2016, Number 3
<< Back Next >>
Revista del Hospital Psiquiátrico de La Habana 2016; 13 (3)
Paraphilic disorder: clinical characteristics of male patients served by Clinical Sexology
de Dios BE
Language: Spanish
References: 35
Page:
PDF size: 140.07 Kb.
ABSTRACT
Introduction: The paraphilic disorders have been little studied in Cuba and it was decided to
carry out the present investigation.
Objective: To identify the clinical characteristics of patients with paraphilic disorder who
requested attention to two services of Clinical Sexology of Havana.
Methods: A descriptive, cross-sectional study was carried out applying the clinical method. The
universe consisted of 30 male patients over 18 years of age who requested voluntary care from
the Clinical Sexology services of the Community Center of Mental Health of Old Havana and the
National Center for Sexual Education in the period 2009-2015, in systematic follow-up for six
months. The results were expressed in percent.
Results: 50% of the cases went to ask for help by external pressure. 8% had a family history of
paraphilias. The main types of paraphilias diagnosed were: 53.33%, exhibitionism 43.33%, and
voyeurism 36.67%. Dependence on alcohol, other drugs and other substances (23.53%)
prevailed in axis 1 comorbidities; For axis II only personality disorders (33.33%) were
diagnosed, with a predominance of antisocial disorder (50%).
Conclusions: Within the clinical characteristics, the request for external pressure aid
predominated. The familiar pathological antecedents of paraphilias and neuropsychosexual
diseases of possible etiological relation with them. The main type of paraphilic disorder was
fouling, followed by exhibitionism and voyeurism. Drug dependence prevailed in axis I
comorbidities; For axis II only personality disorders were diagnosed fundamentally the
antisocial.
REFERENCES
Krafft-Ebing. Psicopatía Sexual, presentado por el Dr. Albert Moll. Buenos Aires: Librería El Ateneo; 1955.
Stekel W. El Fetichismo. Desórdenes con relación al sexo. 1ra ed. Buenos Aires: Ediciones Imán; 1952.
Organización Mundial de la Salud. Descripciones clínicas y pautas para el diagnóstico de los trastornos mentales y del comportamiento (CIE10). Madrid: Técnicas Gráficas Forma; 1992.
Otero Ojeda AA, Rabelo Pérez V, Echezabal Campos A, Calzadilla Fierro L, Duarte Castañeda F, Magriñat Fernández JM, Acosta Nodal C. Tercer Glosario Cubano de Psiquiatría (9C-3). Ciudad de La Habana: Editorial del Hospital Psiquiátrico de La Habana; 2001.
American Psychiatrc Association (DSM-IV-TR). Manual diagnóstico y estadístico de los trastornos mentales. Textorevisado. Barcelona. Masson, S.A. 2000.
McManus AM, Hargreaves P, Rainbow L, Alison JL. Paraphilias: definition, diagnosis and treatment. F1000Prime Reports[Internet]. 2013 [citado 20 nov 2014]; 5: [aprox.14 p.]. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769077/..
Zucker JK. DSM-5: Call for Commentaries on Gender Dysphoria, Sexual Dysfunctions, and Paraphilic Disorders. Arch Sex Behav. 2013; 42:669-74.
Federoff PJ, Di Gioacchino L, Murphy L. Problems wihParaphilias in he DSM-5. CurrPsychiary Rep 2013; 15:363.
Masters HW, Johnson EV, Kolodny CR. La Sexualidad Humana. La Habana: Editorial Científico-Técnica; 1987.
Rubio Aurioles E, Tellez Velasco CA. Las parafilias. En: CONAPO. Antología de la Sexualidad Humana Tomo III. 1ra. Ed. México: Grupo Editorial Miguel Angel Porrúa; 1994. p. 247-275.
Kafka MP. The monoamine hipothesis for the pathophysiology of paraphilic disorders: an update. Ann NY AcadScie. 2003 Jun; 1989; 86-94.
Kafka M, Axis I. Psychiatric Disorders, Paraphilic Sexual Offending and Implications for Pharmacological Treatment. Isr J Psychiatry Relat Sci [Internet]. 2012 [citado 22 Jul 2014]; 49(4) : [aprox. 8 p. ]. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23585462.
Mehdizadeh-Zareanari A, Ghafarinezhad A, Soltani H. Fetishism Due to Methamphetamine (Glass) Abuse: A Case Report. AddictHealth [Internet]. 2013[citado 30 jul 2014]; 5(1-2):[aprox. 8 p. ]. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905562.
MR McNally, WJ Fremouw. Examining Risk of Escalation: A Critical Review of the Exhibitionistic Behavior Literature. Aggression and Violent Behavior [Internet]. 2014 [citado 29 Jul 2014] ;19(5): [aprox. 6 p.]. Disponible en: http://www.sciencedirect.com/science/article/pii/S1359178914000718.
Hulme PA, Middleton MR. Psychosocial and developmental characteristics of civilly committed sex offenders. Issues Ment Health Nurs. 2013 Mar;34(3):141-9.
Davis JF, Loos M, Di Sebastiano AR, Brown JL, Lehman MN, Coolen LM. Lesions of the medial prefrontal cortex cause maladaptive sexual behavior in male rats. Biol Psychiatry 2010;67: 1199-1204.
Matthew FJ. Neuropsychology, neuroscience, volitional impairment and sexually violent predators: A review of the literature and the law and their application to civil commitment proceedings. Aggression and Violent Behavior [Internet]. 2014 [citado 10 Dic 2014] ;17(1): [aprox. 6 p.]. Disponible en: http://www.sciencedirect.com/science/article/pii/S1359178911000899.
Simonetti U, Mignagaray VR, Domíngues PM, Sandobal DM, Paredes IA, Hernández NA. El problema Social del Exhibicionismo. La Habana: Editorial MINSAP; 1976.
Queralta PD. Parafilias. Un estudio cualitativo de caso [Tesis]. Ciudad de La Habana: CENESEX; 1988.
Dios BE de. Parafilias: estudio de caso de cuatro pacientes [Tesis]. Ciudad de La Habana: CENESEX; 2005.
Dios BE de. Las Parafilias. En: García AC, Fragas VR, Alfonso RA, Arrue HI. Salud Sexual y Práctica Sexológica. La Habana: editorial Centro Nacional de Educación Sexual, 2008:70-83.
Dios BE de. Control de las parafilias, su significado en la prevención de las ITS y la violencia [CD-ROM]. IV CongresoCubano de Educación, Orientación y Terapia Sexual; 2010.
Beech RA , Harkins L. DSM-IV paraphilia: Descriptions, demographics and treatment interventions. Aggression and Violent Behavior [Internet]. 2012 [citado 20 nov 2014]; 17: [aprox. 40 p.]. Disponible en: https://www.clinicalkey.es/#!/content/journal/1-s2.0- S0022510X11004485.
Labelle A, Bourget D, Bradford JM, Alda M, Tessier P. Familial paraphilia: a pilot study with the construction of genograms. [Internet]. 2012 [citado 26 Dic 2014];2012: [aprox. 18 p.]. Disponible en: http://www.hindawi.com/journals/isrn/2012/692813/ .
Gaffeney GR, Lurie SF, Berlín FS. Is there familial transmission of pedophilia? J NervMentDis[Internet]. 1984 [citado 20 dic 2014]; 172(9): [aprox 3 p.]. Disponible en: http://www.bishopaccountability.org/reports/1985_12_09_Peterson_Guidelines/Hopkins _12_Gaffney_Lurie_Berlin_IsThere.pdf .
Seto MC, Kingston DA, Bourget D. Assessment of the paraphilias. PsychiatrClin North Am [Internet]. 2014 [citado 20 nov 2014] ;37(2): [aprox 1 p.]. Disponible en:
https://www.clinicalkey.es/#!/content/journal/1-s2.0-S0022510X11004485.
Asociación Americana de Psiquiatría, Guía de consulta de los criterios diagnósticos del DSM 5. Arlington, VA, Asociación Americana de Psiquiatría, 2013.
Kafka MP. Axis I comorbility study of males with paraphilias and paraphilia-related disorders. Sex. Abuse 2002 Oct; 14(4):349-66.
Thibaut F. Pharmacological treatment of paraphilias. Isr J Psychiatry RelatSci [Internet]. 2012 [citado 10 Dic 2014] ;49(4): [aprox. 6 p.]. Disponible en: http://doctorsonly.co.il/wp-content/uploads/2013/03/09_-Pharmacologicaltreatment. pdf
Puentes RY, Bécquer AC. Diagnóstico y tratamiento de la eyaculación precoz. En: García AC, Fragas VR, Alfonso RA, Arrue HI. Salud Sexual y Práctica Sexológica. Ciudad de La Habana: editorial Centro Nacional de Educación Sexual, 2008:70-83.
Garcia F, Thibaut F. Current Concepts in the Pharmacotherapy of Paraphilias. Drug [Internet]. 2011 [citado 22 Jul 2014]; 71 (6): [aprox.24p.]. Disponible en: http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=61216755&lang= es&site=ehost-live.
Roma P, Pazzelli F, Pompili M, Girardi P, Ferracuti S. Shibari: double hanging during consensual sexual asphyxia. Arch Sex Behav. 2013 Jul;42(5):895-900.
Briken P, Bourget D, Dufour M. Sexual sadism in sexual offenders and sexually motivated homicide. PsychiatrClin North Am [Internet]. 2014 [citado 4 Oct 2014]; 37(2): [aprox. 5 p.]. Disponible en: http://www.sciencedirect.com/science/article/pii/S0193953X14000185.
Hebbar S. Doing Psychiatry Right: A Case of Severe Avoidant Personality Disorder with Obsessive-compulsive Personality Disorder, Obsessive Compulsive Disorder, Intermittent Explosive Disorder and Sexual Paraphilias. Indian J PsycholMed [Internet]. 2014 [citado 20 nov 2014]; 36(3):[aprox. 7 p.]. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100425/.