Review Article

Sexual Addiction Disorder— Journal of Psychosexual Health

4(2) 95–101, 2022
© The Author(s) 2022
A Review With Recent Updates Reprints and permissions:
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DOI: 10.1177/26318318221081080
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B. R. Sahithya1 and Rithvik S. Kashyap2

Abstract
Sexual addiction, hypersexuality, sexual compulsivity, and sexual impulsivity are all terms that describe a psychological disorder
that is characterized by a person’s inability to control his or her sexual behavior. This spectrum of symptoms are often referred
to as sexual addiction disorder. Whether excessive sexual behavior should be regarded as an addiction, or a compulsion, or
an impulse control disorder is arguable, as each label indicates a specific etiological model and treatment plan. Sexual addiction
disorder has been largely ignored by the clinicians, although it causes significant emotional and behavioral problems among the
patients. Fortunately, in the recent years, this disorder is gaining recognition, and attempts have been made to understand it
through research. The present article aims to systematically review and summarize the recent understanding and research on
phenomenology, clinical characteristics, etiology, assessment, and management of sexual addiction disorder.

Keywords
Sexual addiction, hypersexuality, sexual compulsivity, sexual impulsivity

Introduction both a generally accepted diagnostic definition, and valid and

Sexual addiction disorder is characterized by repetitive intru-
sive sexual fantasies and thoughts, excessive sexual behav-
iors, and inability to control one’s own sexuality, resulting in
distress and impairment of relational and social life. Although
sexual addiction disorder or hypersexuality was proposed as
a distinct disorder in the latest Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition, it was subse-
quently not included (Table 1).1 Conversely, World Health
Organization2 has planned to include excessive sexual behav-
iors within the latest version of the International Classification
of Diseases (ICD-11) as a disorder of sexual compulsive
behavior (Table 2). Important attributes that distinguish sex-
ual addiction disorder from other patterns of sexual behavior
are (a) failure to control sexual behavior and (b) the sexual
behavior has significant harmful consequences and (c) con-
tinues despite these consequences.3 Sexual addiction disorder
is a serious clinical problem with damaging consequences if
left untreated, and can negatively impact social, occupational,
and mental well-being.
Clinical Characteristics
Prevalence
Currently, there is a paucity of literature examining sexual
addiction disorder in nonclinical samples. Due to a lack of
reliable methods of measurement, estimates of incidence
and prevalence of sexual addiction disorder vary consider-
ably. Nevertheless, a few studies on “hypersexuality” have
estimated its prevalence to be 2% to 6% of the general popu-
lation.4 However, recent epidemiological studies in the United
States estimate higher overall prevalence of “compulsive
sexual behavior” at 8.6%.5
Gender Differences
Although research studies examining gender differences in
sexual addiction disorder are lacking, in general, majority of
the patients seeking treatment for sexual addiction disorder
are men. For instance, a research study by Black et al6 on
persons with self-identified compulsive sexual behavior,
recruited through newspaper advertisements, found that 78%
of respondents were men and only 22% were women. When
the researchers analyzed gender differences on illness and
1
Department of Clinical Psychology, Manipal Academy of Higher Education,
Manipal, Udupi, Karnataka, India
2
Department of Clinical Psychology, JSS Medical College & Hospital, Mysuru,
Karnataka, India
Corresponding author:
B. R. Sahithya, Department of Clinical Psychology, Manipal Academy of Higher
Education, Manipal, Udupi, Karnataka 576104, India.
E-mail: sahithyabr@gmail.com

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96
Table 1. The Proposed Diagnostic Criteria for Hypersexual
Disorder for DSM-5
The proposed diagnostic criteria for hypersexual disorder, although
unaccepted by the DSM, are as follows:
A. Over a period of at least 6 months, recurrent and intense sexual
fantasies, sexual urges, or sexual behaviors in association with 3
or more of the following 5 criteria:
A.1. Time consumed by sexual fantasies, urges, or behaviors
repetitively interferes with other important (nonsexual)
goals, activities, and obligations.
A.2. Repetitively engaging in sexual fantasies, urges, or
behaviors in response to dysphoric mood states (eg,
anxiety, depression, boredom, irritability).
A.3. Repetitively engaging in sexual fantasies, urges, or
behaviors in response to stressful life events.
A.4. Repetitive but unsuccessful efforts to control or significantly
reduce these sexual fantasies, urges, or behaviors.
A.5. Repetitively engaging in sexual behaviors while disregarding
the risk for physical or emotional harm to self or others.
B. There is clinically significant personal distress or impairment
in social, occupational, or other important areas of functioning
associated with the frequency and intensity of these sexual
fantasies, urges, or behaviors.
C. These sexual fantasies, urges, or behaviors are not due to the
direct physiological effect of an exogenous substance (eg, a drug
abuse or a medication).
Subtype:
Masturbation
Pornography
Sexual Behavior With Consenting Adults
Cybersex Telephone Sex
Strip Clubs
Other.1
Table 2. The Proposed Diagnostic Criteria for Compulsive
Sexual Behavior Disorder in ICD-11
Compulsive sexual behavior disorder is characterized by a
persistent pattern of failure to control intense, repetitive sexual
impulses, or urges resulting in repetitive sexual behavior, over
an extended period (eg, 6 months or more) that causes marked
distress or impairment in personal, family, social, educational,
occupational, or other important areas of functioning.
The pattern is manifested in one or more of the following:
i. Repetitive sexual activities becoming a central focus of the
individual’s life to the point of neglecting health and personal
care or other interests, activities, and responsibilities.
ii. Numerous unsuccessful efforts to significantly reduce
repetitive sexual behaviors.
iii. Continued repetitive sexual behavior despite adverse
consequences or deriving little or no satisfaction from
the behavior.
iv. A pattern of failure to control intense, sexual impulses, or
urges, resulting in repetitive sexual behavior, manifested
over an extended period (eg, 6 months or more).
v. Marked distress or significant impairment in personal,
family, social, educational, occupational, or other
important areas of functioning.2
Journal of Psychosexual Health 4(2)
sociodemographic characteristics, they found that the only
significant gender difference was in the number of sexual
partners in the past 5 years. Men had a significantly greater
number of sexual partners (59) compared to women (8).
Risk Factors
Higher incidence of sexual addiction disorder has been
observed among individuals with substance use disorders.7
Sexual addiction disorder has also been linked to adverse
childhood events which include sexual, physical, and
emotional abuse.8 However, systematic data regarding
the risk factors associated with the disorder, weather genetic,
personality, early life experience, and so on, as well as
associated sociocultural and sociodemographic factors
are lacking.
Comorbidity
Sexual addiction disorder usually presents with comorbid
anxiety disorder, depression, substance use disorders, atten-
tion-deficit/hyperactivity disorder (ADHD), and other psy-
chiatric and physical conditions. A study of comorbidity
among individuals with compulsive sexual behaviors found
that 88% of the participants had a comorbid axis I disorder,
and all of them met the diagnostic criteria for an axis I disor-
der at some time in their lives.9 Personality disorders such as
borderline, paranoid, histrionic, and passive-aggressive per-
sonality disorders have been reported to be the most common
comorbid condition in this population.6,9
Onset and Clinical Course
When DSM-5 field trial10 for hypersexual disorder explored
the onset and clinical course of the disorder, it was found that
54% of the participants reported experiencing some difficulties
in regulating their sexual behavior during their adolescent
years, and 30% reported experiencing these difficulties during
late adolescence and early adulthood years. Regarding the
course of illness, 83% reported a gradual onset lasting several
months or years, and 17% indicating a rapid-acute onset in less
than 90 days.
Etiological Models
The sexual addiction diagnosis integrates biopsychosocial
aspects drawn from various etiological theories.
Psychodynamic Model
Psychodynamic theory postulates that excessive sexual
behaviors is an attempt to recover from adverse early
childhood experiences. Unhealthy attachment patterns and
deficits in affect regulation have also been identified as risk
factors predisposing the individual for dysregulated sexual
behaviors. Maladaptive attachment is hypothesized to lead
Sahithya and Kashyap
to a conflicting sexual interest (ie, desire for intimacy, but
intense fear of it). A preoccupied attachment may result in
an emotionally needy individual with uncontrolled sexual
behaviors as they crave for validation from multiple partners.
Some researchers in this field have also discussed life instinct
and death instinct in relation to sexual addiction, suggesting
that sexual addiction is perhaps an attempt to replace death
anxiety through sexual activities, although in a dysregulated
way. Hence, within the psychodynamic perspective, sexual
addictions are considered as a defense mechanism against
death anxiety.
Compulsivity Model
Compulsivity model of sexual addiction has often been com-
pared with the phenomenology of obsessive-compulsive
disorder, characterized by egosyntonic repetitive intrusive
thoughts and uncontrolled sexual acts. Here, repetitive sexual
thoughts and images constitute the obsession, and sexual
behaviors constitute the compulsion. According to this model,
intrusive, repetitive sexual thoughts, images, and fantasies
produce anxiety, and the individual uses sexual acting out
to reduce this tension, but it produces more distress due to
negative self-evaluation.
Addiction Model
Sexual addiction disorder has been postulated as a behavioral
addiction by many researchers. The symptomatology involves
the cravings and preoccupation with sexual activity, and
abstinence-withdrawal symptoms of depression, anxiety, and
blame. Parallel to other substance abuse, sexual behaviors
initially induce pleasure, euphoria, and stress relief; however,
it leads to dependence, craving, and frequent relapse. Sexual
behaviors are thought to serve as a coping mechanism to deal
with painful affects; however, it is a maladaptive coping style,
which results in loss of control despite negative consequences.
As in other forms of addiction, individuals with sexual addic-
tion spend increased amount of time looking for novel sexual
partners, and compromise their social and relational life,
without considering potential negative consequences.
Impulsivity Model
Sexual addiction disorder has parallelism with impulse con-
trol disorder. The core characteristic of impulse-control disor-
ders is an inability to resist an impulse to perform an act that
is harmful to self or others. There is an increased tension or
affective arousal prior to the act, followed by relief after the
act. Similarly, individuals with sexual addiction disorder
engage in sexual behaviors repetitively, although it could be
damaging to self or others. They tend to experience tension
before engaging in sexual behavior, followed by pleasure and
relief during the act, and later experience regret and guilt.
97
Cognitive-Behavioral Model
According to cognitive-behavioral model, sexual addiction
may be attributed to an unrealistic expectation of life, and an
irrational belief system that consists of a deteriorated self-
image. Coleman11 attributed it to maladaptive use of sexual
behaviors as a means to cope with emotional pain. According
to Carnes,12,13 sexual addiction consists of 3 specific beliefs:
(a) “I am a bad person and unworthy of love,” (b) “nobody
can love me as I am,” and (c) “my needs will never be satis-
fied if I have to depend on others.” These ideas generate a
false belief system that prompts a faulty thought which results
in the expression of an addictive behavior.
Childhood Adversities and Trauma Model
Few researchers7 have hypothesized that individuals
with sexual addiction are more likely to have traumatic
family experiences such as sexual abuse during childhood.
Researchers have also suggested that individuals with sexual
addiction disorder are more likely to have experienced or
exposed to violent behaviors in adulthood than healthy volun-
teers.8 These studies suggest that childhood adversity is an
important risk factor for sexual addiction disorder.
Neurobiological Model
Neurobiological models postulate that neurobiological risk
factors such as endocrine abnormality, brain pathology, sub-
stance abuse, and imbalance between the sexual activation
system and the sexual inhibition system, cause sexual addic-
tion disorder. Sexual addiction is also conceptualized as a
sequela of medical conditions such as brain injury, degenera-
tive disorders, or temporal lobe deficits.14 Researchers have
demonstrated a greater activation of the dorsal anterior cingu-
late, ventral striatum, and amygdala among the patients when
they were exposed to sexually explicit stimuli. Activation
of this neural network has been linked to higher subjective
sexual desire among the patient group when compared to
the control group.15 “Monoamine hypothesis” is thought of
as another possible neurobiological cause of dysregulated
sexual desire. According to this model, enhanced dopaminer-
gic neurotransmission is thought to be associated with sexual
excitation, and enhanced serotonergic neurotransmission is
thought to be associated with sexual inhibition.16
The Dual Control Model and Affect Regulation Model
According to dual control model of sexual arousal, neurobio-
logical predispositions moderate individual propensities to
engage in sexual behaviors to regulate negative mood states.17
Equilibrium between the sexual activation/excitation system
and the sexual inhibition system, each of which has a
neurobiological substrate, determine the sexual arousal and
response in an individual. There are individual differences
98
in people’s proclivity for both sexual excitation and sexual
inhibition, and for most people, these predilections are non-
problematic. However, individuals with an unusually high
propensities for excitation and/or low propensities for inhibi-
tion are more likely to engage in problematic sexual behavior.
Whereas, individuals with a low inclination for sexual exci-
tation and/or high inclination for sexual inhibition are more
likely to experience problems with sexual response.
An Integrated Approach to Etiology of Sexual Addiction may contribute to repetitive sexual behaviors, creating
Contrary to unidimensional theoretical approach to the classi-
fication of sexual addiction (whether compulsive, impulsive,
or addictive), integrated models postulate that it may be more
useful to explore several phenomenological and psychobio-
logical mechanisms that underpin sexual addiction disorder.
Stein18 proposed an A-B-C model of the disorder with 3 key
components: (a) affective dysregulation, (b) behavioral
addiction, and (c) cognitive dyscontrol. Similarly, Goodman3
attempted to integrate several models and proposed that
behavioral disinhibition affects dysregulation and an aberrant
motivational-reward system is the cause of sexual addiction.
This model hypothesizes that individuals with poorly modu-
lated sexual behavior are prone to chronic negative mood
states and affective instability, and these individuals may eas-
ily give in to urges for short-term reinforcement, overriding
long-term consequences.
Assessment
Individuals who seek treatment for sexual addiction disorder
are a heterogeneous group. It is therefore essential to conduct a
thorough assessment so as to ascertain the psychopathology
that needs to be addressed. The most important part of assess-
ment is a comprehensive clinical interview which should
include history of the presenting problems, psychosocial his-
tory, sexual history, psychiatric and mental health history, sub-
stance use history, and medical history. Sexual addiction could
also be a symptom of an underlying condition, such as bipolar
disorder or dementia, and organic- and substance related. The
possibility that the patient may have contracted a sexually
transmitted disease should not be overlooked. Questionnaires
and rating scales may also be used to acquire supplemental
information (Table 3). In addition to interviewing the patient,
supplemental information may also be obtained from a spouse/
partner or family members, who can provide objective descrip-
tion of the patient’s observed behaviors.
In general, the detail work up by the clinicians may
explore the following components before making a diagnostic
formulation and treatment plan:
Excessiveness, Frequency, and Duration
The clinicians need to assess how much time is spent engag-
ing in sexual urges, fantasies, and behaviors. Generally,
Journal of Psychosexual Health 4(2)
frequency and duration of sexual urges, fantasies, and behav-
iors can vary among the patients, and may influence the
severity of the disorder, which can help determine whether a
behavior is excessive and problematic.
Level of Impairment, Diminished Control,
and Consequences
In patients with sexual addiction disorder, diminished control
negative consequences which impair the patient’s ability to
function. Consequences may be marital conflicts, divorce,
job loss, and so on. Therefore, clinicians need to explore the
extent to which sexual addiction is causing significant impair-
ment in the patient’s social, occupational, and other important
areas of functioning, as well as adverse life events and
distress as a consequence of the disorder.
Comorbidity
It is important to ascertain comorbid conditions such as anxi-
ety, depression, substance abuse, suicidality, and personality
traits which need to be treated. Individuals with comorbidity
require special consideration as their complexity can influ-
ence the seriousness, pain, and suffering, leading to a greater
level of distress.
Level of Risk Taking
One of the symptom of sexual addition disorder is risk-taking
behavior, which is defined as repetitively engaging in sexual
behavior while disregarding the risk for physical or emotional
harm to self or others. Severity of risk-taking behavior
has significantly higher potential for greater damage such as
sexually transmitted diseases, unintended pregnancies, phys-
ical harm to self or others, legal problems, involvement in
illegal acts in order to engage in sexual activities, and so on.
Overall, the amount of risk a patient is willing to take in order
to pursue sexual urges, fantasies, and behaviors should be
evaluated during clinical interview.
Onset and Clinical Course
The assessment should also explore the onset (adolescence,
early adulthood, stressors, etc) and clinical course (gradual
onset, rapid-acute onset, continuous, episodic, etc) of sexual
addiction among the patients. The onset and clinical course
of sexual addiction symptoms may have implications on treat-
ment adherence, relapse, and overall prognosis for the patients.
Level of Motivation
Individuals with sexual addiction may present with limited
motivation for treatment, because sexual experiences are
Sahithya and Kashyap
Table 3. Questionnaires and Instruments for Assessing Sexual
Addiction
1. The Sexual Inhibition/Sexual Excitation Scale: Measures
the propensity for sexual inhibition and sexual excitation
in men.
2. Sexual Interest and Activity Scale: Rates the frequency of
sexual thoughts and acts over the past week in a Likert
scale.
3. Intensity of Sexual Desire and Symptoms Scale: Rates
the frequency and intensity of sexual fantasies over the
past week and frequency of deviant behaviors over the
past month.
4. Compulsive Sexual Behavior Inventory: Assesses
compulsive sexual behavior and risk for unsafe sex.
5. Sexual Compulsivity Scale: Assesses the impact of sexual
thoughts on daily functioning and the inability to control
sexual thoughts or behaviors.
6. Sexual Addiction Screening Test: Evaluates presence of
sexual addiction in heterosexual males.
7. Hypersexual Behavior Inventory: Measures 3 dimensions
of hypersexuality—control, coping, and consequences.
8. Sexual Outlet Inventory: Documents the incidence and
frequency of sexual fantasies, urges, and activities.
pleasurable. Patients maybe ambivalent about addressing
these behaviors, despite harmful effects. Quite often, it may
be a family member’s pressure or a recent negative experi-
ence that is pushing the patient to seek help. Therefore, it is
important to determine the level of motivation in the patient,
as this will help develop a treatment plan.
Management
Sexual addiction disorder is a complex disorder, and needs
a multifaceted treatment approach that includes various
modalities such as cognitive-behavioral therapy, relapse-
prevention therapy, psychodynamic psychotherapy, and psy-
chopharmacological treatment. Various therapy techniques
are employed to help individuals with sexual addiction disor-
der in individual, group, and/or couples module, with the goal
to help them find the sources of their behaviors, to aid them in
developing adaptive approaches for dealing with triggers,
and to strengthen their sense of self-worth. The high degree of
comorbidity in this population demands that associated con-
ditions such as mood disorders, substance use disorders, and
other psychiatric disorders be treated concomitantly along
with the treatment of sexual addiction.
Cognitive Behavior Therapy
The principles and techniques of CBT are designed to help
the individual to identify unhealthy, negative beliefs, and
behaviors; replace them with more adaptive ways of coping,
and learn more healthy patterns of thoughts and actions.
Treatment plan in CBT includes learning new strategies for
coping with urges, secrecy, shame, and guilt, as well as
99
replacing old behaviors, adopting values-based activities,
practicing new behaviors, and managing relapses. CBT also
focuses on relapse prevention strategies, managing thoughts,
feelings and behaviors, and lifestyle improvements. Principles
of CBT developed for relapse prevention in substance abuse
have been adapted for the treatment of sexual addiction disor-
der. Relapse-prevention uses strategies such as skills training,
cognitive restructuring, and lifestyle modifications. These
strategies help individuals anticipate and identify high-risk
situations, identify and replace cognitive distortions with
more rational thoughts, and cope with stressful situations that
may trigger a relapse. CBT has been found to be effective in
treatment of sexual addiction disorder.19
Psychodynamic Psychotherapy
Psychodynamic psychotherapy is used in the treatment of sex-
ual addiction to explore unconscious content of psyche, past
trauma, and underlying causal factors in order to facilitate the
individual’s awareness of unconscious thoughts and behaviors,
and help them develop new insights into their motivations, and
resolve conflicts. The primary objective of psychodynamic
therapy in treatment of sexual addiction disorder is to improve
the individual’s emotional self-regulation, and to promote their
ability to establish meaningful interpersonal relationships. The
basic processes of psychodynamic psychotherapy are (a) intel-
lectual understanding which allows patients to become aware
of the mental processes and psychological basis of their subjec-
tive experiences and their behavior, (b) integration of feelings,
needs, fears, and basic defenses, hidden from conscious mind
with the healthy part of the system and adaptive personality,
and (c) internalization of self-regulatory process that were not
properly internalized during childhood.
Twelve-Step or Addiction Treatment
Twelve-step model of Alcoholics Anonymous, originally
developed for the treatment of alcohol use disorder, has now
been adapted for sexual addiction disorder as a means to
recovery. These support groups play an important role in
recovery by helping individuals to be honest with themselves
and peers, by holding them accountable to their behaviors in a
supportive atmosphere. Support recovery groups offer group
support, sponsorship, and structured programs, which are
not available in clinical setups. Treatment focuses on helping
the individual control his or her problematic sexual behaviors,
as well as to learn new coping strategies. Some of the self-help
programs for sexual addiction disorder are Sex and Love
Addicts Anonymous, Sex Addicts Anonymous, Sexaholics
Anonymous, and Sexual Compulsives Anonymous.
Couples Therapy
Sexual addiction can affect the partners adversely. The effects
can be severe and may include betrayal, distrust, shame, guilt,
100
self-blame, and low self-esteem. Spouses of individuals
with sexual addiction often report feeling sad, betrayed,
traumatized, angry, and confused about whether to continue
in the relationship. Further, there may be issues related to
deficits in sexual intimacy. Addressing infidelity and learning
skills of intimacy are essential to recovery and to building a
sense of trust.20 Williams21 identified 3 stages of healing
in order for couples to recover from an affair: (a) normalizing
feelings, (b) deciding whether to recommit or quit, and
(c) rebuilding the relationship. Rebuilding relationship
involves owning responsibility for one’s problematic behav-
iors, setting and respecting boundaries, dealing with issues
of honesty, and developing reasonable expectations for the
relationship.
Pharmacological Treatment
Use of psychopharmacological drugs to treat sexual addiction
has been receiving attention in recent years. Hormones and
neurotransmitters are the physiological precursors to sexual
drive. Therefore, treatment of deviant sexual behaviors
may include hormonal agents such as antiandrogens and psy-
chotropics drugs which affect neurotransmitters.22 Given the
similarities between paraphilias and sexual addiction disor-
der, psychopharmacological medications used for the treat-
ment of paraphilias could also provide a basis for treatment
of the sexual addiction, as both types of disorders involve
sexual behavior that is out of control. Some reports indicate
the utility of topiramate, naltrexone, serotonin reuptake
inhibitors, citalopram, leuprolide acetate, nefazodone, clo-
mipramine, and valproic acid.19 A review on the pharmaco-
therapy of sexually compulsive behavior highlights that the
frequently used drugs are selective serotonin reuptake inhibi-
tors, medroxyprogesterone acetate, cyproterone acetate, and
luteinizing hormone-releasing hormone.23
Critical Evaluation
Due to dearth of research and available literature, sexual
addiction disorder has continued to remain a misunderstood
and underdiagnosed condition. It is still uncertain if sexual
addiction/hypersexuality is an addiction or an impulse control
disorder or a compulsive disorder. Researchers have been
using these terminologies interchangeably when describing
the problem. Another problem faced by the researchers is to
differentiate between strong sexual drive and sexual addic-
tion. While, it is generally accepted that socio-occupational
dysfunction and distress are important indicators of mental
disorders, therapists need to be mindful of the religious, cul-
tural, or moral values of the client, mismatch of sexual drive
between the partners, and stigma or negative attitude toward
sexual behaviors, as these may be the source of guilt, shame,
and anxiety in the client. Because of lack of generally
accepted diagnostic definition, it is easy for therapists to
Journal of Psychosexual Health 4(2)
overlook nuances of the disorder. Despite recent efforts
to understand the phenomenon, there is a huge research gap
in the area of sexual addiction disorder. For instance, associ-
ation between sexual addiction and endocrine dysfunction
or other medical conditions is an unexplored area. For a com-
prehensive understanding of the disorder, there needs to be
rigorous research addressing issues in the areas of nosology,
epidemiology, genetics, and neurobiology. Therefore, it is
important that budding researchers take a keen interest and
generate knowledge, which is supported through empirical
studies using strong research methods.
Conclusion
Sexual addiction disorder often commonly referred to as
sexual addiction, hypersexuality, or compulsive sexual
behavior, can have adverse consequences which include
personal distress, guilt, and shame. Quite often, the patient
may not seek help fearing stigma, or due to shame. However,
recent research suggests that a large proportion of the popula-
tion, majority of whom may be males, is suffering from it.
Sexual addiction disorder often presents with comorbid
disorders such as anxiety, mood disorders, substance use
disorders, ADHD, and so on, further emphasizing the psycho-
logical distress an individual is likely to experience. Several
etiological hypotheses have been postulated to conceptualize
sexual addiction disorder based on the models of obses-
sive-compulsive disorder, impulse control disorder, and
addictive disorder. However, a lack of empirical evidence has
resulted in the disease’s absence from the fifth edition of
Diagnostic and Statistical Manual of Mental Disorders1,
although it is now being included in the latest version of the
ICD.2 Several pharmacological and nonpharmacological
interventions have been discussed in treatment and manage-
ment of sexual addiction disorder. However, more random-
ized controlled trials are warranted in order to establish clear
guidelines for treatment. Further, the need of the hour is to
raise awareness of the condition with an aim to remove stigma
and shame associated with it, so that individuals who are suf-
fering from it may seek timely help. Another need of the hour
is to train mental health professionals in identifying, assess-
ing, and managing these conditions successfully.
Acknowledgments
We appreciate all who helped us in this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, author-
ship, and/or publication of this article.
Sahithya and Kashyap
ORCID iD
B. R. Sahithya https://orcid.org/0000-0002-9234-1552
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