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Hypersexual disorder was proposed in 2010 for inclusion in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) of the American Psychiatric Association (APA). The Sexual and Gender Identity Disorders Workgroup recommended inclusion in the DSM-5 in Section III (Emerging Measures and Models, Conditions for Further Study); however, it was ultimately excluded from the final publication of the DSM-5.[1] The label "hypersexual disorder" was reportedly chosen because it did not imply any specific theory for what causes hypersexuality, which remains unknown.[2] A proposal to add sexual addiction to the DSM system had been previously rejected by the APA, as not enough evidence suggested to them that the condition is analogous to substance addictions, as that name would imply.[3][4][5]

In the diagnostic criteria proposed for Hypersexual Disorder by Kafka (2012), it was characterized as a pattern involving repetitive and intense preoccupation with sexual fantasies, urges, and behaviors, leading to adverse consequences and clinically significant distress or impairment in social, occupational, or other important areas of functioning. Further, hypersexual individuals typically experience multiple unsuccessful attempts to control or diminish the amount of time spent engaging in sexual fantasies, urges, and behaviors in response to dysphoric mood states or stressful life events. The proposed criteria indicate that symptoms must also persist for a period of at least 6 months and occur independent of substance use, mania, or a medical condition in order for a diagnosis of hypersexual disorder to be established. [6] The proposal also included specifiers identifying which sexual behaviors were problematic: masturbation, pornography use, cybersex, etc.

Rory Reid, a research psychologist in the Department of Psychiatry at the University of California Los Angeles (UCLA) led a team of researchers around the USA in a field trial to investigate the proposed criteria for Hypersexual Disorder. Their findings were published in the Journal of Sexual Medicine wherein they concluded the criteria were valid and could be reliably diagnosed. [7]

The updated manual, called the DSM-5, was released in 2013.[8] The pre-2013 version of the manual, the DSM-IV-TR includes an entry called Sexual Disorder—Not Otherwise Specified (Sexual Disorder NOS), for disorders that are clinically significant, but do not have their own code. The DSM-IV-TR notes that Sexual Disorder NOS would apply to, among other conditions, "distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used".[9]

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