Is Hypersexuality a Mental Disorder?
It has been 13 years since the American Psychiatric Association has updated the Diagnostic and Statistical Manual (DSM), the evidence-based guide to diagnostic criteria relied on by U.S. mental health professionals. The DSM-V is scheduled for release in May 2013 and is being written as an aid to clinicians, simplifying diagnosis by listing diagnostic symptoms.
The DSM defines a mental disorder as “a behavioral or psychological syndrome that is affiliated to an individual’s distress or disability, or with a highly increased risk of death, pain, disability, or loss of freedom.” The DSM-V has removed homosexuality as a disorder but is introducing a new condition, Hypersexual Disorder (HD), which has been called “sex addiction” in the popular vernacular. Studies have suggested that 3% to 6% of the population suffer from hypersexuality but sexologists disagree about whether hypersexuality is a mental disorder, an addiction, a symptom of bipolar disorder or dementia, or encompasses the far end of the spectrum of normal sexual behavior.
The seriousness of hypersexuality, aside from personal distress, is reflected in the possible consequences of hyperactive sexuality: 1) sexually transmitted infections; 2) unwanted or unplanned pregnancies; 3) work or educational impairment; or 4) other physical and mental anguish.
The proposed diagnostic criteria for Hypersexual Disorder include 3 or more of the following:
1. For at least 6 months, recurrent and intense sexual fantasies, sexual urges, or sexual behaviors interfere with important non-sexual goals, activities, and obligations.
2. These are used to dispel dysphoric mood states (e.g., anxiety, depression, boredom, irritability).
3. These occur in response to stressful life events.
4. Unsuccessful attempts to control or reduce these sexual fantasies, urges, or behaviors.
5. Engage in sexual behaviors without regard of the risk for physical or emotional harm to self or others.
6. Clinically significant personal distress or impairment in social, occupational, or other important areas of functioning due to sexual fantasies, urges, or behaviors.
7. These are not due to the direct physiological effect of drugs or medications.
8. The diagnosis should be accompanied by the specific type(s) of sexual activity: masturbation, pornography, sexual behavior with consenting adults, cybersex, telephone sex, strip clubs, other.
- Do you routinely ask your patients about their sex life?
- For patients who seek a medical consult for a sexually transmitted disease, do you inquire about their sexual habits?
- Do you classify hypersexuality as a mental disorder?