Paraphilias: Differential Diagnoses & Workup

References

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000:566 - 576.

2. World Health Organization. The International Statistical Classification of Diseases and Health Related Problems, Tenth Revision. 2^nd ed. World Health Organization; 2004.

3. Abdo CH, Hounie A, de Tubino Scanavino M, Miguel EC. OCD and transvestism: is there a relationship?. Acta Psychiatr Scand. Jun 2001;103(6):471-3; discussion 473. [Medline].

4. Abouesh A, Clayton A. Compulsive voyeurism and exhibitionism: a clinical response to paroxetine. Arch Sex Behav. Feb 1999;28(1):23-30. [Medline].

5. Allgeier AR, Allgeier ER. Atypical sexual activity. In: Miller J, Brooks CL, Rachlin H, O'Dea M, Michaels T, Roll M. Sexual Interactions. 2^nd ed. Canada: D.C. Heath & Company; 1988:619-641/ 21.

6. Allnutt SH, Bradford JM, Greenberg DM, Curry S. Co-morbidity of alcoholism and the paraphilias. J Forensic Sci. Mar 1996;41(2):234-9. [Medline].

7. Alvarez WA, Freinhar JP. A prevalence study of bestiality (zoophilia) in psychiatric in-patients, medical in-patients, and psychiatric staff. Int J Psychosom. 1991;38(1-4):45-7. [Medline].

8. Balon R. Pharmacological treatment of paraphilias with a focus on antidepressants. J Sex Marital Ther. Oct-Dec 1998;24(4):241-54. [Medline].

9. Berger P, Berner W, Bolterauer J. Sadistic personality disorder in sex offenders: relationship to antisocial personality disorder and sexual sadism. J Personal Disord. Summer 1999;13(2):175-86. [Medline].

10. Berlin FS. Sex offender treatment and legislation. J Am Acad Psychiatry Law. 2003;31(4):510-3. [Medline].

11. Blanchard R. Nonmonotonic relation of autogynephilia and heterosexual attraction. J Abnorm Psychol. May 1992;101(2):271-6. [Medline].

12. Blanchard R. The she-male phenomenon and the concept of partial autogynephilia. J Sex Marital Ther. Spring 1993;19(1):69-76. [Medline].

13. Blanchard R, Barbaree HE. The strength of sexual arousal as a function of the age of the sex offender: comparisons among pedophiles, hebephiles, and teleiophiles. Sex Abuse. Oct 2005;17(4):441-56. [Medline].

14. Blanchard R, Klassen P, Dickey R, et al. Sensitivity and specificity of the phallometric test for pedophilia in nonadmitting sex offenders. Psychol Assess. Mar 2001;13(1):118-26. [Medline].

15. Bradford JM. The neurobiology, neuropharmacology, and pharmacological treatment of the paraphilias and compulsive sexual behaviour. Can J Psychiatry. Feb 2001;46(1):26-34. [Medline].

16. Briken P, Hill A, Berner W. Pharmacotherapy of paraphilias with long-acting agonists of luteinizing hormone-releasing hormone: a systematic review. J Clin Psychiatry. Aug 2003;64(8):890-7. [Medline].

17. Butterfield MI, Panzer PG, Forneris CA. Victimization of women and its impact on assessment and treatment in the psychiatric emergency setting. Psychiatr Clin North Am. Dec 1999;22(4):875-96. [Medline].

18. Chiang YL, Yeh SS, Hsiao CC, Ree SC. Treatment of a transvestic fetishist with cognitive-behavioral therapy and supportive psychotherapy: case report. Chang Keng I Hsueh Tsa Chih. Jun 1999;22(2):299-312. [Medline].

19. Deirmenjian JM. Pedophilia on the Internet. J Forensic Sci. Sep 2002;47(5):1090-2. [Medline].

20. Docter RF, Prince V. Transvestism: a survey of 1032 cross-dressers. Arch Sex Behav. Dec 1997;26(6):589-605. [Medline].

21. Dubasi PM, Fosseus CG. A case of necrophilia in Medunsa. Am J Forensic Med Pathol. Jun 1995;16(2):162-3. [Medline].

22. Fagan PJ, Wise TN, Schmidt CW Jr, Berlin FS. Pedophilia. JAMA. Nov 20 2002;288(19):2458-65. [Medline].

23. Fischer L, Smith G. Statistical adequacy of the Abel Assessment for Interest in Paraphilias. Sex Abuse. Jul 1999;11(3):195-205. [Medline].

24. Frohman EM, Frohman TC, Moreault AM. Acquired sexual paraphilia in patients with multiple sclerosis. Arch Neurol. Jun 2002;59(6):1006-10. [Medline].

25. Glickauf-Hughes C. Etiology of the masochistic and narcissistic personality. Am J Psychoanal. Jun 1997;57(2):141-8. [Medline].

26. Grant JE. Clinical characteristics and psychiatric comorbidity in males with exhibitionism. J Clin Psychiatry. Nov 2005;66(11):1367-71. [Medline].

27. Grasswick LJ, Bradford JM. Osteoporosis associated with the treatment of paraphilias: a clinical review of seven case reports. J Forensic Sci. Jul 2003;48(4):849-55. [Medline].

28. Greenberg DM, Bradford J, Curry S. Infantophilia--a new subcategory of pedophilia?: a preliminary study. Bull Am Acad Psychiatry Law. 1995;23(1):63-71. [Medline].

29. Greenberg DM, Bradford JM, Curry S, O'Rourke A. A comparison of treatment of paraphilias with three serotonin reuptake inhibitors: a retrospective study. Bull Am Acad Psychiatry Law. 1996;24(4):525-32. [Medline].

30. Hollander E, Rosen J. Impulsivity. J Psychopharmacol. 2000;14(2 Suppl 1):S39-44. [Medline].

31. Hoyer J, Kunst H, Schmidt A. Social phobia as a comorbid condition in sex offenders with paraphilia or impulse control disorder. J Nerv Ment Dis. Jul 2001;189(7):463-70. [Medline].

32. Hucker SJ, Stermac L. The evaluation and treatment of sexual violence, necrophilia, and asphyxiophilia. Psychiatr Clin North Am. Sep 1992;15(3):703-19. [Medline].

33. Hyde JS, DeLamater JD. Understanding Human Sexuality. 7^th ed. New York, NY: McGraw-Hill; 2000:439-41.

34. Jackowski C, Römhild W, Aebi B, Bernhard W, Krause D, Dirnhofer R. Autoerotic accident by inhalation of propane-butane gas mixture. Am J Forensic Med Pathol. Dec 2005;26(4):355-9. [Medline].

35. Kafka MP, Hennen J. A DSM-IV Axis I comorbidity study of males (n = 120) with paraphilias and paraphilia-related disorders. Sex Abuse. Oct 2002;14(4):349-66. [Medline].

36. Kaplan HI, Sadcock BJ. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 8^th ed. Baltimore, Md: Williams & Wilkins; 1998:700-7.

37. Maxmen JS, Ward NG. Sexual and gender identity disorders. In: Essential Psychopathology and Its Treatment. 2^nd ed. New York, NY: W.W Norton & Company; 1995:324-328.

38. Nelson E, Brusman L, Holcomb J, et al. Divalproex sodium in sex offenders with bipolar disorders and comorbid paraphilias: an open retrospective study. J Affect Disord. May 2001;64(2-3):249-55. [Medline].

39. Orfanelli L, Borkowski WJ Jr. Conversion disorder in a pediatric transgender patient. J Neurosci Nurs. Apr 2006;38(2):114-6. [Medline].

40. Philpot CD. Paraphilia and aging. Clin Geriatr Med. Aug 2003;19(3):629-36, viii-ix. [Medline].

41. Rosler A, Witztum E. Pharmacotherapy of paraphilias in the next millennium. Behav Sci Law. 2000;18(1):43-56. [Medline].

42. Saleh F. A hypersexual paraphilic patient treated with leuprolide acetate: a single case report. J Sex Marital Ther. Oct-Dec 2005;31(5):433-44. [Medline].

43. Saleh FM, Niel T, Fishman MJ. Treatment of paraphilia in young adults with leuprolide acetate: a preliminary case report series. J Forensic Sci. Nov 2004;49(6):1343-8. [Medline].

44. Sauvageau A, Racette S. Autoerotic deaths in the literature from 1954 to 2004: a review. J Forensic Sci. Jan 2006;51(1):140-6. [Medline].

45. Schober JM, Kuhn PJ, Kovacs PG, Earle JH, Byrne PM, Fries RA. Leuprolide acetate suppresses pedophilic urges and arousability. Arch Sex Behav. Dec 2005;34(6):691-705. [Medline].

46. Shiah IS, Chao CY, Mao WC, Chuang YJ. Treatment of paraphilic sexual disorder: the use of topiramate in fetishism. Int Clin Psychopharmacol. Jul 2006;21(4):241-3. [Medline].

47. Shiwach RS, Prosser J. Treatment of an unusual case of masochism. J Sex Marital Ther. Oct-Dec 1998;24(4):303-7. [Medline].

48. Simon RI. Video voyeurs and the covert videotaping of unsuspecting victims: psychological and legal consequences. J Forensic Sci. Sep 1997;42(5):884-9. [Medline].

49. Singer PP, Jones GR. An unusual autoerotic fatality associated with chloroform inhalation. J Anal Toxicol. Apr 2006;30(3):216-8. [Medline].

50. Templeman TL, Stinnett RD. Patterns of sexual arousal and history in a "normal" sample of young men. Arch Sex Behav. Apr 1991;20(2):137-50. [Medline].

51. Tost H, Vollmert C, Brassen S, et al. Pedophilia: neuropsychological evidence encouraging a brain network perspective. Med Hypotheses. 2004;63(3):528-31. [Medline].

52. Travin S. Compulsive sexual behaviors. Psychiatr Clin North Am. Mar 1995;18(1):155-69. [Medline].

53. Vollenweider FX. Recent advances and concepts in the search for biological correlates of hallucinogen-induced altered states of consciosness. The Heffter Review of Psychedelic Res. 1998;1:21-32.

54. Waismann R, Fenwick PB, Wilson GD, et al. EEG responses to visual erotic stimuli in men with normal and paraphilic interests. Arch Sex Behav. Apr 2003;32(2):135-44. [Medline].

55. Wise TN, Goldberg RL. Escalation of a fetish: coprophagia in a nonpsychotic adult of normal intelligence. J Sex Marital Ther. Winter 1995;21(4):272-5. [Medline].

Further Reading

Keywords

sexual urges, sexual fantasies, masturbation, voyeurism, frotteurism, zoophilia, exhibitionism, fetishism, pedophilia, sexual masochism, sexual sadism, transvestic fetishism, scopophilia, scatologia, necrophilia, partialism, coprophilia, klismaphilia, urophilia, autogynephilia, asphyxiophilia, hypoxyphilia, autoerotic asphyxiation, infantophilia, video voyeurism

Contributor Information and Disclosures

Author

Guy E Brannon, MD, Associate Clinical Professor of Psychiatry, Louisiana State University Health Sciences Center; Director, Adult Psychiatry Unit, Chemical Dependency Unit, Clinical Research, Brentwood Behavior Health Company
Guy E Brannon, MD is a member of the following medical societies: American Medical Association, American Medical Writers Association, American Psychiatric Association, American Society of Addiction Medicine, Association of Clinical Research Professionals, Louisiana State Medical Society, and Southern Medical Association
Disclosure: AstraZeneca Honoraria Speaking and teaching; Takeda Honoraria Speaking and teaching; Wyeth Honoraria Speaking and teaching; Janssen Honoraria Speaking and teaching

Coauthor(s)

Kimberly S Carroll, MA, Clinical Research Coordinator, Brentwood Research Institute
Disclosure: Nothing to disclose.

Medical Editor

Mohammed A Memon, MD, Medical Director of Geriatric Psychiatry, Department of Psychiatry, Spartanburg Regional Hospital System
Mohammed A Memon, MD is a member of the following medical societies: American Association for Geriatric Psychiatry, American Medical Association, and American Psychiatric Association
Disclosure: Nothing to disclose.

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Managing Editor

David Bienenfeld, MD, Vice-Chair, Program Director, Professor, Department of Psychiatry, Wright State University School of Medicine
David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry
Disclosure: Nothing to disclose.

CME Editor

Harold H Harsch, MD, Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin
Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: lilly Honoraria Speaking and teaching; BMS Honoraria Speaking and teaching; Forest Labs Honoraria Speaking and teaching; AstraZeneca Honoraria Speaking and teaching; Pfizer Grant/research funds Other; Northstar Grant/research funds Other; Novartis  Other

Chief Editor

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration and American Psychosomatic Society
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