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The "S" Newsletter


Glenn Hutchinson, Ph.D.  Licensed Psychologist (Atlanta, GA) and Founder of Psyc.TV


Co-occurrence of Sex Addiction and Other Mental Health Problems

It is common for people with addictions, including sex addiction, to suffer from other psychological problems as well. You may know people in the S program who also struggle with depression, anxiety, or other problems. The term comorbidity means that two disorders co-occur. If a large percentage of sex addicts suffer from depression, we would say depression is highly comorbid with sex addiction. Comorbidity rates are important because therapists who work with sex addicts need to know what other problems their clients are likely to be experiencing. Failure to address other difficulties can undermine attempts to bring sexual behavior under control. So, how good is the research and what do we know about comorbidity rates for sex addiction?

As I explained in a previous issue of the Sex Addiction Newsletter, I use the term 'sex addiction' broadly. I use it to refer to out of control sexual urges, desires, and behaviors regardless of whether the desires are considered normal (e.g., intercourse with an adult) or unusual (e.g., fetishes, voyeurism). Recall that experts refer to sex addicts whose out of control behaviors involve normal desires as hypersexuals, whereas sex addictions that involve unusual desires are termed paraphilias. The first question about comorbidity that we might ask is whether hypersexuality is highly comorbid with paraphilias. In other words, if we look at men who have normal sexual interests that have spiraled out of control, do lots of them also have paraphilic interests and behaviors?A large study (Langstrom, 2006) conducted in Sweden investigated this question, and the answer appears to be yes. Langstrom administered a measure of impersonal sex (e.g., sex with strangers, masturbating to pornography) to a random sample of more than 1200 men and more than 1100 women. He considered the top 12% of each gender to have a problem, i.e., sex addiction. These individuals were far more likely than others to report that they were sexually aroused by activities such as exposing themselves to strangers, spying on others who were engaging in sex, and inflicting pain on their partners. Additional studies have also revealed high rates of paraphilic interests among hypersexual individuals.


The next question is whether sex addicts (those with hypersexuality and/or paraphilias) suffer from elevated rates of other mental health problems such as depression, anxiety, and substance addictions. I'm disappointed to say that no large-scale, high quality studies have ever investigated this question. There are a few small-to-medium size studies that we can look to for clues, but none of these studies are based on a large random sample of sex addicts. (Without a random sample, we cannot be confident in our conclusions. I explain why in the free video entitled 'Does Childhood Sexual Abuse Cause Sex Addiction?' on my website.) Results of the best available studies indicate that 39 to 73 percent of sex addicts have a history of a mood disorder (depression and bipolar disorders), 42 to 96 percent have a history of an anxiety disorder, and 43 to 71 percent have a history of a substance addiction. Based on these studies, comorbidity rates for sex addiction appear to be quite high, but given the variability in the numbers for each disorder just cited, it's clear that we do not know exactly what the comorbidity rates are. To clarify matters, we need a study of comorbidity that is based on a large, random sample of sex addicts. Accurate comorbidity rates would increase our understanding of sex addiction and inform therapists about other disorders that their sex addiction clients are most likely to be suffering. Many of you may know people who have been in S programs for years but have never made much progress; in at least some cases, untreated comorbid conditions are likely the reason. 


If you would like more details about findings concerning comorbidity with sex addiction, click here to visit a page on my website where I have provided more information.


Key studies of comorbidity with sex addiction:


Black, Kehrberg, Flumerfelt, & Schlosser, 1997

Kafka & Hennen, 2002

Kafka & Prentky, 1998

Kafka & Prentky, 1994

Langstrom & Hanson, 2006

Raymond, Coleman, & Miner, 2003


If there are topics that you would like to see addressed in future issues, feel free to make suggestions via email: glennhutchinson@mindspring.comAlso, please visit where you can watch free videos in the "Important Topics" section as well as access past issues of The "S" Newsletter.

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