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Cited by 103Sexuality, Behavior, and TechnologyGambling Behavior and TreatmentsSexual function and dysfunction studies

Psychiatric comorbidity in compulsive sexual behavior disorder (CSBD)

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Ballester-Arnal, R., Castro-Calvo, J., Giménez-García, C., Gil-Juliá, B., Gil-Llario, M.D.·2020·Addictive Behaviors
DOI 10.1016/j.addbeh.2020.106384
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Abstract

Compulsive Sexual Behavior Disorder (CSBD) is characterized by a persistent failure to control intense and recurrent sexual impulses, urges, and/or thoughts, resulting in repetitive sexual behavior that causes a marked impairment in important areas of functioning. Data collected from clinical populations suggest that CSBD frequently co-occurs with other Axis I and II psychiatric disorders; however, studies conducted so far suffer from methodological shortcomings that prevent the determination of accurate psychiatric comorbidity rates (e.g., small sample sizes, reliance on non-reliable assessment methods in the estimation of comorbidity or the non-inclusion of healthy individuals to compare prevalence rates). The purpose of this study was to explore psychiatric comorbidity in a sample of individuals with and without CSBD. The study sample comprised 383 participants distributed into two groups through a cluster analyses: 315 participants without CSBD (non-CSBD) and 68 qualifying as sexually compulsives (CSBD). Participants were assessed for co-occurring Axis I and II clinical conditions using structured clinical interviews for the DSM-IV (SCID-I and II). The majority of CSBD participants (91.2%) met the criteria for at least one Axis I disorder, compared to 66% in non-CSBD participants. CSBD participants were more likely to report an increased prevalence of alcohol dependence (16.2%), alcohol abuse (44%), major depressive disorder (39.7%), bulimia nervosa (5.9%), adjustment disorders (20.6%), and other substances -mainly cannabis and cocaine- abuse or dependence (22.1%). Concerning Axis II, prevalence of borderline personality disorder was significantly higher in CSBD participants (5.9%). As expected, prevalence of different psychiatric conditions was significantly increased among sexually compulsive participants, revealing comorbidity patterns with important implications in the conceptualization, assessment, and treatment of patients with CSBD.

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Crossref · 10.1016/j.addbeh.2020.106384

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  • CSB commonly co-occurs with anxiety disorders (46%-96%), mood disorders (39%-81%), attention-deficit/hyperactivity disorder (18.7%), and substance use disorders (46%-71%).

    “It is well documented that CSB commonly co-occurs with anxiety disorders (46%-96%), mood disorders (39%-81%), attention-deficit/hyperactivity disorder (18.7%), as well as substance use disorders (46%-71%).42,98-101”

    From Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective (2024) · cites this paper as [101]

    Section 1.1 reports prior CSBD studies with anxiety comorbidity of 46.2% and 96%, mood comorbidity of 80.8% and 71%, and substance-use comorbidity of 46.2% and 71%; section 3.2 reports major depressive disorder in 39.7% of its CSBD group. These broadly support the cited ranges, but our copy does not report the claimed 18.7% ADHD figure. Section 1.1 also cautions that current evidence cannot establish accurate comorbidity rates. (LLM, conf=0.88)

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  • There is often comorbidity between sexual addiction and BPD.

    “There is often comorbidity between sexual addiction and BPD (Ballester-Arnal et al., 2020;Briken, 2020).”

    From A motivation model of sex addiction – Relevance to the controversy over the concept (2022) · cites this paper as Ballester-Arnal et al., 2020

    The Results (INSERT TABLE 2) report BPD in 5.9% of participants with CSBD, compared with 0.3% of those without it, and the Conclusions identify BPD as more likely among patients with CSBD. This supports an association, but the source does not establish that BPD comorbidity itself is frequent; its statement that psychiatric comorbidity is very common concerns disorders collectively. (LLM, conf=0.85)

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  • In one study of a convenience sample of Spanish college students, more than 91.2% of participants with the ICD-11 diagnosis of compulsive sexual behaviour disorder also had symptoms meeting the diagnostic requirements for at least one other Axis I mental disorder during their lifetime, compared to 66% of those without the diagnosis.

    “In one such study of a convenience sample of Spanish college students 257 , more than 91.2% of participants with that ICD-11 diagnosis also had symptoms that met the diagnostic requirements for at least one other Axis I mental disorder during their lifetime, as assessed by the Structured Clinical Interview for DSM-IV-TR, compared to 66% of those without the diagnosis.”

    From Emerging experience with selected new categories in the <scp>ICD</scp>‐11: complex <scp>PTSD</scp>, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder (2022) · cites this paper as [257]

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  • Participants with compulsive sexual behaviour disorder were more likely to report disorders due to alcohol and other substances, major depression, bulimia nervosa, and adjustment disorder.

    “Participants with compulsive sexual behaviour disorder were more likely to report disorders due to alcohol and other substances (mainly cannabis and cocaine), major depression, bulimia nervosa, and adjustment disorder.”

    From Emerging experience with selected new categories in the <scp>ICD</scp>‐11: complex <scp>PTSD</scp>, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder (2022) · cites this paper as [257]

  • Elevated rates of compulsive sexual behaviour have also been found among individuals with attention-deficit/hyperactivity disorder, bipolar disorder, borderline personality disorder, PTSD, paraphilias, and erectile dysfunction.

    “Elevated rates of compulsive sexual behaviour have also been found among individuals with attention-deficit/hyperactivity disorder (ADHD) 260 , bipolar disorder 261 , borderline personality disorder 257,262 , PTSD 263 , paraphilias 264 , and erectile dysfunction 264,265 .”

    From Emerging experience with selected new categories in the <scp>ICD</scp>‐11: complex <scp>PTSD</scp>, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder (2022) · cites this paper as [257]

    Citation 264 is attached to paraphilias and erectile dysfunction. Section 1.1 describes a study of men with a “paraphilia-related disorder” but does not report elevated compulsive sexual behaviour among people with paraphilias; a search for erectile dysfunction found no relevant passage. The cited paper’s findings about other psychiatric comorbidities do not establish these two claims. (LLM, conf=0.73)

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Research works printed but not linked: 1

  1. Hair, J. F., Black, W. C., & Babin, B. J. (2010). Multivariate Data Analysis: A Global Perspective. Pearson.

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Authors
Ballester-Arnal, R., Castro-Calvo, J., Giménez-García, C., Gil-Juliá, B., & Gil-Llario, M. D.
Venue
Addictive Behaviors
Publisher
Elsevier BV
Published
2020-08
Volume
107
Pages
106384
ISSN
0306-4603 (ISSN-L)
DOI
10.1016/j.addbeh.2020.106384
OpenAlex
W3009802546
Cited by
103
References
63
Citations by year
2026: 23 · 2025: 15 · 2024: 18 · 2023: 18 · 2022: 18 · 2021: 6 · 2020: 5
FWCI
4.70
Type
journal article
Language
en
Open access
Licence
Locations
  • Addictive Behaviors (publishedVersion)
  • PubMed (publishedVersion)
  • Repositori UJI (Universitat Jaume I) (submittedVersion, public-domain)
  • Repository of Digital Objects for Teaching Research and Culture (University of Valencia) (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
  • Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Keywords
compulsive sexual behavior disorder, psychiatric comorbidity, compulsive sexual behavior, alcoholism, alcohol abuse, major depressive disorder, bulimia nervosa, adjustment disorder, substance abuse, borderline personality disorder, prevalence rates
MeSH terms
Mental Disorders, Compulsive Behavior, Depressive Disorder, Major, Major Depressive Disorder, Humans, Psychiatric Status Rating Scales, Comorbidity, Prevalence, Sexual Dysfunctions, Psychological, Diagnostic and Statistical Manual of Mental Disorders

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