Paraphilic Disorder in a Male Patient with Autism Spectrum Disorder: Incidence or Coincidence

Bishoy Kolta,Garrett Rossi

doi:10.7759/cureus.2639

Abstract

Paraphilic disorder in patients with autism spectrum disorder (ASD) can be extremely disturbing to both the patient and caretakers. It can interfere with these patient’s ability to develop social skills, which are essential for adaptation, and function within society. This case report details the history of an 18-year-old male patient previously diagnosed with Asperger’s syndrome, who also exhibited symptoms consistent with paraphilic disorder. A review of the literature was then conducted to determine if there is any documented association of paraphilic disorder, or abnormal sexual behavior in patients with ASD. Several case reports involving patients with ASD, and co-morbid paraphilic disorder have been described in the literature. ASD appears to be associated with paraphilic disorder.

Highlights

The Diagnostic and Statistical Manual fifth edition (DSM-5) describes paraphilia as recurrent, and intense sexually arousing fantasies, sexual urges, or behavior that occurs over a period of six months causing clinically significant distress, impairment in social, occupational, or other important areas of function [1]
We report the case of an 18-year-old male patient diagnosed with autism spectrum disorder (ASD), who exhibited paraphilic behavior and fantasies
The study revealed that 24% of high-functioning individuals with ASD engaged in paraphilic sexual fantasies or behaviors including classic presentations of paraphilic disorder such as pedophilia, voyeurism, and sadomasochism [5]

Summary

Introduction

The Diagnostic and Statistical Manual fifth edition (DSM-5) describes paraphilia as recurrent, and intense sexually arousing fantasies, sexual urges, or behavior that occurs over a period of six months causing clinically significant distress, impairment in social, occupational, or other important areas of function [1]. The patient's second and most severe suicide attempt occurred a few weeks prior to his presentation at the psychiatric emergency service, after having a violent sexual fantasy in which he "had sex with a girl and cut off her head." The patient was deeply disturbed by this fantasy, and he experienced intense fear, anxiety and guilt as a result. On psychiatric review of symptoms, the patient endorsed the following neurovegetative symptoms of depression including poor sleep, a recent loss of interest, difficulty concentrating, guilt over a recent sexual fantasy and his perceived inability to socialize like his peers He denied loss of energy, change in appetite, How to cite this article Kolta B, Rossi G (May 16, 2018) Paraphilic Disorder in a Male Patient with Autism Spectrum Disorder: Incidence or Coincidence.

Discussion

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Disclosures

Müller JL