Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-28T05:15:00.561Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  07 November 2014

Fayez El-Gabalawi  and
Robert Arnold Johnson
Get access Rights & Permissions [Opens in a new window]

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.

Type
Case Report
Information
CNS Spectrums , Volume 12 , Issue 11 , November 2007 , pp. 821 - 827
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Adams, J, McClellan, J, Douglass, D, McCurry, C, Storck, M. Sexually inappropriate behaviors in seriously mentally ill children and adolescents. Child Abuse Negl. 1995;19:555–568.CrossRefGoogle ScholarPubMed
2.Finlayson, AJ, Sealy, J, Martin, PR. The differential diagnosis of problematic hypersexuality. Sexual Addiction and Compulsivity. 2001;8:241–251.CrossRefGoogle Scholar
3.Stein, DJ, Black, DW, Pienaar, W. Sexual disorders not otherwise specified: compulsive, addictive, or impulsive? CNS Spectr. 2000;5:60–64.CrossRefGoogle ScholarPubMed
4.Kafka, MP, Hennen, J. The paraphilia-related disorders: an empirical investigation of nonparaphilic hypersexuality disorders in outpatient males. J Sex Marital Ther. 1999;25:305–319.CrossRefGoogle ScholarPubMed
5.Barth, RJ, Kinder, BN. The mislabeling of sexual impulsivity, J Sex Marital Ther. 1987;13:15–23.CrossRefGoogle ScholarPubMed
6.Bancroft, J, Vukadinovic, Z. Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model. J Sex Res. 2004;41:225–324.CrossRefGoogle ScholarPubMed
7.Montaldi, DFUnderstanding hypersexuality with an Axis II model. J Psychol Human Sex. 2002;14:1–23.CrossRefGoogle Scholar
8.Leedes, R. The three most important criteria in diagnosing sexual addictions: obsession, obsession, and obsession. Sexual Addiction and Compulsivity. 2001;8:215–226.CrossRefGoogle Scholar
9.Rinehart, NJ, McCabe, MP. Hypersexuality: psychopathology or normal variant of sexuality? J Sex Marital Ther. 1997;12:45–60.CrossRefGoogle Scholar
10.Deblinger, E, McLeer, SV, Atkins, MS, Ralphe, D, Foa, E. Post-traumatic stress in sexually abused, physically abused, and nonabused children. Child Abuse Negl. 1989;13:403–408.CrossRefGoogle ScholarPubMed
11.Myers, BA. Treatment of sexual offenses by persons with developmental disabilities. Am J Merit Retard. 1991;95:563–569.Google ScholarPubMed
12.Sharkey, L, O'Donovan, A. Sexual disinhibition induced by risperidone in a child. J Child Adolesc Psychopharmacol. 2002;12:367.CrossRefGoogle ScholarPubMed
13.Malladi, SS, Singh, AN. Hypersexuality and its response to citalopram in a patient with hypothalamic hamartoma and precocious puberty. Int J Neuropsychopharmacol. 2005;8:635–636.CrossRefGoogle Scholar
14.Gadoth, N. Kleine-Levin syndrome: a review of a transient adolescent neuropsychi-atric disorder. Primary Psychiatry. 2004;11:25–27.Google Scholar
15.Pitt, DC, Kriel, RL, Wagner, NC, Krach, LE. Kluver-Bucy syndrome following heat stroke in a 12-year-old girl. Pediatr Neurol. 1995;13:73–76.CrossRefGoogle ScholarPubMed
16.Pradhan, S, Singh, MN, Pandey, N. Kluver Bucy syndrome in young children. Clin Neurol Neurosurg. 1998;100:254–258.CrossRefGoogle ScholarPubMed
17.Antunes, NL, Souweidane, MM, Lis, E, Rosenblum, MK, Steinherz, PG. Methotrexate leukoencephalopathy presenting as Klüver-Bucy syndrome and uncinate seizures. Pediatr Neurol. 2002;26:305–308.CrossRefGoogle ScholarPubMed
18.Geller, B, Zimerman, B, Williams, M, Delbello, MP, Frazier, J, Beringer, L. Phenomenology of prepubertal and early adolescent bipolar disorder: examples of elated mood, grandiose behaviors, decreased need for sleep, racing thoughts and hypersexuality. J Child Adolesc Psychopharmacol. 2002;12:3–9.CrossRefGoogle ScholarPubMed
19.Myers, WC, Carrera, F 3rd.Carbamazepine-induced mania with hypersexuality in a 9-year-old boy. Am J Psychiatry. 1989;146:400.Google ScholarPubMed
20.Krueger, RB, Kaplan, MS, Disorders of sexual impulse control in neuropsychiatry conditions. Semin Clin Neuropsychiatry. 2000;5:266–274.CrossRefGoogle ScholarPubMed
21.Hajcak, F, Garwood, P. What parents can do to prevent pseudo-hypersexuality in adolescents. Fam Ther. 1988;15:99–105.Google Scholar
22.Schmidt, JG, Schneider, WN. Pharmacologic treatment of cognitive deficits and hypersexuality due to “shaken-baby syndrome”. Neurorehabil Neural Repair. 2000;14:155–158.CrossRefGoogle ScholarPubMed
23.Moore, SL. Satyriasis: a case study. J Clin Psychiatry. 1980;41:279–281.Google ScholarPubMed
24.Goodman, JD. The behavior of hypersexual delinquent girls. Am J Psychiatry. 1976;133:662–668.Google ScholarPubMed
25.Widom, CS. Victims of childhood sexual abuse: later criminal consequences. In Victims of Childhood Sexual Abuse (series). National Institute of Justice Research in Brief; 1995. Available at: http://www.ncjrs.org/txtfiles/abuse.txt. Accessed December 1, 2005.Google Scholar
26.Schwartz, MF, Galperin, L. Hyposexuality and hypersexuality secondary to childhood trauma and dissociation. J Trauma Dissociation. 2002;3:107–120.CrossRefGoogle Scholar
27.Wiseman, SV, McAuley, JW, Freidenberg, GR, Freidenberg, DL. Hypersexuality in patients with dementia: possible response to cimetidine. Neurology. 2000:54:2024.CrossRefGoogle ScholarPubMed
28.Rosenthal, M, Berkman, P, Shapira, A, Gil, I, Abramovitz, J. Urethral masturbation and sexual disinhibition in dementia: a case report. Isr J Psychiatry Relat Sci. 2003;40:67–72.Google ScholarPubMed
29.Pruett, JR Jr., Rizvi, STA 16-year-old girl with excited catatonia treated with low-dose oral lorazepam. J Child Adolesc Psychopharmacol. 2005;15:1005–1010.CrossRefGoogle ScholarPubMed
30.Sweet, RA. Case of craniopharyngioma in late life. J Neuropsychiatry Clin Neurosci. 1990;2:464–465.Google ScholarPubMed
31.Gorman, DG, Cummings, JL. Hypersexuality following septal injury. Arch Neurol. 1992;49:308–310.CrossRefGoogle ScholarPubMed
32.Mendez, MF, Chow, T, Ringman, J, Twitchell, G, Hinkin, CH. Pedophilia and temporal lobe disturbances. J Neuropsychiatry Clin Neurosci. 2000;12:71–76.CrossRefGoogle ScholarPubMed
33.Braun, CMJ, Dumont, M, Duval, J, Hamel, I, Godbout, L. Opposed left and right brain hemisphere contributions to sexual drive: a multiple lesion case analysis. Behav Neurol. 2003;14:55–61.CrossRefGoogle ScholarPubMed
34.Elmore, JL, Quattlebaum, JT. Female sexual stimulation during antidepressant treatment. Pharmacotherapy. 1997;17:612–616.CrossRefGoogle ScholarPubMed
35.Samuel, RZ. The unusual side effect of excessive sexual desire with paroxetine use. Primary Psychiatry. 2006;13:40–42.Google Scholar
36.Chollet, CA, Andreatini, R. Effect of bupropion on sexual dysfunction induced by fluoxetine: a case report of hypersexuality. J Clin Psychiatry. 2003;64:1268–1269.CrossRefGoogle ScholarPubMed
37.Chemali, Z. Donepezil and hypersexuality: a report of two cases. Primary Psychiatry. 2003;10:78–79.Google Scholar
38.Grabowska-Grzyb, A, Naganska, E, Wolanczyk, T. Hypersexuality in two patients with epilepsy treated with lamotrigine. Epilepsy Behav. 2006;8:663–665.CrossRefGoogle ScholarPubMed
39.Gondim, FA, Thomas, FP. Episodic hyperlibidinism in multiple sclerosis. Mult Scler. 2001;7:67–70.CrossRefGoogle ScholarPubMed
40.Mulligan, A, Webb, M, Gill, M. A variant of nymphomania in association with obsessive-compulsive disorder. Ir J Psychol Med. 2002;19:96–98.CrossRefGoogle Scholar
41.Kobayashi, T. Effect of haloperidol on a patient with hypersexuality following frontal lobe injury. Psychogeriatrics. 2004;4:49–52.CrossRefGoogle Scholar
42.Narumoto, J, Nakamura, K, Kitabayashi, Y, Fukui, K. Othello syndrome secondary to right orbitofrontal lobe excision [letter]. J Neuropsychiatry Clin Neurosci. 2006;18:560–561.CrossRefGoogle ScholarPubMed
43.Neuwirth, W, Eher, R. What differentiates anal rapists from vaginal rapists? Int J Offender TherComp Criminol. 2003;47:482–488.CrossRefGoogle ScholarPubMed
44.Klos, KJ, Bower, JH, Josephs, KA, Matsumoto, JY, Ahlskog, JE. Pathological hypersexuality predominantly linked to adjuvant dopamine agonist therapy in Parkinson's disease and multiple system atrophy. Parkinsonism Relat Disord. 2005;11:381–386.CrossRefGoogle ScholarPubMed
45.Riley, AJ. Premenstrual hypersexuality. J Sex Marital Ther. 1994;9:87–93.CrossRefGoogle Scholar
46.Levine, SB. A modern perspective on nymphomania. J Sex Marital Ther. 1982;8:316–324.CrossRefGoogle ScholarPubMed
47.Eber, M. Don Juanism. Bull Menninger Clin. 1981;45:307–316.Google ScholarPubMed
48.Needell, NJ, Markowitz, JC. Hypersexual behavior in Hasidic Jewish inpatients. J Nerv Ment Dis. 2004;192:243–246.CrossRefGoogle ScholarPubMed
49.Lubbe, T. Diagnosing a male hysteric: Don Juan-type. Int J Psychoanal. 2003;84:1043–1059.CrossRefGoogle ScholarPubMed
50.Brandell, JR, Nol, J. Hypersexuality as a disorder of the self. Psychotherapy Patient. 1992;8:51–64.CrossRefGoogle Scholar
51.Akhtar, SA, Byrne, JP. The concept of splitting and its clinical relevance. Am J Psychiatry. 1983;140:1013–1016.Google ScholarPubMed
52.Shaffer, HJ. Considering two models of excessive sexual behaviors: addiction and obsessive-compulsive disorder. Sexual Addiction and Compulsivity. 1994;1:6–18.CrossRefGoogle Scholar
53.Myers, WA. Addictive sexual behavior. Am J Psychiatry. 1995;146:473–483.Google Scholar
54.Guss, JR. Sex like you can't even imagine: “crystal,” crack and gay men. In: Guss, JR, Drescher, J, eds. Addictions in the Gay and Lesbian Community. New York, NY: Haworth Press; 2000;105–122.Google Scholar
55.Spinella, M. Hypersexuality and dysexecutive syndrome after a thalamic infarct. Int J Neurosci. 2004;114:1581–1590.CrossRefGoogle ScholarPubMed
56.Absher, JR, Vogt, BA, Clark, DG, et, al. Hypersexuality and hemiballism due to subthalamic infarction. Neuropsychiatry Neuropsychol Behav Neurol. 2000;13:220–229.Google ScholarPubMed
57.Emory, LE, Cole, CM, Meyer, WJ. Use of depo-Provera to control sexual aggression in persons with traumatic brain injury. J Head Trauma Rehabil. 1995;10:47–58.CrossRefGoogle Scholar
58.Mendez, MF, O'Connor, SM, Lim, GTH. Hypersexuality after right pallidotomy for Parkinson's disease. J Neuropsychiatry Clin Neurosci. 2004;16:37–40.CrossRefGoogle ScholarPubMed