Compulsive Sexual Behavior

Donald W. Black

Compulsive sexual behavior (CSB) is characterized by inappropriate or excessive sexual thoughts or behaviors that lead to stress, are overly time consuming, or lead to interpersonal, family, marital, financial, or legal problems. It appears to be widespread, to preferentially affect men, and to have an onset early in life. Psychiatric comorbidity is common, and while its cause remains unclear, CSB probably results from multiple factors. There is little consensus on treatment, but individual psychotherapy, cognitive-behavioral therapy, and 12-step programs may be helpful. Selective serotonin reuptake inhibitors (SSRIs) may help patients regulate their sexual impulses, while testosterone-reducing agents may help control sexual aggressiveness. Additional studies are needed of subjects with CSB using standardized and reliable instruments as are careful treatment studies involving blinded assessments and placebo controls. Compulsive sexual behavior is not listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) , although many of its manifestations ...

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