Paraphilias: Diagnostics, Comorbidities, and Treatment

The present chapter initially summarizes diagnostic criteria and guidelines for paraphilic disorders proposed by standardized diagnostic schemes (i.e., DSM-5, ICD-11). When assessing paraphilic interests in clinical practice, applying multiple sources of information is considered necessary (e.g., self-report questionnaires, objective measures, third-party assessment). Referring to the recent state of research regarding comorbid disorders in individuals with paraphilias, multiple paraphilic interests are not rare. Furthermore, psychiatric disorders (e.g., depression, social phobia, ADHD) were also shown to be related to paraphilic disorders. Concerning treatment in paraphilic patients, research has demonstrated the effectiveness of psychotherapy as well as sex education. In the case of individuals with a risk for sex offending or a psychiatric comorbidity (e.g., depression), pharmacotherapy and social skills training are of additional relevance. Current findings on the effectiveness of the diverse psychotherapeutic and pharmacological treatment strategies are discussed.