Bret S. Stetka, MD; Christoph U. Correll, MD


May 21, 2013

In This Article

Paraphilias and Paraphilic Disorders

The Change

Additional changes in DSM-5 include a rethinking of paraphilic disorders. While their diagnostic criteria remain unchanged from DSM-IV, the updated manual distinguishes between paraphilic behaviors, or paraphilias, and paraphilic disorders. A paraphilic disorder is a "paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others."

The Implications

The new approach to paraphilias demedicalizes and destigmatizes unusual sexual preferences and behaviors, provided they are not distressing or detrimental to one's self or others. Clinicians are tasked with determining whether a behavior qualifies as a disorder, based on a thorough history provided by both the patient and qualified informants.