强迫性性行为的评估与治疗：当前局限性及潜在策略

Evaluation and treatment of compulsive sexual behavior: current limitations and potential strategies

强迫性性行为的评估与治疗：当前局限性及潜在策略

Authors: Lu Zhu, Wenwen Ma, Rongqiu Zhang, Chao Wang, Bing Song, Yunxia Cao, Guanjian Li

Journal: Frontiers in Psychiatry

PMID: 40677854

DOI: 10.3389/fpsyt.2025.1621136

Abstract

Aim: Despite having been introduced into ICD-11, the appropriate classification and symptomatology of compulsive sexual behavior disorder (CSBD) remain controversial.

Methods: In this review, we examined the historical background, epidemiological status quo, comorbidities, neuroscience theories, current diagnoses, and treatment recommendations for CSBD. Additionally, we emphasized the limitations of the current research and the prospects for future work.

Results: Psychotherapy and cognitive-behavioral therapy are the preferred treatment methods for CSBD. Selective serotonin reuptake inhibitors and naltrexone are commonly used as "off-label" drugs. The diagnosis and treatment of patients with CSBD should integrate biological, psychological, and social factors with expertise in sexual medicine by employing a comprehensive and holistic therapeutic approach. This treatment aims not only to control abnormal sexual desires and behaviors but also to assist patients in achieving a healthy and satisfying sexual life and well-being.

Conclusion: Future research should focus on understanding etiology, improving study population representation, correcting methodological flaws in treatment evaluation, enhancing clinician training in sexual medicine, and addressing patients' addictions and sexual function issues. Narrowing these research gaps is crucial for improving clinical diagnosis and treatment levels and formulating targeted social intervention measures.

Keywords: addictive behaviors; compulsive sexual behavior; compulsivity; sexual addiction; sexual function.

摘要

目的：尽管强迫性性行为障碍(CSBD）已被纳入《国际疾病分类第11版》(ICD-11），但其适当的分类和症状学仍存在争议。

方法：本综述探讨了CSBD的历史背景、流行病学现状、共病情况、神经科学理论、当前诊断标准及治疗建议。此外，我们强调了现有研究的局限性及未来研究方向。

结果：心理治疗和认知行为疗法是治疗CSBD的首选方法。选择性5-羟色胺再摄取抑制剂和纳曲酮常被用作“非适应症用药”。CSBD患者的诊断与治疗应整合生物、心理及社会因素，并结合性医学专业知识，采用全面而整体的治疗方法。该治疗不仅旨在控制异常性欲望与行为，更致力于帮助患者实现健康且满足的性生活与整体福祉。

结论：未来研究应聚焦于探索病因学、提升研究人群代表性、纠正治疗评估中的方法学缺陷、加强临床医生在性医学领域的培训，以及解决患者的成瘾问题和性功能障碍。缩小这些研究空白对于提升临床诊断与治疗水平、制定针对性社会干预措施至关重要。

关键词：成瘾行为；强迫性性行为；强迫性；性成瘾；性功能