Johns Hopkins Psychiatry Guide

Paraphilic Disorders

Brian Lerner, M.D., Fred Berlin, M.D., Ph.D.
Paraphilic Disorders is a topic covered in the Johns Hopkins Psychiatry Guide.

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DEFINITION

There is tremendous variability in what people find sexually interesting. It is imperative to distinguish this variability in interests from a disorder.

  • Paraphilia is any intense (in some preferential) and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners. In the very old or medically ill: any sexual interest > normophilic sexual interests.
  • Paraphilic disorder exists when recurrent, intense sexually arousing fantasies, sexual urges, or behaviors currently cause distress or impairment to the individual or whose satisfaction has entailed personal harm, or risk of harm, to others generally involving: non-human objects, the suffering or humiliation of oneself or one’s partner, children, or non-consenting persons.
  • While there is an almost infinite variety of sexual interests, the DSM5 identifies eight (exhibitionism, fetishism, frotteurism, pedophilia, sexual masochism, sexual sadism, transvestism, and voyeurism) because these are the most significant clinically.
    Some others include:
    • Coprophilia (feces)
    • Klismaphilia (enemas)
    • Necrophilia (corpses)
    • Sexual masochism - undergoing humiliation, bondage, or suffering
    • Telephone scatologia/telephonicophilia (obscene phone calls, particularly to strangers)
    • Urophilia (urine)
    • Zoophilia (animals)

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Last updated: November 21, 2014