Hypersexuality in Inpatient Children and Adolescents: Recognition, Differential Diagnosis, and Evaluation

Abstract

We describe a 17-year-old girl with hypersexuality resulting from virilization, the latter a consequence of polycystic ovary syndrome, and we review the literature pertinent to hypersexuality in children and adults. Inappropriate sexual behavior (a common cause of disruption among children who are hospitalized for psychiatric disorders) may be caused either by hypersexuality or by simply ill-regulated behavior: a definition of hypersexuality is proposed that can be applied at the bedside (namely, sexual behaviors or fantasies that have abruptly increased in frequency by comparison with a previous baseline, are of sufficient excessiveness to disrupt expected or usual social, academic, or occupational functioning, or constitute a source of distress), so that this distinction can be made promptly, and we present a differential diagnosis for hypersexuality to direct its evaluation. Virilization does not seem to be a common cause of hypersexuality in children and adolescents, but it should not be overlooked when it does exist. The differential diagnosis of hypersexuality in adults, which we present for comparison, is much larger than it is in children.

Report of a Case of Steroid-Induced Psychosis and Inappropriate Sexual Behaviour in an Adolescent

“…Inappropriate sexual behaviours are defi ned as sexual behaviours that are excessively frequent (hypersexual) or normally frequent but ill-regulated (sexual actions that are not reciprocated by a person capable of autonomous consent). "Excessive" was defi ned as an extent that is unequivocally increased from a previous baseline state, is disruptive to usual or expected social, academic, or occupational functioning, or has become a source of distress in itself [ 6 ] . In the current case, the sexual behaviors were both excessively frequent (hypersexual) and ill-regulated.…”

A difficult case of satyriasis in an adolescent responding ultimately to a combination of paliperidone palmitate and naltrexone

“…Three months have elapsed, at the time of writing, and patient is keeping well on paliperidone palmitate and naltrexone with great tolerability.The working differential for oversexualized behaviors in children should include-sexual abuse, juvenile bipolar mood disorder, impulse dyscontrol (including iatrogenic, eg, aripiprazole with partial D2 agonism), poor social judgment (eg, ID), organicity (eg, Kluver-Bucy, Kleine-Levin), and imitating behaviors (exposure to nudity in the vicinity). 1,2 These behaviors can prove serious, suffice to mention, for instance, using inappropriate "fetish," too excessive masturbation, self-injury during the act, indecent exposure, associated aggression, and forensic repercussions. 3 For primary causes, when social adjustments, counseling, and psychotherapy fail to provide satisfactory results, it may be necessary to resort to pharmacotherapy.One of our group (A.N.)…”

“…The working differential for oversexualized behaviors in children should include—sexual abuse, juvenile bipolar mood disorder, impulse dyscontrol (including iatrogenic, eg, aripiprazole with partial D2 agonism), poor social judgment (eg, ID), organicity (eg, Kluver-Bucy, Kleine-Levin), and imitating behaviors (exposure to nudity in the vicinity) 1 ,. 2 …”

Prevalencia, comorbilidad y correlatos psicológicos de la compulsividad sexual

“…En la literatura se han descrito algunos casos de adolescentes cuya conducta sexual sugeriría la presencia de esta patología (El-Gabalawi & Johnson, 2007) Estos primeros signos y síntomas tienden a empeorar entre los 16 y los 18 años, coincidiendo con el periodo en el que los jóvenes comienzan a iniciarse en mayor medida en la actividad sexual. Durante esta etapa, los jóvenes con rasgos compulsivos se caracterizan por iniciar su actividad sexual más tempranamente, con un mayor número de parejas sexuales y corriendo más riesgos durante la actividad sexual (Långström & Hanson, 2006a).…”