1Excessive Sexual Drive and Prevention of Negative Outcome Associated to Sexual Behavior Outpatient Unit, Institute of Psychiatry (IPq), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
2Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil.
J Behav Addict. 2023 Mar 9;12(1):261-277. doi: 10.1556/2006.2023.00004. Print 2023 Mar 30.
Little attention has been given to efficacious treatment and adherence to treatment of compulsive sexual behavior (CSB).
Randomized controlled trial investigated short-term psychodynamic group therapy followed by relapse prevention group (STPGP-RPGT) and pharmacological treatment (PT) for CSB men on sexual compulsivity and adherence.
135 men, 38 (SD = 9) years old on average, were randomly assigned to 1) STPGP-RPGT; 2) PT; 3) Both. Participants completed measures at baseline, 25th, and 34th week. 57 (42.2%) participants dropped out between baseline and 25th week, and 68 (50.4%) between baseline and 34th week. 94 (69.6%) did not adhere (80% pills taken or attended 75% therapy sessions).
A significant interaction effect was found between time and group (F (4, 128) = 2.62, P = 0.038, ES = 0.08), showing who received PT improved less in sexual compulsivity than those who received STPGP-RPGT (t = 2.41; P = 0.038; ES = 0.60) and PT + STPGP-RPGT (t = 3.15; P = 0.007, ES = 0.74). Adherent participants improved more in sexual compulsivity than non-adherent at the 25th week (t = 2.82; P = 0.006, ES = 0.65) and 34th week (t = 2.26; P = 0.027, ES = 0.55), but there was no interaction effect, F (2, 130) = 2.88; P = 0.06; ES = 0.04). The most reported behavior (masturbation) showed greater risk of non-adherence (72.6%).
Adherent participants improved better than non-adherent. Participants who received psychotherapy improved better than those who received PT. Methodological limitations preclude conclusions on efficacy.
对于强迫性行为（CSB）的有效治疗和治疗依从性，关注甚少。
本随机对照试验旨在调查短期精神动力学团体治疗后复发预防团体（STPGP-RPGT）和药物治疗（PT）对 CSB 男性的性强迫和治疗依从性的影响。
135 名平均年龄 38（标准差=9）岁的男性被随机分配到以下三组：1）STPGP-RPGT；2）PT；3）联合治疗。参与者在基线、第 25 周和第 34 周完成了评估。有 57（42.2%）名参与者在基线和第 25 周之间退出，68（50.4%）名参与者在基线和第 34 周之间退出。有 94（69.6%）名参与者未坚持治疗（服用 80%的药物或参加 75%的治疗课程）。
发现时间和组别之间存在显著的交互效应（F（4，128）=2.62，P=0.038，ES=0.08），表明接受 PT 的患者在性强迫方面的改善程度低于接受 STPGP-RPGT 的患者（t=2.41；P=0.038；ES=0.60）和接受 PT+STPGP-RPGT 的患者（t=3.15；P=0.007，ES=0.74）。坚持治疗的参与者在第 25 周和第 34 周时，性强迫的改善程度均显著高于不坚持治疗的参与者（t=2.82；P=0.006，ES=0.65）和（t=2.26；P=0.027，ES=0.55），但交互效应不显著，F（2，130）=2.88；P=0.06；ES=0.04。最常见的行为（自慰）显示出更高的不依从风险（72.6%）。
坚持治疗的参与者改善得更好。接受心理治疗的参与者比接受 PT 的参与者改善得更好。方法学上的限制排除了有效性的结论。
