Attention-deficit/hyperactivity disorder in males with paraphilias and paraphilia-related disorders: a comorbidity study

• Published in: The journal of clinical psychiatry Vol. 59; no. 7; p. 388
• Main Authors: Kafka, M P, Prentky, R A
• Format: Journal Article
• Language: English
• Published: United States 01.07.1998
• Subjects: Adolescent; Adult; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Child; Comorbidity; Depressive Disorder - diagnosis; Depressive Disorder - epidemiology; Humans; Male; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Middle Aged; Paraphilic Disorders - diagnosis; Paraphilic Disorders - epidemiology; Prevalence; Psychiatric Status Rating Scales; Retrospective Studies; Sex Factors
• ISSN: 0160-6689
• DOI: 10.4088/JCP.v59n0709

We describe a study of DSM-III-R Axis I diagnoses of lifetime comorbid nonsexual disorders in 60 males with paraphilias (PAs; N = 42) and nonparaphilic forms of sexual impulsivity-designated paraphilia-related disorders (PRD; N = 18). Subjects completed a semistructured intake questionnaire and sexual inventories, the Inventory to Diagnose Depression, and the Wender Utah Retrospective Scale for the diagnosis of childhood attention-deficit/hyperactivity disorder (ADHD). The lifetime prevalence of Axis I diagnoses of both sexual and nonsexual disorders was ascertained from the aforementioned data and follow-up psychiatric interviews. Subjects in both PA and PRD groups were diagnosed as having a lifetime prevalence of any mood disorder (71.7%), especially dysthymic disorder (66.7%); any anxiety disorder (43.3%), especially social phobia (28.3%); any psychoactive substance abuse disorders (45.0%), especially alcohol abuse (30.0%); and any impulse disorders NOS (25.0%), especially speeding/reckless driving (16.7%). The only diagnosis that statistically significantly distinguished the PA from the PRD sample (p = .01) was retrospectively diagnosed childhood ADHD, identified in 40.0% of the total sample (50.0% PA vs.16.7% PRD). Childhood ADHD was associated with the presence of educational and behavioral problems, lower current mean income, social/legal consequences associated with antisocial impulsivity, cocaine abuse, increased prevalence of comorbid lifetime mood and impulse disorder NOS, and more diagnoses of lifetime Axis I nonsexual and sexual disorders. Although depressive disorders were the most common Axis I diagnoses across groups, childhood ADHD was the only Axis I disorder statistically significantly associated with paraphilias, socially deviant and aggressive forms of sexual impulsivity.