Sexual Addiction: Diagnosis, Etiology, Treatment
Abstract
More than 100 years ago, Richard von Krafft-Ebing described in his “Psychopathia sexualis” as sexual hyperesthesia a sex drive that “takes over all of one’s thoughts and feelings, allows nothing else to arise alongside it, […] lusts for satisfaction like a rut, […] expresses itself more or less impulsively, […] and yet, after the sexual act has been completed, is not satisfied or is satisfied only for a short time […]. Episodically, it can escalate to a sexual affect of such intensity that consciousness becomes clouded” ([ 19 ] p. 56 f). This quote is significant because it alludes to the points that are still being controversially discussed in connection with so-called sexual addiction, such as compulsiveness, impulsiveness, lack of satisfaction and pathological restriction of consciousness. In his case studies, Krafft-Ebing addresses both what can today be described as paraphilic and non-paraphilic behavior in men and women. Terms such as nymphomania and Don Juanism or satyrism found their way into the American classification system DSM-III. In the revised version of the DSM-III, the term non-paraphilic sexual addiction appeared (albeit to describe a residual category) - a concept that was already abandoned in the DSM-IV. Using the ICD-10, "increased sexual desire" (F52.7) can be diagnosed as a disorder. Reference is made to the traditional terms nymphomania and satyriasis. Other possibilities for the diagnostic classification of "sexual addiction" are (other) disorder of sexual preference (F65.8) or (other) disorder of impulse control (F63.8). The term "sexual addiction" does not exist in the ICD-10.