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Paraphilias in adult psychiatric inpatients

Patrick J. Marsh, MD

Department of Psychiatry, University of South Florida, Tampa, FL, USA

Brian L. Odlaug, BA

Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA

Nick Thomarios, DO

Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA

Andrew A. Davis, BS

Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA

Stephanie N. Buchanan, BS

Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA

Craig S. Meyer, BA

Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA

Jon E. Grant, JD, MD, MPH

Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA

BACKGROUND: The goal of the present study was to examine the prevalence of paraphilias in an adult inpatient psychiatric population.

METHODS: One hundred twelve consecutive, voluntarily admitted, adult male psychiatric inpatients were administered the Structured Clinical Interview for DSM-IV, Sexual Disorders Module, Male Version, to assess the rates of DSM-IV paraphilias.

RESULTS: Fifteen patients (13.4%) reported symptoms consistent with at least one lifetime DSM-IV paraphilia. The most common paraphilias were voyeurism (n = 9 [8.0%]), exhibitionism (n = 6 [5.4%]), and sexual masochism (n = 3 [2.7%]). Patients who screened positive for a paraphilia had significantly more psychiatric hospitalizations (P = .006) and, on a trend level, were more likely to have attempted suicide. In addition, patients with paraphilias were significantly more likely to report having been sexually abused than patients without a paraphilia (P = <.001). Only 2 of the 15 paraphilic patients (13.3%) carried an admission diagnosis of a paraphilia.

CONCLUSIONS: Paraphilias appear to be more common in adult male psychiatric inpatients than previously estimated. The study also demonstrated that these disorders were not screened for by the treating physician and thus may go untreated. Further, larger-scale studies are necessary in order to further examine the rates of these disorders in the general population.

KEYWORDS: paraphilia, voyeurism, sexual masochism, exhibitionism

ANNALS OF CLINICAL PSYCHIATRY 2010;22(2):129-134

CORRESPONDENCE: Patrick J. Marsh, MD University of South Florida Department of Psychiatry 3515 East Fletcher Avenue Tampa, FL 33613 USA E-MAIL: pmarsh@health.usf.edu

 
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