Recent psychiatric literature has used the term "hypersexuality" to denote pathologically increased sexual behavior in children and adolescents. Various patterns of increased sexuality have been described in youth, including sexuality that is excessive, developmentally precocious, compulsive, aggressive, or otherwise socially inappropriate. Such "hypersexual" behavior in children and adolescents is associated with a variety of factors. Social factors include sexual abuse, physical abuse, life stress, and impaired family relationships. Psychiatric factors include emotional and behavioral problems in general, posttraumatic stress disorder and dissociative symptoms in particular, and possibly bipolar disorder. Despite the importance of increased sexual behavior in youth as a possible sign of these problems, there is currently no uniform definition in psychiatric literature of the term "hypersexuality" applied to children and adolescents. The usefulness of this term depends upon the degree to which it can be defined, measured, and distinguished from non-pathological juvenile sexual behavior. Research instruments are described that may be useful in measuring levels of sexual behavior in children and adolescents. Elements of a definition of juvenile hypersexuality are proposed based upon current knowledge about children and adolescents' sexuality in both normal development and a variety of conditions in which it is increased. Care is warranted in distinguishing between normal and abnormal sexual behavior in youth because of the variety of factors that can affect its measurement.

Sexual behavior over the past year of 32 outpatients with Bipolar disorder is compared to that of 44 Comparison patients that had never had an episode of affective illness. Subjects were outpatients treated with drugs and psychotherapy in routine office practice. Differences in sexual behavior between the two groups as a whole were minimal, but meaningful differences emerged when subgroups were compared. Compared to control men, Bipolar men had had more partners in the last year and were more likely to have had sex without condoms. Compared to Bipolar females, Bipolar males had more sex partners, had more sex with strangers, and were more likely to have engaged in homosexual behavior. Even so, some patients in the Comparison group also had engaged in risky sexual behavior. They had failed to use condoms and had had sex with strangers and prostitutes during the previous year.

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While there is consensus that bipolar disorder exists in children and adolescents, its diagnostic criteria are debated. Excessive sexual behavior has been reported in youth who may have juvenile bipolar disorder (JBD), and has been termed "hypersexuality." Although there is no universal definition of this term, this observation has led to a hypothesis that increased sexual behavior characterizes the bipolar syndrome in children and adolescents, and differentiates it from attention deficit hyperactivity disorder. Although this hypothesis is plausible, evidence for it is incomplete, because testing it definitively would require both establishing a standard definition of hypersexuality in children and adolescents, and also reaching consensus about the other nonsexual criteria for pediatric bipolar disorder. In addition, studies to test it would need to control factors other than JBD that are known to increase sexual behavior in children and adolescents. These include sexual abuse and related posttraumatic stress disorder, excessive exposure to sexual stimuli, psychiatric illness in general, and social variables such as family chaos and social stress. Some of these factors might increase sexual behavior in youth with bipolar disorder through psychodynamic mechanisms rather than as a result of the illness itself. Therefore, further research is needed to determine whether increased sexual behavior can serve as a diagnostically valuable criterion for bipolar disorder in children and adolescents, and whether it differentiates the disorder from other conditions known to be associated with increased sexual behavior in youth.

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