Distinguishing between obsessive-compulsive disorder and paraphilias or nonparaphilic sexual disorders in a young patient with sexual thoughts

Abstract

Nonparaphilic Sexual Addictions (NPSAs), characterized by repetitive sexual thoughts and behaviors, have been suggested as falling within the obsessive-compulsive spectrum disorder. In comparison to individuals with NPSAs, those with Obsessive-Compulsive Disorder (OCD) reported significantly higher levels of fear and avoidance related to their sexual thoughts. Individuals with NPSAs reported elevated levels of sexual arousal associated with their thoughts and a greater degree of sexual pleasure derived from engaging in compulsive behaviors. In the context of this article, we will examine the case of a young patient who, while undergoing various therapeutic trials with antidepressants, has recently aroused suspicion of OCD due to the heightened intensity of his obsessive thoughts, particularly in the realm of sexuality. Additionally, we will highlight, following the specialized literature, some clinical aspects that may guide us in differentiating between these two pathologies.