From hero to zero: The manifestation of addictive problematic sexual behaviour

IntroductionAddiction refers to a pattern of:– loss of control, as shown by unsuccessful efforts to stop the behaviour;– continuation of the behaviour despite adverse consequences – such as marriage breakdown;– an obsession with obtaining, using or recovering from the behaviour.To date, DSM-5 does not recognize sex addiction as a disorder, however when problematic sexual behaviours fulfil these same three criteria, the process is considered to be an addiction.This case report describes the development of problematic addictive sexual behaviour, possibly as a result of other psychiatric comorbidities including obsessive-compulsive disorder (OCD), alvinophilia, and obsessional fetishism. The presence of the Madonna-Puttana syndrome is also explored.AimsTo use the biopsychosocial model to investigate the aetiology of addictive problematic sexual behaviour. To explore the role of psychiatric comorbidities in the expression of such behaviour. To examine the holistic impact of sexual addictions. To examine the treatment modalities of addictive problematic sexual behaviour.MethodsA 25 year old happily-married nurse who confessed to serial extramarital affairs was interviewed. Underlying psychiatric comorbidities were identified. Family members were also interviewed for a collateral history. The above objectives were explored and the response to various treatment modalities were evaluated. Literature reviews were carried out.ConclusionsThis case illustrates a form of OCD which manifested as addictive problematic sexual behaviour. The message portrayed is that hope exists for such couples once various treatment modalities are put into action.Disclosure of interestThe authors have not supplied their declaration of competing interest.