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Comorbidity
In medicine and in psychiatry, comorbidity (literally "additional morbidity") is either:
Multiple studies have documented a large degree of Axis I comorbidity with impulsive-compulsive sexual behavior.
Kafka and Prentky prospectively evaluated 60 subjects who were referred (by self or others) for treatment for paraphilias (n=34) and/or impulsive-compulsive sexual behavior (n=26).
The paraphilia subjects and the impulsive-compulsive group did not differ significantly in the prevalence of Axis I lifetime disorders.
Both groups demonstrated elevated lifetime rates of:
Individual rates for people with impulsive-compulsive sexual behavior are:
The predominant forms of repetitive sexual behaviors practiced by the paraphilia and the impulsive-compulsively sexual were “non-paraphilic” in nature:
Kafka and Prentky performed another study on subjects referred for treatment of impulsive-compulsive sexual behavior and paraphilia to see they differed in their rates of childhood ADHD. Sixty subjects (paraphilia: n=42; impulsive-compulsive sexual behavior: n=8) were evaluated, and it was found that the lifetime rates of Axis I disorders differed only the rate of childhood attention-deficit/hyperactivity disorder (ADHD). Fifty percent of the paraphilia subjects and 17% of those with impulsive-compulsive sexual behavior had childhood ADHD. This difference was significant (P=.01). The lifetime rates for the other Axis I disorders in those with compulsive sexual behavior were 66.7% for mood disorder (61.1% dysthymic disorder), 42.9% for anxiety disorder (22.2 % social phobia), 38.9% for any substance abuse, and 16.7% for impulsivity NOS.
Kafka and Hennen’s most recent comorbidity study was performed in 2002. The results were similar to the 1998 study. They evaluated another group of patients appearing for treatment of paraphilia (n=88, 22 of whom were excluded to give an n=64) and impulsive-compulsive sexual behavior (n=32, five of whom were excluded to give an n=27). Once again, the two groups’ rates of lifetime Axis I disorders only differed significantly in their rate of childhood ADHD. Forty-two of the paraphilia subjects had ADHD compared with only 18.7% of those with impulsive-compulsive sexual behavior. The most prevalent comorbidities were mood disorders (71.6%), especially early onset dysthymic disorder (55%) and major depression (39%). Anxiety disorders (38.3%), especially social phobia (21.6%) and psychoactive substance abuse (40.8%), especially alcohol abuse (30%), and impulsive disorder NOS (26.6%) were reported as well. The individual rates for individuals with impulsive-compulsive sexual behavior were mood disorder (71.8%), dysthymia (68.7%), any anxiety disorder (37.5%), social phobia (25%), any substance abuse (25%), and impulsivity NOS (15.6%). In a subsequent examination, Kafka and Hennen16 found these subjects tended to spend between 1–2 hours per day involved in their sexual thoughts, urges, or behaviors (termed unconventional sexual behavior), and 15–30 minutes per day in sexual behavior that involved a mutually consenting relational context (termed conventional sexual behavior.
See also: