation methods for hypersexual disorder (HD). Not all of the 207 patients were seeking treatment for HD.

The surveys used a series of structured measures: the Hypersexual Behavior Inventory, Sexual Compulsivity Scale and the Hypersexual Behavior Consequence Scale.

Ability to regulate emotions and relationships with stress were also evaluated.

Like with other disorders, isolated thought patterns, lasting 6 months or longer, and not being able to hold back on engaging in problematic behavior, were used as indicators of the disorder.

For HD those patterns included persistent thoughts and fantasies about sex, along with urges and acting on those urges.

These thought and behavior patterns could not be associated with other mental health issues such as bipolar disorder. But rather, they were responsive to stress or poor mood.

Dr. Reid said, “As with many other mental health disorders, there must also be evidence of personal distress caused by the sexual behaviors that interfere with relationships, work or other important aspects of life.”

The survey showed life consequences for HD. A total of 28 percent had gotten a sexually transmitted disease, 78 percent had trouble with regular, healthy sex, 17 percent of patients had lost a job and 39 percent had lost a romantic partner due to HD.

A total of 54 percent reported their hypersexual behavior starting before the age of 18, and 30 percent said it began somewhere between 18-25.

The survey testing results found 88 percent of the hypersexual patients had actual HD. Perhaps even more important, the surveys had a 93 percent accuracy rate when determining who did not have HD.

These results suggest the survey criteria are able to distinguish between people with HD and people with other mental health disorders, but still experiencing hypersexual symptoms associated with those other disorders.

Dr. Reid said, “It’s not that a lot of people don’t take sexual risks from time to time or use sex on occasion to cope with stress or just escape, but for these patients, it’s a constant pattern that escalates until their desire for sex is controlling every aspect of their lives and they feel powerless in their efforts to change.”

Like with other mental health disorders, diagnostic criteria and further understanding can influence developments in treatment and intervention.

Further studies on larger groups will be necessary to recreate these results.

This study was published in October in The Journal of Sexual Medicine.

No external funding was used for this study. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
October 26, 2012
Last Updated:
January 2, 2014