CSBD

Compulsive Sexual Behavior Disorder, abbreviated CSBD, is a psychiatric condition characterised by recurring, intense sexual thoughts, urges, or behaviours that are difficult for the individual to control and that result in significant distress or impairment in social, occupational, or other important areas of functioning. The World Health Organization added CSBD to the International Classification of Diseases, 11th Revision (ICD‑11) in 2018, recognising it as a disorder rather than a moral or legal issue.

Diagnostic criteria for CSBD include: persistence for at least six months; repeated engagement in a variety of sexual activities; inability to reduce or control behaviour despite repeated attempts; and continued engagement despite awareness of negative consequences. Clinicians are instructed to separate CSBD from non‑pathological sexual interest, ensuring that other mental disorders or cultural factors do not explain the behaviour before confirming a diagnosis.

Epidemiological data suggest prevalence rates ranging from 1% to 3% of the general population, with higher rates reported in clinical samples. The condition may be comorbid with mood disorders, anxiety disorders, substance use disorders, and personality disorders. While research on underlying neurobiology is ongoing, it is thought that dysregulation in reward pathways, impulsivity, and executive function play contributory roles.

Treatment approaches are typically psychotherapeutic, with cognitive‑behavioural therapy (CBT) and acceptance‑and‑commitment therapy (ACT) leading evidence. Some clinicians incorporate pharmacotherapy, such as selective serotonin re‑uptake inhibitors or beta‑blockers, particularly when comorbid depression or anxiety is present. Ongoing research evaluates the efficacy of neuromodulation interventions and digital therapeutics.

The inclusion of CSBD in ICD‑11 has sparked debate. Proponents argue that formal recognition facilitates research, reduces stigma, and improves access to care, while critics caution that diagnostic criteria may pathologise diverse expressions of sexuality and could be misused in sociopolitical contexts. Continued study and careful application of diagnostic guidelines are essential to balance clinical benefits against potential harms.