Despite recent strides in "sex addiction" research, the condition does not make the cut as an official psychiatric disorder, according to the American Psychiatric Association.
On Dec. 1 the APA approved the latest version of its mental health handbook known as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The manual includes several new disorders such as hoarding and binge eating.
But guidance for diagnosing and treating sex addiction, formally known as hypersexual disorder, won't be included.
Although the manual has an appendix that includes "provisional" conditions requiring further research,hypersexual disorder will not appear in this section either.
The decision comes after a study published in October in which researchers tested the proposed criteria for hypersexual disorder, and found that physicians generally agreed on who should be diagnosed with it — a demonstration of the criteria's reliability and validity.
Rory Reid, a research psychologist at the University of California, Los Angeles, who lead that study, said he was not surprised the APA did not approve hypersexual disorder for the DSM-5, because sexual disorders are generally controversial.
There are also still questions the APA may want addressed. Studies of the criteria included only people who were already seeking help for a mental condition, or were referred to a mental health clinic, Reid said. So it's not clear whether the criteria would apply in diagnosing people in the general population, he said.
In Reid's study, hypersexual disorder was defined as "recurrent and intense sexual fantasies, sexual urges, and sexual behavior," that lasted at least six months.
Diagnosis requires that these urges cause the patient distress, and aren't brought on by drugs or another mental disorder. The behavior must also interfere with their life, for instance, some patients in the study lost jobs because they could not refrain from watching pornography and masturbating at work. Developing the criteria was a significant step in the field because it will allow researchers to study the disorder in a uniform way, Reid said.
And although hypersexual disorder is not officially acknowledged in the APA's new manual, Reid said he would see little change in his day to day work.
"People are still coming into the therapist office and saying this is a problem. As a psychologist...I'm going to try to understand what's going on, I'm going to try to help them," Reid said. "That’s true whether it's in the DSM or not."
The APA did not return a request for comment in time for the publication of this article.
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