Should problematic sexual behavior be viewed under the scope of addiction? A systematic review based on DSM-5 substance use disorder criteria
Addictive Behaviors Reports. 2023-12-01; 18: 100510
DOI: 10.1016/j.abrep.2023.100510
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https://www.bordeaux-neurocampus.fr/12573
1. Addict Behav Rep. 2023 Jul 16;18:100510. doi: 10.1016/j.abrep.2023.100510.
eCollection 2023 Dec.
Should problematic sexual behavior be viewed under the scope of addiction? A
systematic review based on DSM-5 substance use disorder criteria.
Pistre N(1), Schreck B(2)(3), Grall-Bronnec M(2)(3), Fatseas M(1)(4)(5).
Author information:
(1)Department of Addictology, CHU Bordeaux, F-33000 Bordeaux, France.
(2)Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000
Nantes, France.
(3)Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in
Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France.
(4)Department of Addictology, CH Charles Perrens, F-33000 Bordeaux, France.
(5)Univ. Bordeaux, CNRS, INCIA, UMR 5287, F-33000 Bordeaux, France.
Despite similarities between compulsive sexual disorder and substance use
disorder, the issue whether problematic sexual behavior should be viewed within
an addiction framework continues to be a subject of debate with no consensus
regarding its conceptualization and diagnosis criteria. Examining the presence
of addiction criteria among clinical and no clinical samples in the existing
literature could permit to ascertain clinical validity of sex addiction
diagnosis and support its overlapping feature with other addictive disorders.
The aim of this systematic review was to examine this issue by assessing DSM-5
criteria of substance use disorder among individuals engaged in problematic
sexual activity. Methods: Using PRISMA criteria, three databases were
comprehensively searched up to April 2022, in order to identify all candidate
studies based on broad key words. Resulting studies were then selected if they
examined problematic sexual behavior within the framework of DSM-5 addiction
criteria. Results: Twenty articles matched the selection criteria and were
included in this review. DSM-5 criteria of addictive disorders were found to be
highly prevalent among problematic sex users, particularly craving, loss of
control over sex use, and negative consequences related to sexual behavior.
Exposition to sexual cues was also shown to trigger craving, with an association
to problematic use and symptom severity. Conclusions: More studies should been
done to assess homogeneously according to the DSM-5 criteria the addiction-like
features of problematic sexual behaviors in clinical and no-clinical
populations. Furthermore, this work argues for the need of further research to
examine the extent to which anti-craving interventions could be effective in
improving clinical outcomes.
© 2023 The Authors. Published by Elsevier Ltd.
DOI: 10.1016/j.abrep.2023.100510
PMCID: PMC10374865
PMID: 37519859
Conflict of interest statement: The authors declare that they have no known
competing financial interests or personal relationships that could have appeared
to influence the work reported in this paper.