Assessment Methods and Management of Hypersexuality and Paraphilic Disorders

Daniel Turner; Daniel Schöttle; John Bradford; Peer Briken


Curr Opin Psychiatry. 2014;27(6):413-422. 

In This Article


Although the DSM-5 has introduced some important innovations, many unresolved issues persist, especially concerning the noninclusion of hypersexual disorder into the DSM as well as the inconsistent conceptualization of paraphilic disorders. Nevertheless, currently applied assessment instruments seem to validly evaluate constructs of hypersexual behavior (SCS and HBI). However, concerning the conceptualization and assessment of hypersexual disorders (HDSI) based on the DSM-5 criteria, more research is needed for clarifying the importance of the raised concerns. Concerning the assessment of paraphilic disorders and especially pedophilic disorder, mental healthcare providers could additionally consider applying the described implicit measures. Although the studies included in the present review suggested that GnRH agonists could be a useful addition to psychotherapeutic treatment in paraphilic sexual offenders, the recently published meta-analyses found no or only very small treatment effects for psychotherapy as well as pharmacotherapy.[58–60] This should, however, not lead to pessimism. Even in high-risk paraphilic and hypersexual offenders, multimodal approaches may lead to a decrease in the propensity to reoffend over time.[61]