Compulsive sexual behaviour with secondary depression: A case report

Compulsive sexual behaviour (CSB) is characterized by repetitive and intense pre-occupation with sexual thoughts, urges, and behaviours causing clinically significant distress or impairment in occupational, interpersonal, or social domains of functioning. It has also been called by other names such as sexual addiction, sexual compulsivity, and hypersexuality. The estimated prevalence of CSB ranges from 3% to 6% in the general adult population of the United States. We present the case of a 23 year old male patient, studied b.Tech with a 3 year history of persistent pornography viewing and compulsive masturbation. He developed sexual thoughts on seeing all females, ideas of guilt, fearfulness and suicidal ideation since 3 months with failure to resist impulses and fantasies with accompanying intense distress. Because of these thoughts his socio occupational life impaired. Family history of parents being separated, Father was an alcoholic, and never took family responsibilities. Mental state examination shows sad mood, congruent with affect, preoccupation with sexual thoughts, ideas of worthlessness and helplessness, suicidal ideations and had no perceptual disturbances. A diagnosis of compulsive sexual behaviours and mild depressive episode was made because patient met criteria according to ICD 10 and proposed ICD 11. He was started on tablet fluoxetine 20mg and went up to 40mg. With this treatment there was reduction in frequency of sexual thoughts and suicidal ideations were reduced. Considering its low prevalence and no specific diagnostic criteria, careful evaluation, diagnosis and management of such clinical cases should be undertaken.