Ballester-Arnal R, Castro-Calvo J, Giménez-García C, Gil-Juliá B, Gil-Llario M D
Dpto. Psicología Básica, Clínica y Psicobiología. Universitat Jaume I, Castellón, Spain.
Dpto. Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Estudi General, Spain.
Addict Behav. 2020 Aug;107:106384. doi: 10.1016/j.addbeh.2020.106384. Epub 2020 Mar 7.
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.
强迫性行为障碍（CSBD）的特征是持续无法控制强烈且反复出现的性冲动、欲望和/或想法，导致重复性性行为，从而在重要的功能领域造成明显损害。从临床人群收集的数据表明，CSBD经常与其他轴I和轴II精神障碍共病；然而，迄今为止进行的研究存在方法学上的缺陷，妨碍了准确精神共病率的确定（例如，样本量小、在估计共病时依赖不可靠的评估方法或未纳入健康个体以比较患病率）。本研究的目的是探讨有和没有CSBD的个体样本中的精神共病情况。研究样本包括383名参与者，通过聚类分析分为两组：315名无CSBD的参与者（非CSBD）和68名符合性强迫标准的参与者（CSBD）。使用针对《精神疾病诊断与统计手册》第四版（SCID-I和II）的结构化临床访谈对参与者进行轴I和轴II临床共病情况评估。大多数CSBD参与者（91.2%）符合至少一种轴I障碍的标准，而非CSBD参与者中这一比例为66%。CSBD参与者更有可能报告酒精依赖（16.2%）、酒精滥用（44%）、重度抑郁症（39.7%）、神经性贪食症（5.9%）、适应障碍（20.6%）以及其他物质——主要是大麻和可卡因——滥用或依赖（22.1%）的患病率增加。关于轴II，边缘性人格障碍在CSBD参与者中的患病率显著更高（5.9%）。正如预期的那样，性强迫参与者中不同精神疾病的患病率显著增加，揭示了共病模式，这对CSBD患者的概念化、评估和治疗具有重要意义。
