Mental Health

Aims—To review the evidence base for classifying compulsive sexual behavior (CSB) as a nonsubstance or “behavioral” addiction.

Methods—Data from multiple domains (e.g., epidemiological, phenomenological, clinical, biological) are reviewed and considered with respect to data from substance and gambling addictions.

Results—Overlapping features exist between CSB and substance-use disorders. Common neurotransmitter systems may contribute to CSB and substance-use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases. Similar pharmacological and psychotherapeutic treatments may be applicable to CSB and substance addictions, although considerable gaps in knowledge currently exist.

Conclusions—Despite the growing body of research linking compulsive sexual behavior to substance addictions, significant gaps in understanding continue to complicate classification of compulsive sexual behaviour as an addiction.