Tolerability and efficacy of paroxetine and naltrexone for treatment of compulsive sexual behaviour disorder

Lew‑Starowicz, Michał; Draps, Małgorzata; Kowalewska, Ewelina; Obarska, Katarzyna; Kraus, Shane W.; Gola, Mateusz

doi:10.1002/wps.21026

Cited by 14 publications

(14 citation statements)

References 6 publications

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Section: Ppu Measuresmentioning

confidence: 95%

“…Previous research on the BPS has shown acceptable psychometric indicators for reliability and validity (i.e. construct, convergent, criterion, discriminant) among multiple community‐based and clinical samples [33, 44]. In addition, an accurate cut‐off score was established for the BPS with good to excellent sensitivity, specificity, positive predictive value, and negative predictive value [33].…”

Section: Introductionmentioning

confidence: 99%

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Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools

Bőthe,

Nagy,

Koós

et al. 2024

Addiction

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Background and aimsProblematic pornography use (PPU) is a common manifestation of the newly introduced Compulsive Sexual Behavior Disorder diagnosis in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems. Although cultural, gender‐ and sexual orientation‐related differences in sexual behaviors are well documented, there is a relative absence of data on PPU outside Western countries and among women as well as gender‐ and sexually‐diverse individuals. We addressed these gaps by (a) validating the long and short versions of the Problematic Pornography Consumption Scale (PPCS and PPCS‐6, respectively) and the Brief Pornography Screen (BPS) and (b) measuring PPU risk across diverse populations.MethodsUsing data from the pre‐registered International Sex Survey [n = 82 243; mean age (Mage) = 32.4 years, standard deviation = 12.5], a study across 42 countries from five continents, we evaluated the psychometric properties (i.e. factor structure, measurement invariance, and reliability) of the PPCS, PPCS‐6, and BPS and examined their associations with relevant correlates (e.g. treatment‐seeking). We also compared PPU risk among diverse groups (e.g. three genders).ResultsThe PPCS, PPCS‐6, and BPS demonstrated excellent psychometric properties [for example, comparative fit index = 0.985, Tucker–Lewis Index = 0.981, root mean square error of approximation = 0.060 (90% confidence interval = 0.059–0.060)] in the confirmatory factor analysis, with all PPCS’ inter‐factor correlations positive and strong (rs = 0.72–0.96). A total of 3.2% of participants were at risk of experiencing PPU (PPU+) based on the PPCS, with significant country‐ and gender‐based differences (e.g. men reported the highest levels of PPU). No sexual orientation‐based differences were observed. Only 4–10% of individuals in the PPU+ group had ever sought treatment for PPU, while an additional 21–37% wanted to, but did not do so for specific reasons (e.g. unaffordability).ConclusionsThis study validated three measures to assess the severity of problematic pornography use across languages, countries, genders, and sexual orientations in 26 languages: the Problematic Pornography Consumption Scale (PPCS, and PPCS‐6, respectively), and the Brief Pornography Screen (BPS). The problematic pornography use risk is estimated to be 3.2–16.6% of the population of 42 countries, and varies among different groups (e.g. genders) and based on the measure used.

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Section: Ppu Measuresmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools

Bőthe,

Nagy,

Koós

et al. 2024

Addiction

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“…Treatment of compulsive sexual behavior disorder focuses on improving sexual self-control as well as addressing the underlying emotional states and motivations (Briken, 2020;Stein et al, 2020). There is also evidence that certain pharmacological treatments can be helpful in reducing compulsive sexual behavior disorder symptoms (Lew-Starowicz et al, 2022).…”

Section: Compulsive Sexual Behavior Disorder Presentations and Sympto...mentioning

confidence: 99%

Disorders due to addictive behaviors and impulse control disorders.

Billieux,

Fineberg,

King

et al. 2024

A Psychological Approach to Diagnosis: Using the ICD-11 as a Framework.

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This chapter focuses on two groupings of disorders in the 11th revision of the International Classification of Diseases World Health Organization [WHO], 2023): disorders due to addictive behaviors-namely, gambling disorder and gaming disorder-and impulse control disorders, which include pyromania, kleptomania, compulsive sexual behavior disorder, and intermittent explosive disorder. As described in the Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders (CDDR; WHO, 2024), disorders due to addictive behaviors and impulse control disorders are disabling conditions sharing impulsivity and loss of control as core features. A common characteristic of these disorders is that they lie at the extreme pole of an impulsivity continuum linking normal behavior to dysregulated, pathological behavior (Padhi et al., 2012). At the symptomatic level, these disorders may also share common experiences of an overwhelming urge (or craving) before engaging in the behavior and a feeling of relief or pleasure afterwards. A vicious circle involving a dynamic interaction between positive and negative reinforcement therefore can contribute to the maintenance of these conditions (Dell'Osso et al., 2006). Positive reinforcement in the context of these conditions typically relates to feelings of gratification, pleasure, excitement, or euphoria, whereas negative reinforcement typically relates to the relief or reduction of aversive emotional states (e.g., dysphoria, boredom,

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“…Despite the critical prevalence, treatment studies are mostly retrospective or single-group designs, have small sample sizes, short follow-up periods, use non-validated measures, and do not use structured clinical interviews ( Hook, Reid, Penberthy, Davis, & Jennings, 2014 ; von Franqué, Klein, & Briken, 2015 ). There are a few exceptions, such as one RCT comparing group-administered cognitive behavioral therapy (CBT) with a waiting list ( Hallberg et al., 2019 ) and three studies that have included a proper comparative control condition ( Lew-Starowicz et al., 2022 ; Wainberg et al. , 2006 ; Wilson, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

Treatment effects and adherence of sexually compulsive men in a randomized controlled trial of psychotherapy and medication

Scanavino

Guirado

Marques

et al. 2023

JBA

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BackgroundLittle attention has been given to efficacious treatment and adherence to treatment of compulsive sexual behavior (CSB).AimsRandomized controlled trial investigated short-term psychodynamic group therapy followed by relapse prevention group (STPGP-RPGT) and pharmacological treatment (PT) for CSB men on sexual compulsivity and adherence.Method135 men, 38 (SD = 9) years old on average, were randomly assigned to 1) STPGP-RPGT; 2) PT; 3) Both. Participants completed measures at baseline, 25th, and 34th week. 57 (42.2%) participants dropped out between baseline and 25th week, and 68 (50.4%) between baseline and 34th week. 94 (69.6%) did not adhere (80% pills taken or attended 75% therapy sessions).ResultsA significant interaction effect was found between time and group (F (4, 128) = 2.62, P = 0.038, ES = 0.08), showing who received PT improved less in sexual compulsivity than those who received STPGP-RPGT (t = 2.41; P = 0.038; ES = 0.60) and PT + STPGP-RPGT (t = 3.15; P = 0.007, ES = 0.74). Adherent participants improved more in sexual compulsivity than non-adherent at the 25th week (t = 2.82; P = 0.006, ES = 0.65) and 34th week (t = 2.26; P = 0.027, ES = 0.55), but there was no interaction effect, F (2, 130) = 2.88; P = 0.06; ES = 0.04). The most reported behavior (masturbation) showed greater risk of non-adherence (72.6%).Discussion and conclusionsAdherent participants improved better than non-adherent. Participants who received psychotherapy improved better than those who received PT. Methodological limitations preclude conclusions on efficacy.

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Tolerability and efficacy of paroxetine and naltrexone for treatment of compulsive sexual behaviour disorder

Cited by 14 publications

References 6 publications

Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools

Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools

Disorders due to addictive behaviors and impulse control disorders.

Treatment effects and adherence of sexually compulsive men in a randomized controlled trial of psychotherapy and medication

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