Weekly Mind Reader: Treating OCD and Compulsive Sexual Behavior

by Denis Storey
February 16, 2024 at 10:52 AM UTC

The Primary Care Companion for CNS Disorders published a paper that suggests the use of trait mindfulness-based interventions might help reduce anxiety levels in students who present with severe problematic social media use.

Primary Care Companion just published a report that illustrates a unique case of concomitant OCD and compulsive sexual behavior treated with sertraline and naltrexone.

Treatment of OCD With Concomitant Compulsive Sexual Behavior

Contrary to popular belief, compulsive sexual behavior disorder is not classified within the obsessive-compulsive spectrum disorders but rather as an impulse control disorder.

Compulsive sexual behavior disorder is classified under impulse control disorders in ICD-11, rather than within obsessive-compulsive spectrum disorders. While the placement of this disorder in DSM-5 is unclear, there’s the exploration of its co-occurrence with OCD, with rates estimated around 5%-14%. Research suggests positive outcomes with naltrexone treatment for compulsive sexual behavior (CSB), although its efficacy for OCD spectrum symptoms is limited.

A case report details a 58-year-old man with moderate OCD and chronic CSB. Sertraline effectively reduced his OCD symptoms but had no impact on CSB. Naltrexone was added, resulting in significant improvement in CSB while maintaining stable OCD symptoms. Withdrawal and subsequent reinstatement of naltrexone demonstrated its efficacy in controlling CSB.

This case prompts consideration for the classification of dysfunctional sexual behaviors, which exhibit compulsive traits distinct from OCD compulsions, involve some pleasure, and vary in treatment response. Impulse control disorder or addictive disorder categories might better characterize these behaviors, especially considering the positive response to naltrexone.


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