Psych · Specialty psychiatry — clinical paraphilic disorders
Paraphilic disorders (clinical)
Also known as Paraphilias · Pedophilic disorder · Exhibitionistic disorder · Voyeuristic disorder · Fetishistic disorder · Sexual sadism disorder · Sexual masochism disorder · Compulsive sexual behaviour disorder · Antiandrogen therapy · WFSBP paraphilia guidelines
Exam-exhaustive fellowship atlas on clinical paraphilic disorders — DSM-5-TR/ICD-11 interest-versus-disorder threshold, epidemiology of interests, mechanisms (dual control and motivation–facilitation), voluntary help-seeking assessment, differential from CSBD/OCD/gender incongruence, child-protection and suicide red flags, CBT and WFSBP-aligned stepped pharmacotherapy, subtype scenarios, and regional ethics. Clinical primary; forensic interface secondary. FRANZCP-primary, globally tagged.
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10 MCQs with explanations
Target exams
Red flags
Meet the patient
A 34-year-old man walks into your outpatient clinic of his own accord. He has never been in trouble with the law. For ten years he has carried a persistent, preferential sexual interest in prepubescent children; he has not acted on it. He teaches at a primary school. He is exhausted by shame, his sleep is shattered, and he tells you he has thought about ending his life if "this is what I am."[8][11]
Two questions dominate every viva on this leaf, and they are not the same question: "Is this a disorder?" and "What do you do in the next thirty minutes?" The first is nosological; the second is safeguarding and suicide risk. This topic answers both.[4][8]
You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the Psychiatry Fellowship fellowship atlas.
References14Show ledgerHide ledger
- [1]Krueger RB, Reed GM, First MB, et al. Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11) Arch Sex Behav, 2017.PMID 28210933
- [2]Reed GM, Drescher J, Krueger RB, et al. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations World Psychiatry, 2016.PMID 27717275
- [3]Thibaut F, De La Barra F, Gordon H, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of paraphilias World J Biol Psychiatry, 2010.PMID 20459370
- [4]Thibaut F, Cosyns P, Fedoroff JP, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders World J Biol Psychiatry, 2020.PMID 32452729
- [5]Assumpção AA, Garcia FD, Garcia HD, et al. Pharmacologic treatment of paraphilias Psychiatr Clin North Am, 2014.PMID 24877704
- [6]Garcia FD, Thibaut F Pharmacologic treatment of sex offenders with paraphilic disorder Curr Psychiatry Rep, 2013.PMID 23572328
- [7]Kafka MP Hypersexual disorder: a proposed diagnosis for DSM-V Arch Sex Behav, 2010.PMID 19937105
- [8]Seto MC Pedophilia Annu Rev Clin Psychol, 2009.PMID 19327034
- [9]Joyal CC, Carpentier J The Prevalence of Paraphilic Interests and Behaviors in the General Population: A Provincial Survey J Sex Res, 2017.PMID 26941021
- [10]Ahlers CJ, Schaefer GA, Mundt IA, et al. How unusual are the contents of paraphilias? Paraphilia-associated sexual arousal patterns in a community-based sample of men J Sex Med, 2011.PMID 19929918
- [11]Seto MC The Motivation-Facilitation Model of Sexual Offending Sex Abuse, 2019.PMID 28715948
- [12]Turner D, Briken P Treatment of Paraphilic Disorders in Sexual Offenders or Men With a Risk of Sexual Offending With Luteinizing Hormone-Releasing Hormone Agonists: An Updated Systematic Review J Sex Med, 2018.PMID 29289377
- [13]Hanson RK, Morton-Bourgon KE The characteristics of persistent sexual offenders: a meta-analysis of recidivism studies J Consult Clin Psychol, 2005.PMID 16392988
- [14]Krueger RB Diagnosis of hypersexual or compulsive sexual behavior can be made using ICD-10 and DSM-5 despite rejection of this diagnosis by the American Psychiatric Association Addiction, 2016.PMID 27086656