Sexual Addiction

To systematically assess the evidence for an association between sexual abuse and a lifetime diagnosis of psychiatric disorders.|We performed a comprehensive search (from January 1980-December 2008, all age groups, any language, any population) of 9 databases: MEDLINE, EMBASE, CINAHL, Current Contents, PsycINFO, ACP Journal Club, CCTR, CDSR, and DARE. Controlled vocabulary supplemented with keywords was used to define the concept areas of sexual abuse and psychiatric disorders and was limited to epidemiological studies. Six independent reviewers extracted descriptive, quality, and outcome data from eligible longitudinal studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled across studies by using the random-effects model. The I(2) statistic was used to assess heterogeneity.|The search yielded 37 eligible studies, 17 case-control and 20 cohort, with 3,162,318 participants. There was a statistically significant association between sexual abuse and a lifetime

OCD is a clinically heterogeneous condition. This heterogeneity has the potential to reduce power in genetic, neuroimaging, and clinical trials. Despite a mounting number of studies, there remains debate regarding the exact factor structure of OCD symptoms. The authors conducted a meta-analysis to determine the factor structure of the Yale-Brown Obsessive Compulsive Scale Symptom Checklist.|Studies were included if they involved subjects with OCD and included an exploratory factor analysis of the 13 Yale-Brown Obsessive Compulsive Scale Symptom Checklist categories or the items therein. A varimax-rotation was conducted in SAS 9.1 using the PROC FACTOR CORR to extract factors from sample-size weighted co-occurrence matrices. Stratified meta-analysis was conducted to determine the factor structure of OCD in studies involving children and adults separately.|Twenty-one studies involving 5,124 participants were included. The four factors generated were 1) symmetry: symmetry obsessions and

Existing data suggest a genetic association between the met(158) allele of catechol-O-methyltransferase (COMT) and obsessive-compulsive disorder (OCD). However, the results are inconclusive and complicated by possible gender differences. We sought to resolve the question in two ways. First, we carried out a new case-control study in 87 adults with OCD and 327 healthy comparison subjects. The study replicated reports of an increased met(158) allele frequency in men with OCD (odds ratio (OR)=1.91, 95% confidence interval (CI) 1.07-3.40, P=0.026), with no effect in women (OR=1.13, 95% CI 0.74-1.72, P=0.56). Second, we performed a meta-analysis of all published case-control data (n=1908 subjects). This revealed an association of COMT met(158) with OCD (OR=1.23, 95% CI 1.06-1.42, P=0.005) and an interaction with gender (z=4.27, P<0.0001). The association between COMT met(158) and OCD was present in men (OR=1.88, 95% CI 1.45-2.44, P<0.001) but not in women (OR=0.98, 95% CI 0.78-1.22, P=0.83)

Impulse-control disorders (ICDs) are more common in clinic populations with Gilles de la Tourette syndrome (GTS) than in the general population. The clinical phenomenology of ICDs differ between men with GTS (who tend to be externally impulsive) and women with GTS (who tend to be internally impulsive). This article reviews the relevant literature to-date on impulsivity in GTS, with special focus on intermittent, explosive disorder, self-injurious behavior, trichotillomania, and impulsive-compulsive sexual behavior. The medical and legal community should be aware of the full spectrum of organically-based behaviors that may predispose patients with GTS to unwanted legal disciplinary action.

This study aimed (1) to assess the relationship of childhood sexual abuse and revictimization with 6 common mental disorders, alcohol and drug dependence, posttraumatic stress disorder, eating disorders, and suicidal behavior; (2) to test whether gender moderates the relationship between childhood sexual abuse and psychiatric comorbidity; and (3) to assess the association of childhood sexual abuse with health care service use among middle-aged and older adults.|The author conducted secondary analyses of data from a population-based, nationally representative sample of 3,493 community-dwelling adults aged 50 years and above who were interviewed in England in 2006 and 2007 as part of the 2007 Adult Psychiatric Morbidity Survey. The survey assessed childhood sexual abuse (sexual touching and sexual intercourse), sexual abuse revictimization (experiencing both childhood and adult sexual abuse), demographics, health care service use, 6 common mental disorders according to ICD-10 diagnostic

Persistent genital arousal disorder is not well known or adequately understood by physicians. The disorder is characterized by a persistent and highly unwanted state of genital arousal and orgasm-like feelings. Ghusl is an ablution in Islamic culture, which is an obligatory ritual wherein the body is washed thoroughly after exposure to religious contaminants such as sexual intercourse, menstruation, and childbirth. Muslim women suffering from the disorder may bathe frequently because of their religious beliefs. The authors summarize the case histories of 3 patients with persistent genital arousal disorder who were initially misdiagnosed with obsessive-compulsive disorder. All 3 patients presented with complaints of unwanted, persistent orgasms or orgasm-like arousals, and as a result, they performed ghusl several times a day. At previous interviews, the genital arousal was diagnosed as a sexual and somatic obsession, and repeatedly performing ghusl was considered a cleansing compulsion

Patients with obsessive-compulsive disorder (OCD) frequently show poor social adjustment, which has been associated with OCD severity. Little is known about the effects that age at symptom onset, specific OCD symptoms, and psychiatric comorbidities have on social adjustment. The objective of this study was to investigate the clinical correlates of social functioning in OCD patients.|Cross-sectional study involving 815 adults with a primary DSM-IV diagnosis of OCD participating in the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. Patients were assessed with the Social Adjustment Scale, the Medical Outcomes Study 36-item Short-Form Health Survey, the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders. Clinical correlates of social adjustment were assessed with generalized linear models with gamma distribution.|Poor overall social functioning was

Heightened moral sensitivity seems to characterize patients with obsessive-compulsive disorder (OCD). Recent advances in social cognitive neuroscience suggest that a compelling relationship may exist between this disorder-relevant processing bias and the functional activity of brain regions implicated in OCD.|To test the hypothesis that patients with OCD demonstrate an increased response of relevant ventromedial prefrontal and orbitofrontal cortex regions in a functional magnetic resonance imaging study of difficult moral decision making.|Case-control cross-sectional study.|Hospital referral OCD unit and magnetic resonance imaging facility.|Seventy-three patients with OCD (42 men and 31 women) and 73 control participants matched for age, sex, and education level.|Functional magnetic resonance imaging activation maps representing significant changes in blood oxygenation level-dependent signal in response to 24 hypothetical moral dilemma vs nondilemma task vignettes and additional