Hypersexual Disorder Screening Inventory Research Articles

(PM-18) EXPLORING THE CONNECTIONS BETWEEN HYPERSEXUALITY AND SEX HORMONE: A PRELIMINARY STUDY IN BRAZILIAN MEN

Abstract Introduction Compulsive sexual behavior disorder (CSBD) or hypersexual behavior has gained global attention due to its adverse impact on health. However, there is just a few data on sex hormones of people reporting CSBD/hypersexual behavior. Objective Here, we investigate correlations between CSBD/hypersexual behavior and sex hormone in a sample of 34 Brazilian men who met the diagnostic criteria for CSBD/hypersexual disorder. Methods After ethical approval, participants provided informed consent and were assessed through the Instrument of Investigation of CSBD Diagnostic Criteria – ICD11, Hypersexual Disorder Screening Inventory (HDSI), Compulsive Sexual Behavior Inventory (CSBI), Sexual Compulsivity Scale (SCS), and Childhood Trauma Questionnaire (CTQ). Additionally, participants' basal blood levels were evaluated. Results The sample had a mean age of 38.2 years (SD ± 10.05). The median hormone levels of total testosterone 484 ng/dL [356;560], free testosterone 372 pmol/L [285;472], prolactin 9.50 ng/mL [8.30;13.4], estradiol 23.9 pg/mL [23.9;27.5], SHBG 26.7 nmol/L [21.8;33.5], FSH 4.10 IU/L [2.8;5.3], and LH 2.90 IU/L [2.18;3.85]. Mean scores for HDSI, CSBI, SCS, and CTQ were 23.2 (SD ± 3.80), 66.3 (SD ± 8.26), 33.7 (SD ± 4.14), and 37.6 (SD ± 8.03), respectively. Spearman's correlation analyses showed a positive correlation between total with free testosterone levels (Rho: 0.87); Total testosterone levels with SHBG (Rho: 0.59); a negative correlation between total and free testosterone levels with SCS score (Rho: –0.38; Rho: –0.35, respectively); a negative correlation between LH levels and CTQ total scores (Rho: –0.63); a negative correlation between CSBI with SCS scores (Rho: –0.58). Conclusion Our data shows the first exploration between hypersexuality and sex hormones in a Brazilian men sample, supporting previous findings about a relationship of testosterone levels with SCS scores in hypersexual individuals. Financing FAPESP.

High Plasma Oxytocin Levels in Men With Hypersexual Disorder.

ContextHypersexual disorder (HD) involves excessive, persistent sexual behaviors related to various mood states and the diagnosis compulsive sexual behavior disorder is included as an impulse control disorder in the 11th revision of the International Classification of Diseases. Although the neurobiology behind the disorder is not clear, some studies suggest dysregulated hypothalamic-pituitary-adrenal axis. Oxytocin acts as counterregulatory neuroendocrine hormone to cortisol and is also involved in sexual behavior.ObjectiveWe hypothesized that oxytocin may play a role in the pathophysiology of HD with compensatory actions to cortisol.DesignLongitudinal.SettingANOVA clinic (Karolinska University Hospital).Patients or other participants64 males with HD and 38 age-matched healthy volunteers.Main Outcome MeasuresPlasma oxytocin levels, measured with radioimmunoassay; Hypersexual Disorder Screening Inventory; and Hypersexual Disorder: Current Assessment Scale for assessing hypersexual symptoms.InterventionsA patient subgroup (n = 30) completed the manual-based group-administered cognitive-behavioral therapy (CBT) program for HD, and posttreatment oxytocin levels were measured.ResultsHypersexual men (n = 64) exhibited significantly higher oxytocin plasma levels (mean ± SD: 31.0 ± 9.9 pM) compared with healthy volunteers (16.9 ± 3.9 pM; P < 0.001). There were significant positive correlations between oxytocin levels and the rating scales measuring hypersexual behavior. Patients who completed CBT treatment (n = 30) had a significant reduction of oxytocin plasma levels from pretreatment (30.5 ± 10.1 pM) to posttreatment (20.2 ± 8.0 pM; P < 0.001).ConclusionsThe results suggest that the hyperactive oxytocinergic system in hypersexual men may be a compensatory mechanism to attenuate hyperactive stress.

Deviance or Normalcy? The Relationship Among Paraphilic Thoughts and Behaviors, Hypersexuality, and Psychopathology in a Sample of University Students

IntroductionThe actual definitions of paraphilic thoughts or behaviors and hypersexuality are still a matter of debate in the scientific community, and few studies have evaluated their psychopathological correlates in non-clinical samples of both men and women. AimThis study aimed at shedding light on the gender differences in terms of frequency of paraphilic fantasies and behaviors, and the relationship among paraphilias, hypersexuality, and general psychopathology. MethodsA sample of 775 university students (243 men, 532 women) was recruited from 6 Italian universities using questionnaires posted in social networks. Paraphilic behaviors, fantasies, and masturbation during these fantasies were evaluated, as well as hypersexuality, psychopathological correlates, self-perceived gender identity, and a history of adverse childhood conditions. Main Outcome MeasuresParticipants were assessed on the presence of paraphilic fantasies, behaviors, and masturbation related to paraphilic thoughts, and evaluated by means of the Symptom Checklist 90-Revised, the Hypersexual Disorder Screening Inventory, the International Index of Erectile Function, the Female Sexual Function Index, the Gender Identity/Gender Dysphoria Questionnaire, and the Childhood Experience of Care and Abuse Questionnaire. ResultsIn the present survey, 50.6% of the men and 41.5% of the women reported at least 1 behavior considered paraphilic. A gender difference in the prevalence of the main paraphilic interests and behaviors was observed, with men reporting a higher prevalence of voyeurism, exhibitionism, sadism, and frotteurism, and a higher prevalence of fetishism and masochism in women. Both general psychopathology and sexual dysfunctions were associated with hypersexuality, rather than with the content of sexual fantasies. Finally, an association between childhood adversities and hypersexuality was found in women but not in men. Clinical ImplicationsUnderstanding the psychopathological correlates of paraphilic fantasies/behaviors and hypersexuality may allow clinicians to develop specific psychological and pharmacological interventions. Strengths & LimitationsThis is one of the few studies assessing paraphilic phenomenology and psychopathological correlates of hypersexuality in a non-clinical sample of both men and women. ConclusionThe results seem to demonstrate that paraphilic thoughts and behaviors are not really a deviation from normalcy, rather they are quite widespread in the young population, and the distinction between healthy and pathological sexual interests may be better replaced by an all-encompassing approach considering ego-dystonic sexuality, hypersexuality, and their psychopathological correlates.Castellini G, Rellini AH, Appignanesi C, et al. Deviance or Normalcy? The Relationship Among Paraphilic Thoughts and Behaviors, Hypersexuality, and Psychopathology in a Sample of University Students. J Sex Med 2018;15:1322–1335.

114 A Network Approach to Hypersexuality: Insights and Clinical Implications

In spite of a growing interest in research on hypersexuality, consensus about its etiology and best treatment strategy has not been achieved. This study furthers the empirical and clinical understanding of hypersexuality by exploring the structure of its symptoms using a novel network analytic approach. In 2014, an online survey advertised as focusing on Internet pornography, sexual health and relationships was carried out among Croatian men and women aged 18-60 years (Mage = 31.1, SD = 9.67). In a sample of 3,028 participants, we estimated and plotted regularized partial correlation networks by gender to explore the structure of hypersexuality. Network nodes represented hypersexuality symptoms and associated sexual behaviors (i.e., items from the Hypersexual Disorder Screening Inventory, the Hypersexual Behavioral Consequences Scale, as well as indicators of sexual desire, pornography use, sexual intercourse and masturbation frequency). Four research questions were addressed: (1) Does the hypersexuality network differ between genders; (2) which symptoms are centrally positioned; (3) what is the topological location of pornography use; and (4) are there distinct clusters (“communities”) of symptoms in the network?

A Network Approach to Hypersexuality: Insights and Clinical Implications

BackgroundIn spite of a growing interest in research on hypersexuality, consensus about its etiology and best treatment strategy has not been achieved. AimTo further the empirical and clinical understanding of hypersexuality by exploring the structure of its symptoms using a network analytic approach. MethodsIn 2014, an online survey advertised as focusing on Internet pornography, sexual health, and relationships was carried out among Croatian men and women aged 18–60 years (Mage = 31.1 years, SD = 9.67). In a sample of 3,028 participants, we applied a network analytic approach to explore the structure of hypersexuality symptoms. In the network, nodes represented hypersexuality symptoms and associated sexual behaviors, while their connections were operationalized as partial correlations. 4 Research questions were addressed: (1) does the hypersexuality network differ between genders; (2) which symptoms are centrally positioned; (3) what is the topological location of pornography use; and (4) are there distinct clusters (“communities”) of symptoms in the network? OutcomesWe estimated and plotted hypersexuality networks by gender using items from the Hypersexual Disorder Screening Inventory and the Hypersexual Behavioral Consequences Scale, as well as indicators of sexual desire, pornography use, sexual intercourse, and masturbation frequency. ResultsThe structure of the hypersexuality network was surprisingly similar in women and men, both in terms of symptom centrality and the clustering of symptoms. Psychological distress and negative emotions triggered by sexual fantasies and/or behaviors, together with a loss of control over sexual feelings, occupied central positions in the networks. Pornography use was located peripherally in both the men’s and women’s hypersexuality networks. Clinical TranslationPsychological distress and negative emotions triggered by sexual fantasies and/or behaviors constituted the core of the hypersexuality network, which makes them potential prime targets for clinical intervention and calls for normalization of (presumably self-stigmatized) sexual expression through affirmative therapy and interventions that enhance self-care, self-compassion, and adaptive coping mechanisms. Strengths & LimitationsThis is the first network analytic approach to hypersexuality. Apart from its novel insights about the structure of hypersexuality, the study employed several methods to assure reliability and robustness of findings. Considering that networks were estimated in a convenience-based community sample, the findings might not generalize to clinically distressed individuals. ConclusionOur results demonstrate the usefulness of network analytics to hypersexuality in a non-clinical sample and we encourage future clinical and longitudinal explorations of hypersexuality using this novel approach.Werner M, Štulhofer A, Waldorp L, et al. A Network Approach to Hypersexuality: Insights and Clinical Implications. J Sex Med 2018;15:373–386.

Hypersexual Disorder According to the Hypersexual Disorder Screening Inventory in Help-Seeking Swedish Men and Women With Self-Identified Hypersexual Behavior.

IntroductionThe Hypersexual Disorder Screening Inventory (HDSI) was developed by the American Psychiatric Association for clinical screening of hypersexual disorder (HD).AimsTo examine the distribution of the proposed diagnostic entity HD according to the HDSI in a sample of men and women seeking help for problematic hypersexuality and evaluate some psychometric properties.MethodsData on sociodemographics, the HDSI, the Sexual Compulsivity Scale (SCS), and the Cognitive and Behavioral Outcomes of Sexual Behavior were collected online from 16 women and 64 men who self-identified as hypersexual. Respondents were recruited by advertisements offering psychological treatment for hypersexual behavior.Main Outcome MeasuresThe HDSI, covering the proposed criteria for HD.ResultsOf the entire sample, 50% fulfilled the criteria for HD. Compared with men, women scored higher on the HDSI, engaged more often in risky sexual behavior, and worried more about physical injuries and pain. Men primarily used pornography, whereas women had sexual encounters. The HD group reported a larger number of sexual specifiers, higher scores on the SCS, more negative effects of sexual behavior, and more concerns about consequences compared with the non-HD group. Sociodemographics had no influence on HD. The HDSI’s core diagnostic criteria showed high internal reliability for men (α = 0.80) and women (α = 0.81). A moderate correlation between the HDSI and the SCS was found (0.51). The vast majority of the entire sample (76 of 80, 95%) fulfilled the criteria for sexual compulsivity according to the SCS.ConclusionThe HDSI could be used as a screening tool for HD, although further explorations of the empirical implications regarding criteria are needed, as are refinements of cutoff scores and specific sexual behaviors. Hypersexual problematic behavior causes distress and impairment and, although not included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, HD should be endorsed as a diagnosis to develop evidence-based treatment and future studies on its etiology.Öberg KG, Hallberg J, Kaldo V, et al. Hypersexual Disorder According to the Hypersexual Disorder Screening Inventory in Help-Seeking Swedish Men and Women With Self-Identified Hypersexual Behavior. Sex Med 2017;5:e229–e236.

A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study

BackgroundThe proposed criteria of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition for hypersexual disorder (HD) included symptoms reported by patients seeking help for excessive and out-of-control non-paraphilic sexual behavior, including sexual behaviors in response to dysphoric mood states, impulsivity, and risk taking. Although no prior studies of cognitive-behavioral therapy (CBT) for the treatment of HD have been performed, CBT has been found effective for dysphoric mood states and impulsivity. AimTo investigate the feasibility of a CBT manual developed for HD explored through symptom decrease, treatment attendance, and clients’ treatment satisfaction. MethodsTen men with a diagnosis of HD took part in the CBT group program. Measurements were taken before, during, and at the end of treatment and 3 and 6 months after treatment. OutcomesThe primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS) score that measured the severity of problematic hypersexual symptoms and secondary outcomes were the Hypersexual Disorder Screening Inventory (HDSI) score, the proportion of attended sessions, and the Client Satisfaction Questionnaire (CSQ-8) score. ResultsMain results were significant decreases of HD symptoms from before to after treatment on HD:CAS and HDSI scores and a decrease in the number of problematic sexual behaviors during the course of therapy. A high attendance rate of 93% and a high treatment satisfaction score on CSQ-8 also were found. Clinical ImplicationsThe CBT program seemed to ameliorate the symptoms of HD and therefore might be a feasible treatment option. Strengths and LimitationsThis study provides data from a CBT program for the treatment of the specific proposed criteria of HD. Because of the small sample and lack of a control group, the results can be considered only preliminary. ConclusionAlthough participants reported decreased HD symptoms after attending the CBT program, future studies should evaluate the treatment program with a larger sample and a randomized controlled procedure to ensure treatment effectiveness.Hallberg J, Kaldo V, Arver S, et al. A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study. J Sex Med 2017;14:950–958.

Conceptualization and Assessment of Hypersexual Disorder: ASystematic Review of the Literature.

Despite the rejection of hypersexual disorder (HD) as a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), clinical and research interest in HD continues. To systematically review the existing scientific literature on the conceptualization and assessment of HD and out-of-control sexual behavior. Studies were identified from PsychInfo, PubMed, JSTOR, Google Scholar, and Scholar's Portal using an exhaustive list of key terms. Of 299 total articles identified and screened, 252 were excluded, and 47 are included in this review. To review two categories of articles: HD conceptualization and HD psychometric assessment. First, results of the review of theoretical conceptualizations of HD reflected a large proportion of the peer-reviewed literature devoted to discussing conceptualizations of HD without reaching consensus. Second, results of the review of HD psychometric assessments were analyzed using Hunsley and Mash's (2008) criteria to evaluate psychometric adequacy of evidence-based assessment measurements. The six most researched measurements of HD were evaluated, including the Hypersexual Disorder Screening Inventory, the Hypersexual Behavior Inventory, the Sexual Compulsivity Scale, the Sexual Addiction Screening Test, the Sexual Addiction Screening Test-Revised, and the Compulsive Sexual Behavior Inventory. Psychometric properties of the scales are reviewed, evaluated, and discussed. The Hypersexual Disorder Screening Inventory, the measurement proposed for the clinical screening of HD by the DSM-5 workgroup, currently has the strongest psychometric support. Future researchand clinical directions are discussed in light of findings after the literature review and synthesis. Montgomery-Graham S. Conceptualization and Assessment of Hypersexual Disorder: ASystematic Review of the Literature. Sex Med Rev 2017;5:146-162.

Is High Sexual Desire a Risk for Women’s Relationship and Sexual Well-Being?

Historically, women’s sexual desire has been deemed socially problematic. The growing popularity of the concept of hypersexuality—which lists high sexual desire among its core components—poses a risk of re-pathologizing female sexual desire. Data from a 2014 online survey of 2,599 Croatian women aged 18–60 years was used to examine whether high sexual desire is detrimental to women’s relationship and sexual well-being. Based on the highest scores on an indicator of sexual desire, 178 women were classified in the high sexual desire (HSD) group; women who scored higher than one standard deviation above the Hypersexual Disorder Screening Inventory mean were categorized in the hypersexuality (HYP) group (n = 239). Fifty-seven women met the classification criteria for both groups (HYP&HSD). Compared to other groups, the HSD was the most sexually active group. Compared to controls, the HYP and HYP&HSD groups—but not the HSD group—reported significantly more negative consequences associated with their sexuality. Compared to the HYP group, women with HSD reported better sexual function, higher sexual satisfaction, and lower odds of negative behavioral consequences. The findings suggest that, at least among women, hypersexuality should not be conflated with high sexual desire and frequent sexual activity.

Is High Sexual Desire a Facet of Male Hypersexuality? Results from an Online Study

Despite a growing number of studies, hypersexuality remains controversial and empirically elusive. Using a group comparison approach, this study revisited the claim that hypersexuality cannot be reliably distinguished from high sexual desire. An online survey, advertised as focusing on pornography use and sexual health, was carried out in 2014 among 1,998 Croatian men aged 18 to 60 years (Mage = 34.7, SD = 9.83). Membership in the hypersexuality group (HYP; n = 57) was determined using the Hypersexual Disorder Screening Inventory and the Hypersexual Behavior Consequences Scale. The highest values on two indicators of sexual desire/interest set membership in the high sexual desire group (HSD; n = 70). The overlap between the groups was negligible (n = 4). Compared to the rest of the sample, men in the HYP group had significantly higher odds of being single, not exclusively heterosexual, religious, depressed, prone to sexual boredom, experiencing substance abuse consequences, holding negative attitudes toward pornography use, and evaluating one's sexual morality more negatively. In contrast, the HSD group differed from controls only in reporting more positive attitudes toward pornography use. The study findings point to a distinct phenomenology of HSD and HYP in men. Clinical implications of the findings are briefly discussed.

Erectile Dysfunction, Boredom, and Hypersexuality among Coupled Men from Two European Countries.

Much of the research on the association between erectile dysfunction (ED) and possible clinical relevant hypersexuality up to now has been only descriptive in nature. The present study aimed to explore the relationships among hypersexuality, ED, and sexual boredom in a sample of coupled community men. An Internet-based survey was conducted in two European countries. The sample included 911 Croatian and 210 German coupled men. The survey comprised the Hypersexual Disorder Screening Inventory, the International Index of Erectile Function and the Sexual Boredom Scale. Poisson regression analysis was used to examine how ED, solitary sexual activities and sexual boredom were associated with hypersexuality. Among Croatian and German men, hypersexuality was significantly correlated with proneness to sexual boredom and more problems with erectile function. In some men, hypersexual behavior may serve as a coping mechanism for sexual fantasy poverty-associated boredom. In addition, ED within an intimate relationship can accompany this simultaneously.

An item response theory analysis of the sexual compulsivity scale and its correspondence with the hypersexual disorder screening inventory among a sample of highly sexually active gay and bisexual men.

Numerous scales and assessments are available to assess sexual compulsivity (SC). This study sought to conduct an item response theory (IRT) analysis of the Sexual Compulsivity Scale (SCS) to provide evidence about its measurement precision at the various levels of the SC construct in a sample of highly sexually active gay and bisexual men (GBM). SCS data from a sample of 202 GBM who are highly sexually active but who vary in their experiences of SC symptoms were modeled using Samejima's polytomous graded response IRT model. To describe the performance of the SCS relative to the Hypersexual Disorder Screening Inventory (HDSI), SCS scores were compared with participants' corresponding HDSI results to determine sensitivity, specificity, positive and negative predictive values, and accuracy. This study examined the correspondence between the SCS and the HDSI, a diagnostic instrument for the screening of hypersexuality. IRT analyses indicated that, although two of the SCS items had low reliability, the SCS as a whole was reliable across much of the SC continuum. Scores on the SCS and the HDSI were highly correlated; however, no potential cutoffs on the SCS corresponded strongly with the polythetic scoring criteria of the HDSI. Comparisons of SCS scores with HDSI results indicated that the SCS itself could not serve as a substitute for the HDSI and would incorrectly classify a substantial number of individuals' levels of hypersexuality. However, the SCS could be a useful screening tool to provide a preliminary screening of people at risk for meeting criteria on the HDSI. Combining the SCS and the HDSI may be an appropriate evaluation strategy in classifying GBM as negative on both (i.e., "non-hypersexual/non-SC"), positive on the SCS only (i.e., "at risk"), and positive on both the SCS and the HDSI (i.e., "problematic hypersexuality/SC").

Sexual Compulsivity Scale, Compulsive Sexual Behavior Inventory, and Hypersexual Disorder Screening Inventory: Translation, Adaptation, and Validation for Use in Brazil.

Epidemiological, behavioral, and clinical data on sexual compulsivity in Brazil are very limited. This study sought to adapt and validate the Sexual Compulsivity Scale (SCS), the 22-item version of the Compulsive Sexual Behavior Inventory (CSBI-22), and the Hypersexual Disorder Screening Inventory (HDSI) for use in Brazil. A total of 153 participants underwent psychiatric assessment and completed self-reported measures. The adaptation process of the instruments from English to Portuguese followed the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. The reliability and validity of the HDSI criteria were evaluated and the construct validity of all measures was examined. For the SCS and HDSI, factor analysis revealed one factor for each measure. For the CSBI-22, four factors were retained although we only calculated the scores of two factors (control and violence). All scores had good internal consistency (alpha >.75), presented high temporal stability (>.76), discriminated between patients and controls, and presented strong (ρ>.81) correlations with the Sexual Addiction Screening Test (except for the violence domain=.40) and moderate correlations with the Impulsive Sensation Seeking domain of the Zuckerman Kuhlman Personality Questionnaire (ρ between .43 and .55). The sensitivity of the HDSI was 71.93% and the specificity was 100%. All measures showed very good psychometric properties. The SCS, the HDSI, and the control domain of the CSBI-22 seemed to measure theoretically similar constructs, as they were highly correlated (ρ>.85). The findings support the conceptualization of hypersexuality as a cluster of problematic symptoms that are highly consistent across a variety of measures.

A psychometric investigation of the hypersexual disorder screening inventory among highly sexually active gay and bisexual men: an item response theory analysis.

The Hypersexual Disorder Screening Inventory (HDSI) was designed as an instrument for the screening of hypersexuality by the American Psychiatric Association's taskforce for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Our study sought to conduct a psychometric analysis of the HDSI, including an investigation of its underlying structure and reliability utilizing item response theory (IRT) modeling, and an examination of its polythetic scoring criteria in comparison to a standard dimensionally based cutoff score. We examined a diverse group of 202 highly sexually active gay and bisexual men in New York City. We conducted psychometric analyses of the HDSI, including both confirmatory factor analysis of its structure and IRT analysis of the item and scale reliabilities. We utilized the HDSI. The HDSI adequately fit a single-factor solution, although there was evidence that two of the items may measure a second factor that taps into sex as a form of coping. The scale showed evidence of strong reliability across much of the continuum of hypersexuality, and results suggested that, in addition to the proposed polythetic scoring criteria, a cutoff score of 20 on the severity index might be used for preliminary classification of HD. The HDSI was found to be highly reliable, and results suggested that a unidimensional, quantitative conception of hypersexuality with a clinically relevant cutoff score may be more appropriate than a qualitative syndrome comprised of multiple distinct clusters of problems. However, we also found preliminary evidence that three clusters of symptoms may constitute an HD syndrome as opposed to the two clusters initially proposed. Future research is needed to determine which of these issues are characteristic of the hypersexuality and HD constructs themselves and which are more likely to be methodological artifacts of the HDSI.

An Indian Study of Hypersexual Disorder in Patients with Anxiety and Mood Disorders

Hypersexuality is characterized by repetitive and intense preoccupation with sexual thoughts, urges, and behaviors that lead to clinically significant distress or impairment in socio-occupational functioning of the affected individual. Although hypersexuality is commonly associated with mania, interestingly studies have reported hypersexuality in persons suffering from depression and anxiety disorders. This study assessed the presence of hypersexual disorder (HD) and type of hypersexual behavior in diagnosed cases of mood and anxiety disorder. Ninety-three patients having mood and anxiety disorders were assessed once for hypersexuality at any time in their life using the Hypersexual Disorder Screening Inventory (HDSI) and Hypersexual Disorder: Current Assessment Scale (HD: CAS). On HDSI, 25% of patients having a mood and/or anxiety disorder screened positive for HD. The most common sexual behavior in these patients was consensual sex with adults. Those screening positive for HD were assessed for their most recent 2-week symptom severity, and most patients had mild symptom severity. This study points toward hypersexual disorder being a separate diagnostic entity and being prevalent in patients with depression and anxiety disorder too.